The Very Last Word At Dr. J's Housecalls: An Exchange Of Correspondence Between Steven Eblin, CEO of Randolph Hospital, And Dr. Mary Johnson, Homegrown Pediatrician From Asheboro - Who Wants To Come Home - Indeed, Who Never Wanted To Leave

On Friday morning, Buzz-Armfield-of-the-Asheboro-Armfields dropped 75 cents on a Greensboro News & Record so that I could read all about Edward Cone-of-the-Moses-Cone-Hospital-Cones putting down Word Up (his personal blog).

Ironically, you could not read the article in its entirety online.  And, as of today, the story has no comments.  It was a fitting last nail in the coffin of the notion of "citizen journalism" that brought me to the blogosphere in 2005.

I had my say on Ed's departure on Facebook.  

After so many words on Word Up - which, as far as I can tell, made no real difference in anything, Ed finally wants to do (with his writing) what he never would do for me as a journalist . . . what I begged for years for him to do . . . i.e. go deeper (and longer) than the pithy soundbite.

To mark this momentous occasion, I thought I would share a recent exchange of correspondence between myself and Steven Eblin - my former boss at Randolph Medical Associates, and now CEO of Randolph Hospital.

As much as I have railed against the overpriced/over-hyped leadership of Robert Morrison over the years, Steve Eblin was the true architect of the destruction of my life's dream.

I've been doing an exercise in Bible study for Lent, as I wrap up an extended sabbatical from work.  Today is day 40 of Lent/Palm Sunday and the "last word" on this blog will be related to Scripture from the workbook.  The exercise has helped immensely as I worked through the emotional and physical fallout from yet another PTSD-generating turn of the corporate screw - in its way, very reminiscent of what I endured fifteen years ago in Asheboro.  The brutal/cruel betrayal by an organization/people I trusted - and had only served faithfully/well - after YEARS of laboring for them to the point that I simply had next-to-nothing left to give was devastating. It wasn't fun .  . . and at times has been a very rough go.  But I survived.  And I'm starting to see Light.    

Things simply have to change for doctors soon - or medicine in this state/country is going to be in a very bad way.  Hospitals really need to clean up their act.  Healthcare includes caring about the people providing the care.  Clearly, a lot of the MBA's in the equation don't.

Speaking of (places in a very bad way), this morning's Sunday School lesson was about the "rich young ruler" (Mark 10:17-31), which I believe has many parallels to the sad/sorry state of things in Asheboro today.  We'll get to that in my correspondence with Steve.

Anyway, I am at a crossroads, and really don't know what I want to do for the rest of my life.  I've accepted a Locum Tenens assignment that will last at least through the summer - probably longer if I like the assignment/they like me.  Meanwhile, I'm doing interviews/looking around for something more "permanent" (whatever "permanent" means), and with LESS CALL (because what I've been doing for the last four years - for people/an organization who clearly did not appreciate it - was just absurd).  I'd really like to get off the road and find something within commuting distance of Asheboro - because Asheboro is home and I don't want to move.  But if I do that, I will likely have to give up hospital medicine/a hospital affiliation once and for all.  And that's a shame, because I love holding down the Pediatric fort at smaller hospitals, and I am very, very good at it - much better, I'd say than some inexperienced newbie coming out of a training system producing doctors ill-prepared to be lone ranger in the middle-of-nowhere-in-the-middle-of-the-night.   

But I've reached a point in life and my career where I've decided I've got nothing to prove to anybody any more.

And, after a while, affiliated with a hospital, you get tired of being everyone's pawn and battering ram.  For when it comes to community hospitals, Pediatricians are ALWAYS at the bottom of the food chain.  We don't book OR's and we don't make wheel-barrows full of money for the hospital.  Never mind that any decent OB service needs good Pediatric back-up.  And when they really need us, it's about a whole lot more than just drying off the baby.  Oftentimes, the executives/bean-counters/lawyers treat us little better than an RN (no offense intended to RN's - many of whom pick up a lot of slack in the really bad situations), no matter how many nights/weeks/months of call we take, or messes we clean up . . . or how many lawsuits we prevent.

Pediatricians all over North Carolina are sick and tired of being taken for granted by community hospitals, and are pulling out of call rotations en masse.  They cannot run busy offices (for shrinking reimbursements - because we all know just how "valuable" the health and well being of children really is to this society) and be at the beck-and-call of the OB's and ER, and make a living, and have any kind of life. 

Community hospitals are being forced to turn to/contract with larger hospitals to provide Pediatric hospitalist coverage . . . which is a whole nuther loaded topic outside the realm/purpose of this post.

And the purpose of this post is to put the final punctuation on why I became a citizen of Ed Cone's blogosphere at all. 

As I started the job hunt, I discovered that Randolph Hospital is recruiting a new Pediatrician (I would presume to the practice I started for them in 1995).  One of my pals suggested I send a copy my CV ("Curriculum Vitate" or doctor's resume) to Steve Eblin.

It was a joke.  But the joke took hold.

If I do say so myself, my CV is impressive/loaded.  You name it, I've done it.  39 assignments since 1994.  Private practices, hospital clinics, Federal clinics, urgent cares, Pediatric ER/trauma centers, community hospital wards.  I've actually had to take the CV offline because I was getting too many phone calls from too many recruiters (most of whom cannot figure out WHY I want to continue to live in dead/dying Asheboro).

And/so, I did sent the CV in to Eblin . . . I mean, I'm more qualified for the job than any other applicant he will ever get.  So why not?  With a cover letter.

Eblin responded on March 8 (at least he didn't ignore the letter - which is the usual modus operandi of the very important MBA's running medicine who cannot be bothered with the MD's actually practicing it).

Inspired by the Lent exercise, and a guy named Ben Carson, I decided to write back, and serve up a little truth to power. 

And, of course, I still have this blog.  The letters will be presented in sequence.  And I really do think that, short of eventually republishing selected archived posts in the sidebar, this will be the last word for Dr. J's Housecalls.

This is the cover letter to my CV, dated February 29th:


Mr. Eblin,

As you may have heard, I am looking for permanent employment.  I am much older than when we first met, I’d like to think wiser, world-weary, and tired-to-my-bones of the road.

And, I understand that Randolph Hospital is recruiting again – to the practice I started from nothing in 1995.

Attached is my updated CV – which, in the wake of what happened fifteen years ago, demonstrates extensive experience in all areas of Pediatrics.  You won’t find another Pediatrician anywhere more seasoned in handling every manner of bad thing in a rural/small town setting.

Be advised that I do not take back a single thing I’ve said over the years about what Randolph Hospital did to me . . . and what the government I served ignored.  It was wrong – in every way that something could be wrong.  And, in the end, even as the Randolph County justice system once again covered your tracks, a judge still could not say that you/Bob Morrison didn’t lie in discovery – he simply let you skate on a technicality.  But there isn’t anything else I can do on the legal front.  I have to surrender this in order to move on.

I’m not sure that what I’m doing now could be called forgiveness – because I do not believe in cheap grace.  And I won’t be forgetting anything.  But I have to give it to Someone Else.  I have to let it go.

I don’t know what you really “won” by employing the tactics that you did.  Asheboro isn’t the Asheboro I was recruited back home to serve in 1994/95.  The Mayberryesque landscape of my hometown has been decimated by “important” people who could look no further than their own pocketbooks – and who’ve long treated people they deemed lesser beings very badly.  What’s happened to Asheboro is Biblical.  Its leaders have reaped what they’ve sowed.  Unfortunately, there has been a lot of collateral damage.

But I still live here.  I have deep roots.  I know the playing field.  There is nothing you have to “sell”.  I’m still willing to serve – and to be a part of the solution.  Recruitment would not cost you a dime.

This idea started as a joke.  But I am serious now.

Accordingly, I am willing to negotiate a burial of the hatchet (with the concessions that might entail) – in order to sleep in my own bed at night, be near my Mother/family/friends, and actually attend the church to which I tithe . . . which was kind of the point of my legal battle all along.

A resolution of our on-going conflict in the form of a public reconciliation makes a lot of sense in difficult economic/medical times – and would be a good public relations move for the hospital.

