On The Exhibits: Conspicuous Absences And Breaches Of Hospital Peer Review & NC Medical Board Confidentiality

Well, I've pretty much exhausted the letters of recommendation I obtained once the ordeal of RMA's "notice" was over (and it became clear resuming practice in Asheboro would be impossible). It was imperative to get as many letters as I could in order to try and crawl out of the medical cesspool that I fell into when I made the colossal mistake of putting aside all of the medical hurts of the past . . . trusting the medical bigwigs & mill-town kings in Asheboro . . . and taking the the job at Randolph Medical Associates.

And I have to wonder. At what point does Cheryl Freeman, DDS, get cancelled out?

I guess at some point, we'll have to serve up a the stack of letters of the parents who did not share her opinion of me . . . after all, what Dr. Freeman thinks is just sooooooo much more important than anyone else . . . because you-know, she's a member of the Board of Health.

I digress. When obtaining letters of recommendation, one tries to obtain at least one from letter each of the specialties one has worked with. I tried to cover those bases.

Alert readers will note that several of my letters were from doctors who also left Asheboro. I was advised by people who do this for a living (people dodging blackballs on my behalf) that it was important to show prospective employers that other very good physicians shared my view of Randolph Hospital management . . . and that my abrupt departure from RMA was not (1) because I was "disruptive"/"difficult"/whatever, or (2) due to "normal turnover".

But there are some conspicuous absences . . . letters I ordinarily would have obtained. And at this point in this game, I need to say something about that. In one case in particular, I've waited a long time.

(1) Breton Juberg (Randolph Hospital Chief of OB-Gyn). He was headed for a fall, and I knew a letter of recommendation from him would do more harm than good.

He had aborted his own child. Yet the powers-that-be at Randolph Hospital looked the other way and kept him on staff (until the Medical Board clipped his wings) while they mercilessly kicked me to the curb for saving a baby's life.

That, and I just didn't want his recommendation.

(2) Jim Kinlaw (Family Practice, long-time Randolph Hospital Board member, physician to my parents). Kinlaw, also my childhood physician, the man primarily responsible for getting me back to Asheboro, was too busy playing the gentlemanly game of going-along-to-get-along with all the "right people" . . . swallowing everything Morrison & Eblin told him as if it were the gospel . . . hiding behind his "privileged relationship" with my parents (something they did not want him to do - in fact, they pleaded with him to take action) . . . and (of course) protecting White Oak's interests on the Randolph Hospital BOD. You cannot live in a "vacuum" after all.

And I understood what was happening fairly early on. Having Mary Johnson at RMA . . . cleaning up the Pediatric messes . . . backing up everybody 24/7 . . . answering EVERY call . . . taking all the dumps . . . seeing a good portion of the child abuse cases . . . going to Court . . . AND absorbing all the political slings & arrows when she had to step on toes in order to do all of that . . . well, that was just fine with White Oak. But at the time, Mary Johnson starting a private Pediatric practice was perceived as a competitive threat - not just to RMA Pediatrics, but to the Family Physicians in town.

Ergo, it was okay for the hospital to use every dirty trick in the book to squash her - and for White Oak to look the other way.

I have said this before. But it bears saying again. Jim Kinlaw was/is the biggest disappointment/betrayal of all. I expected some of the other people in this fiasco to behave badly. But I had this man on a pedestal for a very long time. And after Randolph Hospital broken my heart, Jim Kinlaw stepped on it and ground it into the floor as he turned his back and walked away.

(3) Kathy Riley (my former "partner" at RMA). We simply did not mesh in ANY way (a risk a practice takes when it hires people without letting them meet). Personally and professionally, it just was a dead end. And it's not that I did not try.

For a long time, I played by every "collegial" rule in the book in dealing with her. And for the most part, I've held off on making any public comment about our relationship FOR YEARS. But I'm done with that.

So, for the record:

I bent over backwards to get along with Kathleen Riley . . . for the sake of the sacred "best interests" of RMA. I smiled through grimaces until my face cracked over our (significant) clinical differences. I could list them here. In fact, I'd love to list them here. I won't. That's the cat-fit you expect.

