Conflict between administration and staff surfaced at North Texas Medical Center as grievances of medical staff were aired, though briefly, during the Gainesville hospital district board of directors meeting Monday night.

As mentioned in the article, “NTMC to purchase diagnostic equipment” in the Nov. 17 issue of the Register, NTMC Chief of Staff Bhupinder Khaira, during his turn to report to the board, was stone-walled by hospital board members and Lawyer Fletcher Brown of Davis & Wilkerson, P.C. of Austin.

Khaira had stood to read a letter the board members received Sept. 21, 2009 from fifteen members of the medical staff.

Though board members had already received the letter, Khaira said the medical staff requested that the letter be read in the public meeting.

He did not have the opportunity to get through much of the letter.

In a telephone interview with the Register Thursday afternoon, Dr. Khaira said that as chief of staff, one of his primary responsibilities is to, “present whatever their needs are.”

He is in fact a liaison between the medical staff and administration.

Khaira did not argue down those who did not want the letter read.

“I was not going to make a scene,” he said. It was a public meeting and they asked if there was anything from the medical staff.

“That’s how the medical staff feels,” Khaira said about his actions.

Khaira is on the official agenda for each regular meeting to give a chief of staff report.

The letter, dated Sept. 18, 2009 and addressed to the hospital board members starts, “We, the undersigned physicians, would like to express our concerns about the direction in which North Texas Medical Center is heading. The steps taken by this administration are directly or indirectly affecting the present and the future health care in this community.”

“Our patients have expressed deep concerns about the difficulties they face with registration, pre-certification and billing. Thus, more and more of them are asking to be referred to other facilities for laboratory, radiology, outpatient surgery and inpatient services. This is felt to be a significant factor contributing to declining census (population).”

The letter also voiced concern with the reduction of educational services for the community and, “a crisis concerning the on-call coverage for the various specialties.”

The letter goes on to say, “This administration has treated nursing staff, medical staff and ancillary personnel with intimidation and in a demeaning manner. This has led to frustration and anger which can eventually affect the way ‘our patients’ are treated in the hospital. With the attitude of this administration towards physicians and with the firing of certain long term hospital personnel, in what many in the community perceive as unfair circumstances, a backlash of ill will is developing which we believe is adversely affecting our census.”

“In summary, most of us have been in practice here for a long time. We have made a commitment to be a part of this community first by bringing our families here. Secondly, we have taken part in the city and community projects, been involved in local service clubs and dedicated our lives to the medical care of our patients and their families. The direction that this administration is taking threatens the viability of this hospital and the future health care of this community.”

“To this end, we express our vote of ‘no confidence’ in this administration.”

The letter was put together by three or four people for the group and was then reviewed and signed by fifteen physicians.

Khaira said not everyone on the medical staff signed the letter. Some staff were not available or around or maybe didn’t know about the letter. He said a majority of those who are actively involved did sign the letter to the board. All fifteen signatures on the letter are those of physicians practicing with NTMC.

During the Monday night meeting, NTMC Board President Don Wallace said that the letter had already been received by the board and addressed.

Following the executive session Monday night board members said they would call a meeting of the board, arbitrator and attorney to mediate physician relation issues.

Khaira said he did not know the details of the action taken following the executive session.

NTMC Community Relations Director Gayla Blanton said the action to call a meeting including the board, arbitrator and attorney is to set in motion a mediation for some of the physician relations issues.

She said they haven’t yet set a date but it will probably take place the week after Thanksgiving.