I am quite willing to work within the traditional practice model.  But I am also willing to discuss a non-traditional extended hospitalist/Pediatric call coverage arrangement - along the same lines as what I’ve been doing for the last four years in Eastern North Carolina – if local physicians seeing children would be interested/amenable.  An independent-contractor relationship is preferred, but I would consider employment.  Salary is negotiable.  It was never about the money for me.  If you will recall, I’m the doctor who wanted the straight/fair salary befitting the mission of a “non-profit” – in exchange for the provision of quality Pediatric care . . . as opposed to volume bonuses and incentives to treat patients like cattle.

Obviously, any contract would need to be carefully negotiated.

It took a lot of soul-searching to send this letter and to take this chance/risk.  Given all of the talk, in church circles, about healing a broken, dying city, I am giving you and your Board-of-Directors the opportunity to walk your talk – something I did not see or experience fifteen years ago – and have not seen since.

Again, Asheboro is on life support for a reason.

Real leaders – real Christians – admit it when they’ve made mistakes – and they work to correct them.  We both made mistakes when we were younger – mistakes with their foundations in the deadliest of sins – pride.

Please do not believe that if you do not answer this letter – or ignore the CV, I will be crushed or defeated.  Quite the contrary, in the act of sending it to you, I am finally free of the past. 

The hospitals in this state really must STOP treating the doctors they employ – particularly Pediatricians - so badly.  I am seeing the fall-out everywhere.  Some “villages” are like war zones.  It will not stop unless someone puts a flower in the gun.

And/so here I am.  Call me “crazy”.  But, of course, I know you/Bob/the lawyers already have.

I would welcome your call. 

Sincerely,

Mary H. Johnson, M.D., FAAP

This is Mr. Eblin's response, dated March 8:



Dear Dr. Johnson,

Thank you for your letter of February 28, 2013, expressing an interest in a position at Randolph Medical Associates and/or the Hospital.

In your letter, you reference our "on-going conflict".  Please understand I truly have no conflict with you, nor does this hospital.  That said, I do not believe that employment of an independent contractor relationship would end in a good result for you or this organization.

I know you probably won't believe this, but I take no satisfaction in what happened 15 years ago or since.  Our accounts of what happened during and after your employment could not be more different.  Perhaps the only thing we agree on is you were/are a skilled clinician.  I genuinely hope you will be able to use those skills in a way that is fulfilling to you.

Sincerely, 

Steven E. Eblin


Now, before we proceed with my response, which will be mailed out tomorrow, I have to tell a story.  When I got the letter, late on a Saturday afternoon, I slipped it in my Bible after reading it.  A few days later, on a drive to Greensboro with a friend, I was telling her about the letter.  She asked to see it.  I told her that my Bible was sitting on the backseat.  

She opened the Bible, pulled out the letter, and began to laugh/slap her knee - before even reading it.  I asked her what was so funny.

She, chortled, "Do you realize where you put it?"

"No", I responded.

She read the Scripture (Romans 16:17-18/Holman Christian Standard Translation): "Now I implore you, brothers, watch out for those who cause dissentions and pitfalls contrary to the doctrine you have learned.  Avoid them; for such people do not serve our Lord Christ, but their own appetites, and by smooth talk and flattering words, they deceive the hearts of the unsuspecting."

Bottom line:  Asheboro is sick.  Very sick.  We're paying for the appetites and business ethics of people like Steven Eblin - people who've misused/plundered our resources and cannot admit their mistakes - even when they're caught red-handed - even when their lies are recorded in the black and white of Court documents.  And if Asheboro is to ever get well, we simply cannot afford to put a pretty face on it any more.

I'm not going to pretend that Mr. Eblin's "account" of what he did to me fifteen years ago - and after - is simply a misunderstanding - or a point upon we should simply agree to disagree.  What the MBA did to this MD was WRONG.

I debated for a while about replying to Eblin's letter.  But as I contemplated the subtle threat (that only an educated eye might see) and the back-handed "complement", I decided that it wasn't something that could be relegated to the "by-gones" of cheap grace.  This is my response, dated today:

Dear Mr. Eblin,

I am in receipt of your letter, dated 3/8/2013.  I was surprised to get the letter, but not surprised by its content.  I know that penning this response is probably a waste of my time, but like Dr. Ben Carson, I think it’s way past the time doctors in this country stood up to the bullies – wherever they may be – and spoke truth directly to power.

In your response to the submission of my CV for consideration of an employed or independently-contracted position in Asheboro, you state that you don’t believe it would result in a good outcome for me or the organization.  I am sorry, but it's a cop-out.  For rather than my good, or the organization’s good or even the community’s good, I believe that the issue has always been what you believed/believe would be a good result for you.  I think it’s far past the time that you adjusted that belief system and owned up to the inaccuracies in your account of what happened during and after my employment as your first Pediatrician at Randolph Medical Associates (RMA), Pediatrics.

Like many healthcare executives in this state, running a community charity “too big to fail”, you’ve been insulated from the consequences of your actions and strategies for the last fifteen years.  You do pretty much what you want to do, with little real oversight or resistance.  But what happened in 1998 has affected EVERY minute and aspect of my life since.  From the limited choices I had for work (the local blackball) and future training (getting fired by a hospital really puts a damper on fellowship opportunities) . . . to forever complicating the job applications and credentialing . . . to decimating my income and savings . . . simply everything was derailed.  I could not escape the fall-out of what you did to prove who was “boss”, and have had to armor myself in “explanations” explaining the unexplainable to this very day.

As more and more of medicine’s young guns enter into employment relationships with hospitals, my experience working for you stands as a prime example of WHY employed and contracted physicians in North Carolina need protections and reform that Obamacare did not deliver.

In stark contrast to yours, my “account” is well-substantiated by the blank-and-white of unpleasant but irrefutable facts:  You hired me to “clean-up” Pediatrics at Randolph Hospital, and then did NOTHING to have my back as I did.  You fired me two weeks after I defied your Director’s edicts (edicts that YOU endorsed, then angrily/arrogantly defended), answered a terrified nurse’s call, intervened in a case being mismanaged by a doctor whose skills your PR team falsely advertised, and saved a critically-ill baby’s life . . . the next morning reporting the mess to hospital Peer Review.  Like many things going on at the hospital/practice at the time, I would not/could not just pretend that what had happened was okay, and you retaliated.  It was a classic whistle-blower scenario.

There is nothing about what I just said that isn’t absolutely true.  Our “accounts” differ simply because you LIED from day one about your mission, your intent, and your actions.  In fact, you were busted on your “account” long ago.  You just were never held accountable by anyone who should have held you accountable.  It’s a very sad commentary on the moral core of many of Asheboro’s finest citizens – rich mill town rulers (young and old) - who've sat on the boards and controlled the newspapers.

When you fired me, you kept me in a contractual box for six months (the written instructions I got were very clear on what I could not do while still “employed” by RMA – no matter what “accounting” you gave to your Board-of-Directors), and lied to my patients about the circumstances of my termination – literally stealing my practice/patient base out from under me, and not allowing me the opportunity to smoothly transition to private practice – in breach of agreements we both had with the Federal government.  You wanted to keep my patient base as RMA’s own , and you did not want the competition.  To quote Mike Bridges (your former Director), you wanted me to “just go away”.

Here’s the thing about that:   Even if you believed that I was not a “good fit” for RMA . . . you had no right to do what you did the way that you did it.  It was a knife in my back (for once-upon-a-time I did believe/trust you), a disservice to the community (because you ultimately drove away not one, but two stellar Pediatricians), and a fraud upon the taxpayer (when the Federal/state money used to recruit and RETAIN those Pediatricians in Asheboro was poured down the drain due to your actions).

I am different from most doctors in that I did not tuck tail and run, I fought back. I did it because Asheboro was my home.  I was part of the fabric of Randolph County long before either you or Bob Morrison were even aware of the blip on the map.  As a child I collected small change in milk cartons for the zoo.  I grew up shadowing my Mother and her colleagues as they taught school.  I chased local trains with my Father, and told Uwharrie ghost stories at Camp Caraway.  I marched in the band of J.B. Fields.  And I rubbed shoulders with some of the legends of Seagrove as they threw their pots.  I am literally a part of the mud here.

