Mission Hospital doctors oppose silencing governing documents in nail-biting vote

ASHEVILLE - Doctors who use Mission Hospital facilities voted against governing documents that threatened to punish physicians who criticize the hospital. The doctors voted against the bylaws and policies by a single vote.

“We are pleased with our physicians’ engagement in participating in this process and vote,” Mission Hospital spokesperson Nancy Lindell told the Citizen Times in a Nov. 16 statement.

The Citizen Times previously reported that the pending bylaws and policies could have placed doctors in professional review for making degrading, demeaning, or condescending comments about the hospital, or impugning quality of care in patient notes.

Under the drafted governing documents, physicians would have had to pay HCA Healthcare’s legal fees if they challenged the hospital in court over a professional review decision and lost. The pending bylaws also gave the HCA executive-laden board of trustees discretion to terminate privileges for doctors who use Mission facilities. These doctors are known as medical staff.

HCA Healthcare, a Nashville-based for-profit company, bought the Mission Health system in 2019 for $1.5 billion.

Doctors said the vote was a consequential moment for patient advocacy. Criticizing deteriorating conditions in the hospital in public forums has become a recourse for physicians concerned that HCA has harmed quality of care in Western North Carolina.

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According to an email on behalf of current Mission Hospital Chief of Staff Ansley Miller, who will soon assume her promoted position as chief medical officer of HCA North Carolina, 46% of the 871 eligible active medical staff members cast a vote:

• 201 members voted for the bylaws and policies; and

• 202 members voted against the bylaws and policies.

The vote was not anonymous, but Miller did not reveal the identities of the physicians in her email, which the Citizen Times obtained.

Miller’s email said that the options for next steps would be presented to the Medical Executive Committee, which will meet Dec. 1. This committee, now mostly seated by doctors who signed a letter supporting the care provided under HCA, represents the medical staff and is responsible for reviewing the bylaws and policies before they go to a vote.

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Martin Palmeri, who leads Messino Cancer Center’s treatment at Mission entities, sent multiple emails earlier this month to medical staff physicians explaining his frustrations with the draft policies. Palmeri is a member of the Medical Executive Committee. He did not sign the letter supporting HCA.

Palmeri was pleased with physicians’ participation in the vote.

“I’m proud to see our medical staff is engaged,” Palmeri told the Citizen Times Nov. 16. “Western North Carolina needs people to work together for the community. No matter how doctors voted on these documents, physicians working together, and feeling free to exchange perspectives on how we can serve our patients, will serve Western North Carolina well.”

Mitchell Black covers Buncombe County and health care for the Citizen Times. Email him at mblack@citizentimes.com or follow him on Twitter @MitchABlack. Please help support local journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: Mission Hospital governing documents fail in physician vote