Ordinary day-to-day molehills a physician (or group of physicians) might deal with in any office anywhere were always MOUNTAINS. Every day was a stupid, soul-sucking turf war. As a Locum Tenens, I've worked in nearly forty situations since then . . . a number of private groups and hospital-owned practices . . . and I have NEVER seen anything like it!

Moreover, I got involved in staff disputes at the office because Steven Eblin (and later, Mike Bridges) were NOT managing them, and Kathleen Riley was not "representing" anyone but herself.

I particularly had NO USE for the way this woman . . . my so-called "partner" treated my nurses . . . VERY GOOD NURSES . . . Jean Hare, and later Sandra Cole.

As soon as Laurie and I gave Kathy just a little bit of power, all she did all day long was whine, whine, whine behind Mike Bridges' closed office door (an office Laurie and I did our level-best to avoid). Mary was so "mean" to her. It was like watching a tattle-tale in pre-school!

And it was just a lie. I covered Riley's butt over and over again (at the practice, in the hospital, through her pregnancy) to the nth degree . . . and for my trouble, I got nothing but knives in my back.

I don't care who knows it anymore. It was a *&^%$# "non-profit" practice. Federal dollars were spent to bring Dr. Anderson and I to Asheboro. We were not little girls. We were supposed to be treated with respect . . . and have competent, fair management. My opinions (and Dr. Anderson's for that matter) were/are just as valid as Dr. Riley's . . . but Morrison, Eblin & Bridges were all deaf in one ear.

And that was because Laurie and I did not always tell them what they wanted to hear. Meanwhile, Kathleen Riley was telling RMA management everything it WANTED to hear and she KNEW it! She WORKED it.

Moreover, if Kathleen EVER wants to talk about "damages", I will have no problem reminding her that her opinions about me have held the floor EVERYWHERE in Asheboro for eleven years. Indeed her zeal in expressing her opinions was the primary force that drove me out of my own hometown. Mike Bridges swallowed her version of everything because it suited his agenda. Without vetting it through anyone else and with NOTHING in my personel and peer review files to back it up, he put it all in a letter that TO THIS DAY, Randolph Hospital executives (who are not doctors) have not retracted or allowed to be challenged in ANY venue. THERE WAS NEVER A MEETING OF THE BOARD OF DIRECTORS OF EITHER THE PRACTICE OR THE HOSPITAL TO DISCUSS THIS - before or after it happened! So any time ANYONE wants to talk about "damages" I will roll up my sleeves and rumble.

I'll also have no problem comparing my for-many-years pulverized salary (as a locums) to Kathleen Riley's phat RMA bonus plans.

Let's review: Kathy did not accept her responsibility for initiating the Cheryl Freeman debacle . . . but she was all too willing to ride in on the white horse and scoop up Ms. Freeman as a "customer" once Mary Johnson's guts were splattered all over the wall.

She could paint me as a "racist" (because my RN appropriately triaged a well-child), and Mike & Steve ate it up.

And, of course, her fingerprints were all over Mike Bridges' warning letter.

In the end, aside from the part about me just rolling over and going away (why did ANYONE with a brain think I would do that?), poor put-upon, victimized Kathleen Riley got exactly what she wanted. She's big-cheese at RMA Pediatrics. She inherited my practice and all of the bonus money that came with it.

A number of Pediatricians have revolved through RMA's doors since they were slammed in my face. I guess all those doctors were difficult too.

And I've always wondered: After I was gone, did Kathy ever get her loan repayment?

(4) Randolph Hospital/RMA. I was there on day one and had built their Pediatric practice from nothing. I did everything I was asked to do and then some. Morrison & Eblin traded heavily upon my status as an Asheboro "home-girl" to build their precious "business". But the more I gave, the more these two micro-managing, control-freaks wanted. There was not one thing in my personnel or Peer Review files that can justify their heavy-handed, greed-soaked actions.

As for what RMA did produce in discovery to justify their actions . . . disputes over parking tickets? Patient discharges (a doctor's right)? Turf wars at the hospital?