When I did fight back in Court, you sued me for “libel”, only to have the veracity of my accounting of the events preceding and after my termination (as documented in a confidential narrative I sent to USDHHS Secretary Donna Shalala – in response to a direct request for “feedback” from the National Health Service Corps) confirmed in letters written by two of my medical colleagues (both of whom subsequently left Asheboro). In FACT, the NHSC, removed RMA from their list of approved provider sites because of that account – which they clearly deemed both credible and disturbing.

You might remember this quote from one of those colleague’s letters to JCAHO, pertaining to your “accounting” of what happened:

Unfortunately, Randolph Hospital and Mr. Eblin have not made the same effort to be factual in their communication with other physicians, other hospitals or JCAHO.

That characterization even extended to your behavior in Court.  You lied repeatedly during the discovery phase of your own despicable “libel” lawsuit (filed to humiliate and intimidate me into silence), in order to settle on the cheap . . . to avoid paying me what my stolen practice was truly worth.  The “great sum of money” (as you’ve styled it to others) wasn’t even one year’s salary and did not begin to reimburse me for what you had stolen/the damage you had done to my life and career.  

As I said in the cover letter that accompanied my CV, you got out from under those lies on a legal technicality (indeed, it's probably the only reason you responded to the letter - you're scott-free now).  But in the end, even an “outside” judge (hand-picked to favor our DA’s decision to bury a fraud upon me/the taxpayer that should have been investigated/prosecuted long ago) couldn’t say that you did not lie.  He just told me (and the rest of the more ordinary citizens of Asheboro) that it did not matter when people entrusted with the public good lie – even in a Court proceeding – to get what they want.

(I once believed in our Court system as a vehicle driven to find the truth and protect/serve those who tell it.  I do not any more.)

But your lies remain recorded on the Court record in black and white.  You cannot hide from the false accounting.  You run a “non-profit” hospital.  Your financial records and salaries were NOT confidential.  You knew it.  Your lawyers knew it.  Still, you all negotiated a settlement on the lies – the proverbial cherry of bad faith topping the whole spoiled sundae that was my state/Federal service experience in Asheboro, not that it matters to anyone running a town so often likened to Mayberry.

At the very least, Randolph Hospital should have been fined by the IRS (for withholding information that was, by law, public record) . . . and you should have been fired (for cause) by your Board when what you did was brought to their attention.  Of course, I believe you should have been fired long before that . . . when it became clear you had retaliated against a medical whistle-blower.

And yes, I believe deep-in-my-bones that both you and Robert Morrison took great satisfaction from doing what you did – and (in particular) networking with your friends-in-Asheboro’s-high-places to get away with it.  Far from being about serving the best interests of children in Randolph County, your actions were all about money and power and control – about “winning” no matter what the cost.  You were the quintessential mill-town corporate bullies – for your tactics were not just about destroying me, but were also designed to send a very clear message to every other physician in town about who was “boss” . . .  and instilling fear in anyone else who might dare stand up to you – a message that unfortunately resonates through the medical landscape to this day. 

My memory of ALL of this is exceptionally clear – I still have nightmares about some of it.  I expect the same is true of the memory of the parents of the baby I came in to help.  And the ugly story of the homegrown doctor mercilessly “done dirty” by Randolph Hospital is permanently weaved into the fabric of Asheboro’s history.  It’s your legacy – even as you/your old boss/Board members attend local prayer services and ask for God’s mercy upon the economic wasteland you helped fashion.  Using and abusing and throwing away your fellow man/woman (from illegal immigrants to homegrown doctors) you’ve all reaped what you’ve sown – and I daresay you won’t be seeing/getting any mercy from Above until you change your ways.

Your management of RMA and Randolph Hospital – and what you’ve done to doctors (not just me) and the medical landscape – has made a mockery of the “non-profit” mission you recruited me home to serve.  I am seeing a kind of karmic justice (for lack of a better term) in Asheboro now that I could never have imagined or crafted on my own.  It’s rather like Celie’s curse, except that you did it to yourselves.

I will never forget – or completely get over – watching the Pastor of my home church embrace a physician who brazenly carried on an extramarital affair with a nursing colleague, and then aborted his own child in their apartment (something that you knew about, but did nothing to address until the Medical Board forced your hand), as a reformed/repentant sinner . . . while so many of Asheboro’s “right people”, responsible for running Randolph Hospital – and attending the town’s churches, stood silently by and let Mary Johnson be professionally crucified for saving a baby’s life . . . a baby that you, your Director and your old boss would have had me let die.  For rest assured, that’s the VERY CLEAR message you delivered to me just two days before I had to make the decision that would forever change my life:  “Right and wrong do not matter.  Shut up/march-in-step, or ELSE."

While I understand and appreciate the example the Pastor was trying to set (regarding redemption and forgiveness), to this day, I cannot wrap my head around what Asheboro's supposedly-ethical leaders (particularly their medical leaders) allowed to be done to me by virtue of their silence, determined indifference and apathy.

I do predict that if you do not clean up your act, which is by your own admission “unsustainable”, another larger organization is going to swoop in, take over and clean your house for you.  Indeed, it’s probably too late to stop it.  I know that many people in Asheboro – patients and physicians alike - are praying for this to happen soon.

Fifteen years ago, you were able to walk away from your decisions/actions personally unscathed – shielded by your way overpaid boss, and your rubber-stamping Board-of-Directors, employment laws that treat doctors little better than janitors at one of Asheboro’s dead/dying mills,  and the dishonest tactics of your corporate lawyers – all of your expenses underwritten by the taxpayer.  The Courier Tribune winked and nodded and deliberately kept the general public in the dark.  State and Federal oversight organizations condoned what happened with determined silence – none of them standing to challenge what was clearly wrong, or to actually do what they tell the public they do.

Worst of all, for going on two decades, and as crippling physician shortages loom, the North Carolina Medical and Pediatric Societies have allowed hospitals to decimate community Pediatrics in so many locales – and abuse/treat Pediatricians like the enemy . . . as if we’re errant rebels surrounding some faltering Death Star instead of vital assets to the towns where we practice.  I’ve been appalled by what I’m seen in many North Carolina communities as I travel, work and interview.

Old mentors, prominent in these organizations, privately shake their heads and bemoan the sad/sorry state of things, but do/say NOTHING about or against it.  And the legislature has done nothing to protect employed and contracted physicians from corporate malfeasance.  Excellent MD’s can easily be fired, cast-off, treated as criminals and professionally brutalized, while the corporate wagons circle around incompetent management and shield/protect them at all costs.  While doctors and nurses bear the brunt of the mistakes and bad management, hospital executives remain largely untouchable.

And/so, in stark contrast to your idyllic existence as a “master of industry” in Asheboro . . . because I stood to do the right thing by a patient, I was literally cast out of my hometown, and everything I had worked so hard to build was destroyed.  I was not-so-subtly slandered . . . legally mauled to the point of near-bankruptcy . . . black-balled for miles . . . and have never completely recovered from the professional/personal trauma.  And that’s not even considering the physical scars from two surgeries horribly botched at your institution.  So “on-going” is really the ONLY way I know how to describe the consequences of our conflict.

All of this being said, Asheboro apparently needs another Pediatrician, and I want to come back home to practice.  That’s how I want to use my skills – that’s the fulfillment I crave.  Again, my Mother is here.  My friends are here.  When I came home to Asheboro in 1995, it was my intention to be here for my entire career.  You/Randolph Hospital worked a great wrong – drenched in greed, malice and spite.  I certainly understand that the truth makes you and your lawyers uncomfortable, but it IS the truth.  

Good Pediatricians are NOT “a dime a dozen”, and it is far past the time that YOU made it right.  There are ways to accomplish that would benefit both the community and your organization, but in order for it to happen, YOU have to be a real leader, acknowledge that serious mistakes were made, and reach across the wreckage caused by your decisions.

I expect you might be surprised how well it could turn out – for you, for your organization – and for me.  Unless, of course, if what you said in your letter is actually confirmation of the threat I always feared if I attempted to put out my own shingle in Asheboro and re-apply for admitting privileges at Randolph Hospital . . . acknowledgement that, if I had launched a new start-up, competing with "your" practice, I would have had a target on my back (for something far worse than "just" getting fired) from the day I opened the door.  A lot of physicians have been destroyed by bad-faith hospital peer review - i.e. one or more groups trumping up charges against a doctor they want to get rid of.

So many people did not understand why I was so reluctant to take that risk after the big swindle.

You are absolutely right.  I am an excellent clinician (if nothing else has changed, you remain the master of the back-handed complement).  But I am so much more than that, and fifteen years ago I needed/deserved a hospital management team to match my skills, to mentor and feed and mold/temper my youthful passion as a child advocate, and to have my back when I was in the right.  Indeed, that was the “you practice good medicine, and we’ll take care of all the rest” environment you promised when you recruited me home.

Yours was an epic failure in physician management.

Nevertheless, if providing excellent/principled Pediatric care to the children of Asheboro is truly what you want from a Pediatrician, then there is simply isn’t any good reason for Randolph Hospital not to talk to me about coming back home to practice – and how to make that happen.

And/so my offer to call a truce and rebuild something from the ashes stands.  As I said before, noting recent trends, I would be particularly interested in discussing contracted Pediatric hospitalist call coverage – so that the Pediatric providers in the community (Family Practitioners and Pediatricians alike) can concentrate more on their office practices.

But any reconciliation must have its foundation built upon truth.  It’s not an “agree-to-disagree” kind of thing.  Your letter was worthy of the lawyer(s) who probably wrote it – I would expect the very same lawyer(s) who got you into this mess in the first place – who told you that it was okay to break promises and maul contracts/ignore agreements because, with the right “spin” (your “account”), no one would care or do anything about it.

Getting Mary Johnson out of your way was just a game to them.

As you well know, in my youth, I was never one for playing games.  And I am too old now to mince words now.

You can continue to ignore this letter/offer.  You can do what you’ve always done, and smirk/snicker with your corporate pals on Asheboro’s increasingly barren/brown golf courses that the lady doctor who faced you down in Court (and won) is somehow “crazy” (the tried-and-true brand of a coward without a good argument), or a Bible-thumping prude (a notion that would be really amusing to anyone who really knows me) . . . as opposed to a principled and (as you say) clinically-gifted homegrown child advocate who, while working for you, ALWAYS put her patients first – not matter whose toes she stepped on or what the cost.  

I will survive (as I have survived) no matter what – or where - or how.  In the end, your decision is not so much about success or failure unless you do right by someone you did a great wrong.  It’s about a man who once-upon-a-time presented Church attendance as a financial incentive to “his” physicians, actually being the Christian he says he is every time he walks into his own Church.

One day (knowing how your mind works, please be clear that this is not to be construed as a threat), when you finally cannot hide behind lawyers – or the trappings of your job, and must answer to the Maker we both believe in, your false accounting of what you did to me WILL matter.

From Exodus to Revelation, the Bible is crystal clear on where the Lord God stands on liars.

Once again, given your track record, I likely will not ever completely trust you (I'm wondering if any medical practitioner in Asheboro does), but I am willing to take the risk and bury the hatchet.  It is a golden opportunity for you and your organization to finally put the past in the past.  But you have to own up to the sins that you tried to bury there, and make real amends.

You have my CV and my contact information.

Sincerely,

Mary H. Johnson, M.D., FAAP

As I indicated at the beginning of this post, I've been doing a Bible Study exercise for Lent entitled, "Seek God for the City".  I've read the exercises every night - posting them on Facebook - sometimes with commentary, sometimes not.

Today is Day 40 of Lent, and Palm Sunday.

One of the featured Scriptures in the final lesson is Psalm 118:22:  "The stone the builders rejected has become the capstone."

I was brought up short when I read it - for it brought back a memory:  As I walked out of RMA Pediatrics for the very last time all those years ago, Dr. Anderson's nurse (a preacher's wife) burst into heavy sobs, crying (paraphrasing), "This is WRONG, it's so wrong!  Dr. Johnson, what are we going to do?  You are the heart and soul of this practice."

I was the foundational stone upon which Steve Eblin built his Pediatric house, but for whatever reason (in his formal "accounting", he actually never gave one - that's what "without cause" means), I was extracted/rejected.  

Strictly speaking, a capstone, is actually a protective/often decorative covering on a masonry wall.  The Old Testament Scripture is referring to the trials of David as he served King Saul - being driven out of his home, becoming a champion of the oppressed, then returning as Israel's anointed king.  The passage, of course, in the context of the study, refers to Christ's triumphant arrival in Jerusalem the week before he was crucified and ultimately became the Cornerstone of mankind's redemption.

My desires are not nearly so ambitious.  But I would dearly like to be vindicated and return home . . . to get a simple, "I'm sorry.  You did not, in ANY way, deserve this.  We went too far.  And now, we're going to work to make it right." 

When I started writing this, I thought about dedicating the last word at Housecalls to Edward Cone.  But that would be giving him too much credit - which, I think, was my mistake all along.  "Blogsboro" was all and only about how the rest of us fit into Ed's orbit.  It's the reason so few hang out there anymore . . .

. . . when you really think about it, there are a lot of analogies to be made to Asheboro and its mill-town kings.

This post is instead dedicated to my parents, who gave me my faith, who taught me right and wrong and to speak-out/fight back . . . as well as to THE Cornerstone upon which I rest my hopes for the future.  

And what is the last word at Housecalls, you ask?  

FEAR NOT!  Don't be sheep, people.  Stand up for what is right and just and true.

You Could Say That It Just Took Time

I had not planned to put up any new posts.  But this Time Magazine article is, hands-down, the BEST-researched and written article I have EVER read on what is wrong with our healthcare system . . . particularly our "non-profit" healthcare system.  And it totally underscores why, in the battle with Randolph Hospital, the lone Pediatrician's fight for justice was doomed from the start.

WHY MEDICAL BILLS ARE KILLING US

Please note the article's length.  Some stories cannot be told in a soundbite.  Perhaps I was in the wrong venue all along.

CASE DISMISSED: A Randolph County Judge's Decision Resoundingly Demonstrates Why Employed And Contracted Physicians In North Carolina Desperately Need Legislative Help, Legal Reform And Protection From The Hospitals They Work For

I've done all that I, as one physician, can do.  I cannot do any more.

I can now say, with considerable authority, that there is NO JUSTICE in this state for employed and/or contracted doctors who are punished or retaliated against for doing the right thing by our patients.  Our contracts and agreements – be they with the state and Federal government – or the hospitals that we work for – are not worth the paper they’re printed on.  People charged with the public good can lie to us at will and with impunity.  And in this “right-to-work” state, physicians are treated little better than janitors at the mills that have closed down in the small towns that greed killed.

It is going to get exponentially worse with Obamacare – as small hospitals consolidate into bigger systems, more doctors choose employment over ownership, and power shifts even more to the suits and the lawyers.  The newbies are going to need a business - or a law - degree, in addition to their MD, in order to practice medicine. 

 

The New York Times will talk a lot about the trend – and its consequences – but no one will do anything about it until a lot of people – doctors and patients alike – get hurt.

If you, dear reader, expect the lone doctor to stand up in this environment and do the right thing by your child – or your spouse – or your parent/grandparent – when something goes horribly wrong, I daresay in most cases you will be expecting too much.  Doctors are learning to keep their heads down and their mouths shut.  The Mary Johnsons of this world stand as shining examples to them of what happens when you don’t.

Most doctors are NOT going to do what I did fifteen years ago this January.  The Honorable Judge Stuart Albright had a chance this week to make a difference in that regard.  He did not. 

In December, fueled by white-hot-pain and rage over yet another turn of the corporate screw . . . and disgusted by the Randolph County Sheriff shielding the District Attorney’s brother from the consequences of a crime captured on camera . . . I authored an affidavit and submitted it to the Court citing North Carolina General Statute 7A-66, “Habitual Intemperance”, and asking that a judge hear evidence that DA Garland Yates be removed from office.

My allegations of corporate malfeasance and criminal conduct on the part of "non-profit" Randolph Hospital's senior executives . . . originally submitted to the DA in 2003 . . . were the primary focus of the affidavit.  Because of its complexity and local conflicts . . . as well as its relevance to public welfare and policy . . . I had asked that the case be referred to the North Carolina Attorney General for investigation and prosecution.

But Garland Yates, like other politicians before him, had to live in this town.  This case had to stay in Asheboro - where he had control . . . and it had to stay buried.  