Oh, and investigating patient & nursing complaints brought to my attention in my capacity a chair of a hospital committee equaled "openly complaining" about my colleagues? Were they nuts?

NONE of the petty crap Randolph Hospital eventually produced in discovery . . . if ANYONE had looked at it objectively or seriously (and no one ever did) . . . came remotely close to justifying blowing the investment the hospital & taxpayers had made in bringing me home to Asheboro. . . or completely turning my life (and ultimately Dr. Anderson's) upside down.

And again, Breton Juberg could stay on Randolph Hospital's medical staff unencumbered, but Mary Johnson was "disruptive" and a menace? Are you fricking kidding me?

Adding injury to insult, instead of providing a decent letter of recommendation as a courtesy . . . something that might have allowed me to move on along . . . something that might have helped propel me into fellowship . . . or negate the local blackball their minions had thrown out to block my path locally . . . Mike Bridges only offered a "neutral" letter of reference.

He wasn't just slapping me in the face, he was spitting on me.

You see, it wasn't just about landing on my feet in another practice. Getting fired by a hospital-owned practice (in my own hometown no less) . . . and being handed a neutral reference pretty much killed any chances at an Pediatric ED fellowship . . . at least at a time when I was young enough to do one.

The all-knowing management team of Randolph Medical Associates did not give that a second thought.

Before my head explodes, it's time to move on along to the next subject.

As I noted in the previous post, readers who know more about medical politics and Peer Review and (especially) confidentiality & privacy laws, might be wondering why I am talking about these things more openly . . . and especially why I'm blowing a giant hole through all the traditional, noble notions of medical collegiality and professional camaraderie?

Nevermind that physician collegiality is pretty much a myth in medicine these days. Everything - and I mean everything - is about the damned dollar bill.

The same folks who know about these things (apparently there aren't many - even in the medial field and especially in Asheboro) understand that complaints filed with hospital/medical Peer Review and the N.C. Medical Board are supposed to be strictly confidential. In North Carolina, such documents are not discoverable in court - except/unless (in the Board's case) public action is taken.

The theory is that giving doctors the opportunity to speak freely in matters of quality assurance (i.e. they cannot be sued for what they say) serves the bests interests of patients.

Well, first and foremost I think that after six years of begging for an independent criminal investigation by the Medical Board, the N.C. State Bar and/or North Carolina law enforcement . . . not to mention four years in the blogosphere coloring just outside the lines trying to get a disinterested, so-in-the-Cone/Randolph-back-pocket press to take an interest . . . we've established that regular channels DO NOT WORK!

Dr. Mary Johnson has played by every rule and jumped through every hoop. And she's been spat on and/or ridiculed and/or ignored. Her case for perjury, contempt and fraud against Randolph Hospital is not "important" enough to prosecute - no matter what the IRS and Eric Holder might tell you now.

But the biggest reason I can talk about things/cases (like the case of the extreme premie in Exhibit I), is because the things I'm talking about are not "confidential" anymore.

And they are not confidential because Bob Morrison and Steven Eblin BREACHED confidentiality when they filed documents I had authored for purposes of Peer & N.C. Medical Board Review in discovery responses during the lawsuits.

Bob Morrison apparently just plundered anything he wanted. He was "king".

But what Bob did (using document I had submitted to peer review to his own ends) was against the law. So Bob Morrison broke the law long before he perjured himself.

Nobody did anything about that either.

I wonder how many other physicians at Randolph Hospital have had their peer review files plundered and played with?

The reader needs to keep in mind that, during RMA's "six-month" notice period . . . because of the oily way/under-handed Bridges & Eblin operated . . . not-to-mention the disinterested stance Randolph's Medical Executive Committee & Board of Directors took with regards to my employment situation (i.e. I got no "fair hearing" at any level or of any kind . . . no chance whatsoever to counter/challenge what Bob & Steve & Mike were doing or telling others) . . . hospital Peer Review was the only outlet I had to get through to somebody-in-a-position-to-challenge-what-had-happened . . . someone who might be moved to do something besides pretend the situation didn't exist.