And his "discretion" could see to that.

I've wanted to file this affidavit for years - pretty much since the Duke-Nifong debacle.  But I was afraid of what I was all-but-certain would happen if I did.  In the end, it all came down to taking the risk, as opposed to going through the rest of my life wondering, “What if?”.  One way or the other, I had to have some closure.

Click herefor a link to the affidavit that was filed with the Court:  12 CvS 2899.  I believe it speaks for itself. 

On Monday, Judge Stuart Albright issued a ruling in the case . . . and dismissed it . . . with prejudice (meaning I am "estopped" from any further legal recourse) . . . refusing to even grant a hearing.  He also declined to refer my long-standing allegations against Randolph Hospital and its executives (including but not limited to perjury, contempt, fraud, false advertising, peer review violations and misuse of Federal funds) OUT OF RANDOLPH COUNTY to the North Carolina Attorney General for the proper COMPREHENSIVE investigation that they've never gotten by ANY local, state or Federal law enforcement agency.

As of the 14^th of January, it’s clear that I’ll never get anyone to look at "the totality of the circumstances" surrounding my case.

Those circumstances, which could not be MORE RELEVANT to the public welfare now, never mattered to Garland Yates.  Judge Albright barely references them in his decision to dismiss the case - they're something vague and nebulous lost in my Herculean battle with Randolph Medical Associates and Randolph Hospital.  In the judge's eyes, I’m just a disgruntled ex-litigant who isn’t happy with her settlement.

To some degree, that’s the truth.  But it’s not even close to the whole truth.  Never has been.  And therein lies the rub.

You see, my original case against Randolph Hospital was never a "simple contract case" – inasmuch as all of the lawyers (including my own) wanted to frame it that way.  Of course, because the law is light-years behind what is actually going on in medicine, it was pretty much the only way they could frame it.

To be clear, I did not care one bit about getting a hearing on the issue of booting Garland out of his chair.  It wasn't about him losing his job as much as it was about him DOING his job.  But I did have some small hope that my criminal case against Randolph would finally get where it needed to go – and get the thorough dissection/assessment - by outside eyes - that it deserved.  Alas, with his ruling, Judge Albright effectively slammed the coffin lid shut on holding Bob Morrison and Steve Eblin responsible for that they did to a physician who defied them to do the right thing by a patient . . . not-to-mention any remaining hope I ever had of ever practicing in Asheboro again.  I could not/cannot practice here safely without someone holding these executives accountable.

 

As I read the judge's ruling, I had to shake my head in sadness at what the law allows.  It basically says that “non-profit” hospital executives . . . supposedly charged with the public good (and held to a higher standard) . . . can lie . . . repeatedly . . . in the discovery phase of a lawsuit . . . about the confidentiality of information that is NOT confidential . . . information that is "material and relevant" to a damages claim . . . and it’s not perjury.  They can defy a judge’s order to produce the documents containing that information, and it’s not contempt . . . or obstruction of civil justice.  They can negotiate a settlement on a pile of lies and it’s not fraud.  They can spit on the mission and intent of Federal programs, pour taxpayer dollars down the drain – all the while stuffing their own pockets – and it’s ALL “legal” (mostly because no one in a position of oversight ever cared enough to say that it is not).

The judge turned his decision with regards to the issue of perjury on a technicality.  In fact, Judge Albright does not dispute that Bob Morrison and Steven Eblin lied during discovery.  His argument is that RMA/Randolph Hospital executives only swore that their interrogatory (written discovery) responses were true . . . not the written responses accompanying the production of documents (which withheld the documents and asserted confidentiality – something that both the executives and their lawyers KNEW was a lie) that were all filed at the same time.  The judge said the lies technically did not come into evidence under Oath, so the lies do not constitute perjury.

I could buy that if and only if Randolph's executives and their lawyers had just produced documents without filing written objections with them (which I would consider interrogatory responses) - objections citing confidentiality - objections that they KNEW to be FALSE. Moreover, the officers of the Court (hospital lawyers) submitting those answers (supposed "experts" on "non-profits" and knowing better), LIED TO THE COURT!  There is NO QUESTION they all acted - and negotiated a settlement - in bad faith.

Judge Albright's decision, in effect, winks and nods at that.  The spirit and intent of the law is lost in its lettering.

Dishearteningly, the judge's decision clearly states that, as a litigant, coming to Court in good faith, I had no right to expect Bob Morrison and Steven Eblin, as executives of a “non-profit” hospital, to tell the truth during discovery  . . . and I had no criminal recourse later, when I discovered (after the fact of a settlement) that they did not. 

The thing that really KILLS me here is that the documents we’re talking about here are IRS tax returns.  

And the IRS tax returns of a “non-profit” are PUBLIC RECORD.  

So CONTRARY to Judge Albright’s opinion that RMA/Randolph Hospital had “no obligation” to provide those documents when the information in them (profits/losses/physician and executive salaries) was requested – and to do so BEFORE negotiating a settlement that relied upon the information they contained, IRS CODE IS CRYSTAL CLEAR THAT THEY DID HAVE EXACTLY THAT OBLIGATION.

Even if you accept that Bob/Steve did not commit perjury in discovery (and I do not), withholding the returns containing the financial information I had requested was STILL a fineable offense (as of the law now, $20 a day after 30 days up to $10,000 for each document) when it happened (before the settlement) . . . and that act alone more-than-meets the not-very-high hurdle of "probable cause" to launch a criminal investigation into the hows and whys behind the destruction/absorption/theft of my publicly-seeded hometown practice for Randolph Hospital’s financial gain.

“Non-profit” executives withholding those IRS returns/public records in discovery . . . claiming they were “confidential” . . . in order to get out of their mess on the cheap . . . did not just SPIT in my face - but also SPEWED in the faces of the state-and-Federal taxpayers that paid for my medical education (and that of my former partner, Dr. Laurie Anderson - who eventually left town) in return for service to my hometown . . . the same taxpayers that subsidized the hospital's legal bills, all the big salaries, and even my (comparatively paltry - despite what the judge thinks) settlement.

The bills that KILL.

Moreover, when they failed to produce the IRS returns containing the fiscal information I requested .. . . AFTER A JUDGE ISSUED A MOTION TO COMPEL . . . Bob Morrison and Steven Eblin didn't just treat me with contempt - or the Court with contempt - they treated every citizen who has ever paid a dime (much less nearly half their paycheck) in to the IRS with contempt.

NO additional hearings before ANY judges should have been required.  

Moreover, Judge Albright is viewing this all in hindsight - assuming that I, as an ordinary citizen (as opposed to a lawyer or a "non-profit" officer), already knew (then) what I was looking for - and where to find it.  It is my fault that I did not have psychic abilities as I negotiated a settlement agreement with so-called public servants who had done NOTHING BUT LIE about what they had done for three years.

So.  Despite all of the noble talk from our political leaders these days about "sunshine" and public accountability for public entities and non-profits, with this decision, the lights are OFF in Randolph County.

Contrary to Judge Albright's disappointing and harsh conclusions, I've not been trying to “re-litigate” a civil case.  I’ve been trying to prosecute a criminal one. 

But, in order to get prosecuted, it must be investigated first . . . in its "totality" . . . preferably by people in higher offices in Raleigh - and perhaps even Washington - who have some direct authority over the state and Federal agencies that were charged with oversight in this mess.  

It IS a matter of the public welfare.  Doctors MUST be protected from corporate malfeasance - so they can protect patients.

Speaking of the public welfare, Obamacare threw millions-more in federal funding into the National Health Service Corps (the very program that repaid the bulk of my medical school loans in exchange for my service in Asheboro) on the premise of recruiting and RETAINING (key to the "mission") physicians to under-served areas.  The under-served areas were designated in close cooperation with the state of North Carolina - specifically the NC Office of Rural Health (the agency to whom I served a concurrent public service obligation).  What happened to me in Asheboro - what Randolph Hospital executives were allowed to do to me - speaks VOLUMES about the poor oversight of these Federal and state programs. 

[Of all the NHSC providers in Asheboro during my tenure at RMA - I was the ONLY doctor who was not allowed to transition into private practice (have you ever noticed how most whistle-blowers in recent years are women?).  Everyone else, if they wanted to stay, was allowed to transition.  And that's mostly because I WAS FIRST AND I FOUGHT BACK.] 