And/so, to protect myself . . . wanting the Executive Committee to know that Bob and his Board members (including Rob Robbin's partner, Jim Kinlaw) were flat-out lying to patients & colleagues about me being "free" to open my own practice . . . because I was in a contractual box with no windows or doors . . . because I was forbidden (under threat of termination "for cause") to speak to anyone except the bullies who put me in the box . . . because my malpractice insurance had been cancelled, I filed a complaint about the management of Rob's premie with hospital Peer Review.

Morrison and Eblin were not in the Peer Review equation (except to somehow later have license to plunder Peer Review documents) . . . and they could not fire me "for cause" for employing it while I was on staff.

You use what you have. I didn't have much . . . no matter what Eblin and his oily lawyers were telling everyone.

But mainly, I didn't want anybody to say (as the lawyers later predictably tried to imply), "Well Mary didn't come in to help that poor little premie because she's just an angry bitch."

Morrison & Eblin had already given many of my patients the impression that I had thrown a snit fit and just abandoned them (the Medical Board didn't look into that). Morrison told my patients that I was "not a team player" . . . and RMA's management team was determined to paint me to the medical staff and Board of Directors as some kind of extortionist (for the sin of wanting my employment and NHSC contracts fully honored . . . and for wanting to be properly compensated for the damage I incurred because of the in-your-face breach of those contracts).

I was also really-sick-and-tired of Teflon-coated Kathleen Riley getting cut all kinds of slack . . . especially in terms of maintaining the CME (Continuing Medical Education) we had ALL agreed upon to hold Neonatal & Pediatric ventilator privileges. Laurie and I had jumped through the hoops. But at the time of my termination, Kathy was not up-to-date.

She didn't have to be. She had generally just dumped those kind of things on me (or, to a lesser extend, Laurie) . . . because critical care was "my thing" (as speaking Spanish fluently was hers) I willingly backed her up 24/7 (something Eblin made light of in a letter he later wrote to the medical staff).

As an aside, lay-people never seem to understand/appreciate the burden that 24/7 call (even if it's "only" back-up) in a small town is. I for sure know that hospital administrators don't. Because their idea of "call" is leaving a cell phone number for the underlings while they have dinner in Greensboro or Winston . . . or play golf at the club.

Of course Eblin & Bridges didn't get why I was so "angry" when they corralled the Pediatric group in a room and told us we were not working hard enough . . . or bringing in enough money.

I freely admit, I totally lost it that day. I didn't work hard enough? It was just too, too much.

Cutting to the chase, Robert Morrison and Steven Eblin released the complaint I filed with Peer Review (on Rob's premie) to discovery. Now if I was the "disruptive" witch these executives would have you believe I am, I could have published that document yesterday on Housecalls . . . right along with the story behind the subtitle told in Exhibit I. And in that document, the case is much more bluntly stated than anything I've said on this blog.

But I elected not to do that. I still have some "couth". It's the reason I probably won't post the letter I wrote to Secretary Shalala in this series.

I'm just out of patience. ANYONE at Randolph Hospital releasing that document was against the law. It corrupts the entire process of Peer Review at Randolph Hospital!

AND IT PROVES NO PHYSICIAN IS SAFE FROM THESE TWO MEN WHEN THEY ARE ON A MISSION TO DESTROY SOMEONE!

I've waited eleven years for this town and this hospital and this medical staff to wake up and get a clue.

I've also waited on the North Carolina Medical Board to grow a spine and start telling hospitals & the state legislature that it will NOT TOLERATE retaliation against physicians doing their jobs (especially doctors in public service) . . . that "right-to-work" employment laws must be revised in order to respect doctors' unique status as licensees with special obligations . . . and that medical whistle-blowers will be protected.

I'm still holding my breath.

Moreover, eleven years ago, when parents and colleagues started to complain about what had been done to me . . . and the way it had been done, the Boards of Directors of RMA and Randolph Hospital should have convened, there should have been a hearing, and Bob & Steve should have been told they SCREWED UP . . . and to FIX IT.

That did not happen. Because we cannot have any of the mill-town-gods at Randolph Hospital admitting they were wrong!