Moreover, the IRS (who never cared enough to fine the hospital for lying to me) has been made the primary overseer and policeman of healthcare under Obamacare.  The agency's dismal oversight in my case does not bode well for the rest of the nation.

Although he disputes perjury, the judge actually does not deny that several of my criminal allegations - pertaining to these issues - could be true.  But Judge Albright simply says, over and over again, that the Randolph County DA has the absolute right to shut me down – without discussion or explanation.  

And so he has.  For in the nine years since I brought these allegations of “non-profit” corruption and white collar crime to the attention of Garland Yates, NOT ONE law enforcement agency has conducted an official investigation . . . not the Randolph County Sheriff’s Department . . . not the Asheboro Police Department . . . and certainly not the SBI. 

And that's because Garland Yates, Randolph County’s godfather of justice for three decades, buried this from the start.  He NEVER saw fit to pick up a phone to speak to me.  He NEVER scheduled an appointment to talk about it (despite multiple entreaties).  He’s NEVER asked to see anything from my legal files . . . indeed, the Judge's office could not find the complaint/supporting documentation I gave him nine years ago (I was called by a clerk and asked to produce copies).  It was/is within Yates' “discretion” to simply ignore the case altogether.

It's just WRONG.  Arrogant.  Disrespectful of Yates' law-abiding constituency.  I pay a WHOLE LOT of taxes to Randolph County to be treated this shabbily by one of its elected officials.  If Garland Yates is upset about this affidavit, the ONLY place he needs to look for the reason that it was filed is in the mirror.

The cold, hard truth that I am pulling from Judge Albright’s ruling is, that from the morning after I defied the threats of hospital executives to save a child’s life fifteen years ago, I was SCREWED.  It has never been about telling/discovering the truth . . . but keeping it buried.  

As a physician doing the right thing by a patient, I could not rely upon the law of this state to protect me.

And now, “Prosecutorial discretion” excuses Garland Yates from doing the right thing by a physician done wrong in state and Federal service.  With the victim of the crimes jumping up and down and screaming for help, Mr. Yates had/has no duty to avoid even the appearance of conflicts-of-interest, and get these allegations/ this case OUT from under the mill town cabals of Randolph County and Asheboro for a fair and proper investigation that looks at ALL of the FACTS surrounding it . . . from a “non-profit” hospital’s brutal retaliation against an employed medical whistle-blower . . . to the corruption of medical peer review . . . to a pair of greedy/power-hungry hospital executives' taxpayer-subsidized use of the legal system as a battering ram . . . to brazenly lying about the confidentiality of their books and salaries in their own bogus "libel" action . . . to Randolph Hospital spitting on the mission of a Federal program and defrauding the state/ Federal taxpayer out of what they PAID for . . .

. . . NAMELY MY PEDIATRIC PRACTICE IN ASHEBORO.

It’s a practice that would have been EIGHTEEN YEARS OLD this year . . . because I can guarantee you that were it not for Bob Morrison and Steven Eblin, I NEVER would have gone on the road to make my living.

The judge seems to completely miss the point that I wasn't the ONLY person ripped off here - that the state/Federal taxpayer got fleeced too.  "The People's" interests are represented by the State (as embodied by Garland Yates)  But their interests are not worthy of an investigation. 

Bob Morrison and Steven Eblin lied and bullied and sued and stole and cheated a homegrown physician out of what she had built and what she had earned.  When she fought back, they employed every legal dirty trick in the book and called her every ugly name under the sun.  They attacked her sanity and her character.  They're the local equivalent of Lance Armstrong.  It bears pointing out that Armstrong's legal victims settled a long time ago too (I'm sure, given that they didn't lie about Armstrong's deception, they were unhappy with their settlement).  Now that it's out that Armstrong lied, they'll likely be getting their money back.

Well, Bob Morrison and Steven Eblin lied too . . , and got out on the cheap.  I may not have them confessing their sins on camera, but I have the proof in writing and I presented it to Garland Yates YEARS ago.  But their victim has to EAT IT.  

AND/SO, NO MATTER WHAT JUDGE ALBRIGHT'S CONCLUSIONS ARE, I WILL NEVER AGREE WITH ANY OF THE LEGAL LOGIC THAT ALLOWED TWO NON-PROFIT HOSPITAL EXECUTIVES TO BEHAVE LIKE COMMON BULLIES AND THIEVES . . . THAT ALLOWED THEM TO ACT SO AMORALLY AND UNETHICALLY WITH TOTAL IMPUNITY . . . THAT ALLOWED THEM TO GET RICH DOING SO . . . THAT EXCUSES THEIR LYING, CHEATING AND STEALING ON A LEGAL TECHNICALITY.

 

Additionally, in his ruling, Judge Albright absolves Garland Yates of responsibility for the behavior and performance of his ADA’s . . . from bullying the testimony of witnesses in a child sex abuse case that was ultimately overturned on appeal (because the accused was not afforded his basic constitutional rights) . . . to failing to produce material evidence in criminal trials (that evidence being public admissions of guilt on the part of the defendant - statements that we should not reasonably believe would have swayed one of Judge Albright’s colleagues to render a guilty verdict). 

We-the-People assisting or seeking justice have no right to be treated with care and respect in Garland Yates' courtrooms as his office conducts its business, and we have no reason to conclude that the buck stops at the DA’s desk (?!?) . . . that the DA actually discusses the management of cases on his docket with his underlings, and that (like bosses in every other sector of the world) Garland Yates is ultimately responsible for what his ADA’s do.  

Garland Yates apparently does his job in a vacuum.

As I indicated earlier, the "Habitual Intemperance" affidavit was "born" when Garland Yates’ brother, Tony, stole and destroyed political signs posted on my friend, Tim Greene's, property.  Sheriff Maynard Reid's decision not to prosecute the former parole officer clearly turned on a legal dodge that has nothing to do with what the law actually says.  

And I'm sorry folks, for Maynard to get there, he had to be getting coached by somebody.  

But Judge Albright's decision says that unless We-The-People are actually flies-on-the-walls as the big guns converse behind the locked-doors-surrounded-by-metal-detectors, conflicts of interest amongst “the honorables” do not exist.  And/so the DA’s brother being caught-on-tape stealing political signs the day after an election does not merit referral to an outside law enforcement agency – for assessment by someone other than the accused's former law enforcement compatriot and his brother.  

Once again, the District Attorney and local Sheriff have no responsibility to recuse themselves in a case involving the DA’s brother  . . . never mind that the Sheriff gets his legal advice from the DA’s office . . . and if the Sheriff did pursue charges, the District Attorney would be prosecuting the case.

The notion that just because We-the-People cannot produce the proof that can only be found behind locked doors (and would never be documented or witnessed by an outsider), that there are no inherent conflicts here is just absurd.  Shameful.  Doesn't remotely pass the smell test.  One equally-disgusted friend calls what the Sheriff did "crookery".

Even as I rail against this decision, it is important for the reader to understand that what Judge Albright did is EXACTLY what I expected to happen when I filed this affidavit.  

What was most important to me was to get my entire experience with the Randolph Hospital – and the Randolph County Court System ON THE COURT RECORD – for the first time since the settlement in 2001.  And that’s because the narrative speaks to THE IMPOSSIBLE POSITION our state’s legislature has placed contracted and employed physicians who stand up for patients – or blow the whistle on bad care – or simply talk back to bad management. 

As individual physicians (not-to-mention nurses), we simply don’t have the resources – the mechanisms or the precedents - or even the proper venues – to fight back against hospitals or hospital systems that do us wrong.  

For decades, the North Carolina legislature has kowtowed to the big hospitals in this state and done NOTHING to level the playing field for employed/contracted physicians.  We're pawns on the chessboards - with patients increasingly seeing us as the enemy as we cope with things far beyond our control. 

Most community/"non-profit" hospitals are run by local Boards that are populated with local big-shots, who eschew their legal duties and “oversee” in name only.  They walk in exalted circles – networking and schmoozing amongst themselves – as big fish in the small pond, quietly brokering power – controlling what goes in the newspaper – and funding the elections of the people they want in office – including District Attorneys and Sheriffs.  Most of the real wheeling and dealing is done at golf courses and country clubs and restaurants and behind closed doors.