Six years ago, when evidence of perjury, contempt and fraud was first brought to the attention of hospital attorney, Robert Wilson . . . the Board should have convened . . . Bob & Steve should have been told they screwed up . . . and to FIX IT.

That has not happened either. They are all above the law!

So, as we get ready to talk about the "Mick Irwin" incident . . . and the neonatal case that got me fired for stepping up and going above & beyond . . . in order to clean up Cone-owned Mick's mess, a couple of things should be clear:

(1) The Irwin fiasco is not a secret. It's a small town and many, people know about it - and know the parents/child involved. The parents have talked about it openly. They've wanted someone to listen to them . . . and to help me for a long time. They've wanted to help right the great wrong worked against the doctor who put their baby before her own well-being & happiness.

But no one has. This child's parents are not "right people". And I've never been "right people".

(2) Mick Irwin also violated confidentiality when, as litigation raged, he gave a copy of the N.C. Medical Board complaint I authored & filed against him to Bob Morrison and Steven Eblin. The baby's parents supported that complaint. Irwin did not have my permission to do that. He did not have the parents' permission. His only purpose was revenge. Bob and Steve could use the complaint against me in litigation . . . to paint me as "disruptive".

For how dare I take on the Cone-owned? How dare I not drink the Morrison Kool-aid?

And what did Bob & Steve do with that document . . . a document which, as "non-profit" hospital administrators, they should have known was confidential?

Well, boys & girls, Bob, Steve and their "expert" lawyers released the Medical Board complaint to discovery!

I actually went so far as to file another complaint with the North Carolina Medical Board against Irwin over that breach of confidentiality, but the Board's chief legal eagle, Thomas Mansfield, said that Irwin could do whatever he wanted with the complaint.

Well, alrighty then. As we've established, I was under the impression that complaints filed with Peer Review and/or the North Carolina Medical Board were strictly confidential and not discoverable under law - unless the Board took action against Irwin.

But, as we've established, the North Carolina Medical Board cannot be bothered with Mary Johnson's "problems". Being the good-ole-boys club that it is, the Board took no public action against the doctor whose arrogance and ignorance almost killed a baby . . . and more pointedly/tragically, the Board made no move whatsoever to stop the fiendish legal hammering of Dr. Mary Johnson for acting on her conscience.

Mr. Mansfield and the North Carolina Medical Board could not help Dr. Johnson with her "problems". Never mind that her problems existed because she did the job she was licensed and had taken an Oath to do.

So the bottom line is this: If Mick Irwin could share, so can I.

And/so we shall proceed.

And if ANYONE in Asheboro/at Randolph Hospital has a problem with what I am doing now, let me be crystal clear: YOUR BEEF IS WITH BOB MORRISON & STEVEN EBLIN, NOT ME!

They screwed up. They lied to you. Talk to them.

Moreover, if any of the lawyers running the N.C. Medical Board (who according to StatCounter, are now dropping in) fancy loding a bogus "unprofessional conduct" claim because I am throwing off the chains and blogging this story the way I should have blogged it when I first got started in the blogosphere four years ago . . . think very carefully before you do that.

First, there's the little matter of the First Amendment. I'm done with the cover-up. You can take your gag and you can stuff it.

And second, I have been on the WRONG END of unprofessional and ILLEGAL conduct . . . from administrators and doctors and lawyers for well over a decade . . . conduct that is WELL-DOCUMENTED . . . conduct that the North Carolina Medical Board has determinedly IGNORED for the sake of its precious highly-overated collegiality.

No one at the North Carolina Medical Board should DARE talk to me about "transparency" . . . or "accountablity" . . . or my duty to be "collegial" to people & organizations that have treated me like dirt . . . until the Board and the State of North Carolina STEPS UP and does something about what was done to me.

Dear God, this feels good. You can't have any idea. It's like a massive weight coming off my shoulders.

Update: This post was tweaked this morning. And comments are closed. Kathleen Riley, Mike Bridges, Steve Eblin and Robert Morrison all had their say.

Now I'm finally having mine.