We-the-People don't have a way into that.

Additionally, the privacy and confidentiality of medical records – and of medical peer review -  have evolved into monsters that make it very hard – and prohibitively expensive – for doctors to litigate when they’re done wrong.  It’s much harder even than pursuing a malpractice case.  

The truth is buried and very hard to get to.  Hospitals routinely hide behind the very laws that are supposed to protect patients - as those laws are literally DECADES behind what we need in place.

My story in Asheboro – from start to finish – is a textbook case for the reform of medical oversight and employment laws as they pertain to physicians – real reform, as opposed to what doctors got with Obamacare.

The short version goes something like this:  A hometown girl makes good, becomes a doctor, and comes home to build a Pediatric practice.  She takes a job with the local “non-profit” hospital.  She secures state and Federal loan repayment of her medical school loans in exchange for service – with the hospital agreeing not to interfere with her continued practice in the area during or after her service obligation is completed.

This concept is KEY in the whole saga:  The doctor's agreement with the Federal government essentially says that her practice is HERS - whether she stays under the hospital’s “umbrella” or transitions into private practice - unless she walks away from it.

At least that was the theory. It NEVER translated into reality.

But as is the case with many small town hospitals, the newly-minted Pediatrician cannot clean up all the messes – and even as she tries, the mess-makers don’t like their apple-carts upturned.  Hospital executives, new to practice/physician management (and who SUCK at it) are so concerned with market share and making money that they’re willing to falsely advertise and overlook medical mis-steps, and the young/idealistic Pediatrician bucking that mindset is ultimately told to shut up – or else.

But the trouble is, the Pediatrician took an Oath to put patients first.  And so one night-in-the-middle-of-the-night . . . just-a-few-nights after she was told to shut-up-or-else . . . and only days away from completing her state/Federal service obligations . . . the Pediatrician answers a charge nurse’s terrified phone call . . . and, doing her duty, makes the spit-second decision to defy executives’ threats against her livelihood - in order to help a critically-ill newborn baby whose care is being botched by someone else. 

By all accounts, she saves the child’s life – a patient not even her own.  In terms of hometown healthcare heroes, she’s the real deal. 

Then, she does what ALL of our medical oversight agencies now say she is supposed to do, and reports the incident to hospital peer review (adequate/fair peer review mechanisms being another requirement of her agreement with the Federal government).

Within two weeks, the thugs-in-suits running Randolph Hospital make good on their threats and fire the doctor.  They keep her sidelined in a contractual box for six months . . . chained to exclusivity . . . threatening to fire-her-for-cause (a career-destroying event) if she opens her mouth.  They bold-faced LIE to her patients about what happened – and quietly steal/absorb her practice.  No one on the hospital's Board-of-Directors (legally responsible for their actions) lifts a finger to stop them (mostly because hospital executives have lied to them too).

The people (including hospital board members) who thought that the doctor could just go across the street and hang out her own shingle just didn't get it.  That's because hospital executives and their lawyers were LYING to everyone about what they had done.

And/so the practice that the young Pediatrician worked like a dog to build is simply handed over to other doctors – one of whom supposedly “represented” her to hospital management.  In the wake of her departure, the incomes of these doctors skyrocket – some doubling and tripling – as the hospital switches from straight salaries to bonuses and incentive plans based on “volume” . . .

. . . as opposed to quality (another recent subject of discussion at the New York Times). 

Meanwhile, the Federal and state governments that paid for her recruitment and the retention of her services in Asheboro take total dives in terms of honoring and enforcing their own agreements with the doctor (again, I lived Obamacare fifteen years ago).  

One phone call from the Department of Health and Human Services - admonishing Randolph Hospital to honor its agreement with the physician - would have stopped this mess in its tracks from the beginning.  Likewise, one admonishment from JCAHO - condemning the retaliation against a physician for reporting a sentinel event - would have put the brakes on Randolph's legal bullying before things got so ugly. 

But none of these medical "oversight" agencies that were supposed to have my back did their jobs.  Indeed, JCAHO admitted that while they could call doctors "disruptive" all day long, they had no mechanisms in place to deal with bad managers/executives.  Meanwhile, the North Carolina Medical Board only disciplines doctors - not the hospitals that put them in the position of making horrible choices.  

I was alone in a sea of swill.

[Surely, Judge Albright has to realize that I have not just been "complaining" about a settlement.  Surely, he understands that filing this affidavit was just as much about what's wrong with my profession as what's wrong with his.  Certainly, he understands that this is about using the only weapon I have left - my voice - to speak truth to power.  I am "complaining" about an entire system of medical oversight that does not do what it tells the public it will do - and that is HELP DOCTORS PROTECT PATIENTS!!!]

A whistle-blower LONG before whistle-blowing was cool, the doctor gets a local lawyer and fights back – with the limited resources her income as a Locum Tenens physician can fund . . . against not just a corporation, but an entire town – again, because the hospital is run by the mill-town kings.  She files complaints with every medical oversight agency under the sun (again, what all the oversight agencies and boards now say you’re supposed to do) . . . getting mostly lip service and regrets . . . only to get SLAPP-sued for her trouble.  She’s able to fight that off because former medical colleagues have written letters of support – confirming the veracity of her version of events.

Three hellish years later, the doctor finally gets to Court.  She is emotionally exhausted and all-but-bankrupt, but also exhilarated – because she’ll finally get to tell her story.  But the trouble is, NOBODY but the doctor wants this mess in a Courtroom.  The trial judge admonishes the lawyers on both sides to work out a settlement.  So instead of picking a jury in an open Courtroom, the doctor is locked in a room with lawyers yelling at her all day.  

Hospital executives plead near bankruptcy – and tell the doctor that they cannot afford a large settlement – but they’ll help her get another practice off the ground if she works with them on something they can afford, and walks away from the Court battle.  Her own lawyer tells her that punitive damages are not taxable (they are).  So she accepts a $125,000 settlement – less than one year’s salary.  

But that sum certainly does not begin to reflect the damages the Pediatrician suffered after losing a practice she spent three years building – not-to-mention another three years mired in litigation/counter-litigation.  It doesn't begin to reflect what she might have been making at RMA or in private practice or after a fellowship-she'd-never-get-now had this never happened (a simple review of the IRS returns hospital executives withheld during discovery proves that).  The Pediatrician is not even reimbursed for the attorney’s fees she spent fighting off the SLAPP-suit.  But the lawsuit was ALWAYS more about vindication and being able to return home/start over than it was money.  So the doctor accepts the deal - based on the hospital's promises of cooperation and support.

But once the case is settled, hospital executives, now completely off the hook, completely renege on their promises to assist the Pediatrician in re-building her practice from scratch.  They continue recruiting to their own Pediatric practice (which now includes the doctor's stolen patient base) with no regard whatsoever for what that means for the Pediatrician who already lives in Asheboro (in other words, they don't have to spend many thousands of dollars recruiting someone new) and is trying to rebuild from ashes.  As for the “large sum of money” she got at settlement, after taxes and paying three years of bills, there is nothing left for the Pediatrician re- build with.  Starting over means going into massive debt – in an openly hostile environment and amidst early signs that the local economy will shortly be taking a giant nose-dive.  And/so, the Pediatrician’s dream of rebuilding her practice in her hometown – the whole point of the legal battle – died with the settlement.

Meanwhile, hospital executives laugh all the way to the bank.  Before he retires, the CEO is pulling down over $700,000/year.  It’s a very nice salary indeed to collect from a “nearly bankrupt” organization.

[You have to wonder if Judge Albright thinks that’s a large sum of money - or even wonders how a small-town hospital could justify paying it to one executive.]

One day, a little over a year after the settlement, as she’s going through her legal files, the doctor discovers evidence that hospital executives repeatedly and knowingly lied during discovery about the confidentiality of financial information contained in public records - information that was "material and relevant" to the true value of her practice and her damages claim.  

As we've previously established, when they filed these answers, hospital executives - and their lawyers - KNEW this information was not confidential – as it was contained in IRS tax returns and even posted (albeit in a delayed fashion) online.  They also knew the numbers were very relevant to the doctor’s damages claim.  But they lied in the answers they filed with the Court.  The whole point of the ruse was to hide what they were paying themselves and their doctors - as well as the true value of the patient base they had stolen . . . and to paint the Pediatrician fighting for the restoration of her practice - wrongfully taken as their own - as a "crazy", greedy banshee . . . instead of a dedicated physician deeply wounded - her dreams destroyed - by the amoral, unethical things they had done.

And/so, the settlement in 2001 was negotiated on a pile of lies – and in bad faith – a point that was lost on the Randolph County DA when the doctor first brought him the evidence in 2003 . . . and a point that, as of Monday, remains lost on the Court - a court whose officers and processes I was foolish enough to trust.

The ruse is brought to the attention of hospital's lawyer (the one who originally crafted the contested terms of the doctor's departure) . . . who squirms and dodges, but offers no solution, and invites the doctor to return to civil court to sue - knowing the legal deck is stacked against the doctor.

But the doctor has had enough of the corrupted civil process, and turns to Garland Yates for help.  The rest is history.  Nine years of being ignored.

Yates may not have had anything to do with the settlement.  But he's the ONLY person who can level the playing field and reign the liars in.  In fact, it's part of his job,.

Again, Judge Albright's very personally dismissive ruling essentially says that it was my fault I was not clairvoyant - that I believed the lies and the liars when I settled.  

Legal trickery rules the day and is more important than the truth.  

Likewise, “non-profit” hospital executives have no obligation or duty to comply with the law.  NO ONE in a Randolph County jurisdiction is going to hold them accountable.  

Over the years (particularly since penning/filing/posting the affidavit), people have told me that, with a legal degree instead of a medical one, I would have been an outstanding lawyer.  But I don't think so.  Our justice system is adversarial and very ugly, and my heart/soul just isn't wired that way.  At my core, I am wired to help and to heal.  I would have become disillusioned with law far faster than I have with medicine (of course, most of my unhappiness with medicine has to do with how the law is applied to its practice).  I've come to understand that in North Carolina, the men and women of medicine live on a very different planet than the men and women of law.  As bad as things are, I very much prefer the planet where ethics and morals matter more than who can turn the better legal trick . . . or the faster corporate screw.

In the end, I have to wonder if all of these lawyers and judges with children would have liked it very much if, fifteen years ago, the infant gasping-for-air-and-blue-from-the-chest-down had been theirs, and looking into my crystal ball and seeing what would befall me, I had ignored the nurse, rolled over and gone back to sleep.

For make no mistake, that's EXACTLY what Bob Morrison and Steven Eblin would have had me do.

And/so, I’m done.  I cannot do anymore.  With Judge Albright’s decision, which eschewed the wisdom of Solomon and could not split the difference, I’ve lost what little faith I had remaining in the administration of justice in Randolph County and there's nowhere that I, as an individual, can go with this case.  But the Judge is an honorable man, applying the law as he sees it, and I have to accept this decision - no matter how much fault I find in how he got there.  

It is a small comfort that the affidavit stands – on the record – and online – documenting one North Carolina Pediatrician’s horrific experience with her hometown hospital – and the systems of medical and legal oversight that utterly failed her.  

I'm told that the lawyers at the Randolph County Courthouse are already snickering and “buzzing” about the judge's decision.  Some are reportedly deeply offended that a lay person dared file a motion that put Garland Yates' job on the line.  But the joke’s on them and it’s a sad one.  For far from making the doctor-who-actually-lost-her-job-BECAUSE-she-did-it-the-right-way (without the due process that allowed Garland to keep his) look “crazy”, it makes them/their system look very bad. 

For in the end, one truth stands above all the others.  This legal mess all started fifteen years ago, when I put the well-being of an innocent/very sick newborn baby girl and her parents above my own security and happiness.

Or maybe I didn't.  Maybe, at that moment in time in which the decision was made, I knew I could never be happy - or sleep at night - if I hung up the phone and rolled over, and left the care of that infant-barely-clinging-to-life to the care of an arrogant pretender (did I mention that his training and abilities were falsely advertised by the hospital?) who had no clue as to what he was doing.

Maybe I knew, even then, that the photo album that started the following Christmas - containing only the pictures of that child as she grew into young womanhood - would be worth MUCH MORE to me than staying with a practice/hospital whose bosses would have had me LET HER DIE.

My heart was warmed just a little bit this week - and I saw a spark of hope for real change - when another judge in another county - dealing with another set of hospital executives - actually challenged the prosecutors.  Federal Judge Terrence Boyle "shredded" a deferred prosecution settlement agreement between Wake Med and Federal prosecutors in a Medicare fraud case.  Demonstrating the supreme arrogance that many North Carolina hospital executives embody, none of Wake Med's board members or administrators who were-getting-off-the-criminal-hook-with-the-deal-that-was-proposed were in the Courtroom to answer questions.  And Judge Boyle refused to accept the agreement.

"There are a lot of corporations that steal from the government," said Judge Boyle.  "Most of them are convicted, fined and banished." 

Judge Boyle obviously does not live in Randolph County.

Judge Albright was spot-on about one thing.  I DO vigorously disagree with the wisdom and manner in which Garland Yates operates his office.  I think he's been in the job WAY too long and he needs to go.  I DESPISE the good-ole-boy machine politics that have kept him in power.  And I believe he is a prime example of absolute power corrupting absolutely. 

And I would submit that Judge Albright holds the citizen who would dare challenge that power to impossible standards.  Because, in the hallowed halls of law enforcement, we CANNOT be flies on the wall.  We’re literally stripped when we enter the Courthouse, deprived of our cell phones and cameras, not allowed behind the locked doors, and certainly not privy to the secret deals that the DA’s office makes behind locked/closed doors – with the Sheriff’s Department or anyone else.  

We don't have the access to provide the cold hard proof of conflicted interests - that's WHY it's so important for the DA and law enforcement to AVOID even the appearance of those conflicts.

That's WHY both my case - and Tim Greene's - should have been referred out and up.

Finally, contrary to Judge Albright's assertions in his ruling, barring a free press that reports critically of those in power (which we ordinary types who live in Asheboro do not have), the truth is that NC General Statute 7-66 is, in fact, the ONLY vehicle short of an election (which is a mute point, because Garland Yates generally runs unopposed) by which citizens can challenge the wisdom, legality and constitutionality of the manner in which a District Attorney conducts his business.

THERE IS NOTHING ELSE.  

I tried to do that.  I am not the least bit sorry.  I actually feel as if a huge burden has been lifted off my shoulders.

This town - my hometown - is DYING - in large part because of the way our mill-town kings have conducted business and treated people - FOR YEARS.  But incredibly, as the young professionals leave for higher/safer ground and the jobs dry up, Asheboro's leaders cannot figure out why.

I would submit that, like Garland Yates, they need look no further than the case of Dr. Mary Johnson and their own mirrors. 

I will close with a prediction:  If the North Carolina Medical Board, and Medical Society, and Hospital Association and state legislature do not shortly get their heads out of their tuckuses . . . and don’t do something SOON to legislate fair play for employed/contracted physicians in their dealings with hospitals (I’d LOVE to be appointed to that task force) . . . we are only a few years away from doctors and nurses in North Carolina turning to unions for representation - and the power that comes with numbers.

Because individuals doctors are just LOST.

With 5 medical schools (4 MD and 1 DO) in North Carolina and multiple residency programs, and lots of newly-minted physicians not-so-inclined to be stomped on (after spending decades getting an education - and spending sometimes hundreds-of-thousands-of-dollars on it), the landscape is ripe for it.  And the result will be everything some of our hospitals – given the nasty tactics they’ve employed against physicians – richly deserve.

As much as I am opposed (in theory) to the mix of unions and medicine, I wonder what might have happened if, on the morning I was fired in 1998, I could have pick up a phone and called a union representative – instead of a lawyer.

And/so a small part of me actually is rooting for Norma Rae.

I am taking a break from blogging for a while.  With the affidavit now on-the-record, and this (respectful as I can craft it) reaction to Judge Albright's decision now posted, I don't think there's anything left to say.

Monday Morning Update:  I have linked this post on Facebook - where friends can comment.  And they have (apparently there was more to say) - thanks Mr. Armfield;)