The Alameda County Board of Supervisors voted Tuesday to remove the entire Alameda Health System’s Board of Trustees. The supervisors explained their decision by saying that the all-volunteer, nine-person board failed to hold the hospital system’s executive leaders accountable for serious mistakes and mismanagement, including decisions that led to a five-day strike by health care workers earlier this month. The supervisors’ vote is the first step in establishing a new governing structure for the county’s safety net hospital system.
“I’ve lost my faith. I’ve lost my hope in the leadership at AHS, specifically the current trustees,” said Alameda County Board of Supervisors President Richard Valle during Tuesday’s meeting.
The board’s nine trustees are to hand in their resignations or be removed effective Nov. 30. The new Board of Trustees will have a minimum of five members, and each of the five county supervisors will be given one appointment. Any new applications or current trustees who’d like to reapply must submit their applications by Nov. 6.
The supervisors’ decision to remove the trustees comes after months of conflict between AHS employees and leadership.
Before Tuesday’s vote, The Oaklandside spoke with multiple physicians who said that AHS’s executive leaders failed to adequately respond to the COVID-19 pandemic and created a workplace culture of “intimidation” that de-prioritized patient care and alienated staff.
More than 50 physicians working for AHS signed a letter that was sent to the county Board of Supervisors ahead of Tuesday’s meeting, which described multiple incidents of “retribution” against medical staff who spoke out about patient safety concerns.
“We find ourselves in a workplace where intimidation and fear of retribution is real and explicit.”
“During a time when healthcare providers need support and advocacy more than ever, the Executive Leadership has provided neither,” the physicians wrote. The doctors signed the letter anonymously for fear of losing their jobs for speaking out. “We find ourselves in a workplace where intimidation and fear of retribution is real and explicit.”
Unlike most of AHS’s nursing staff and other employees, physicians at AHS hospitals are not unionized and have few job protections. In July 2020, all AHS physicians had to sign new contracts with AHS. Those agreements say that physicians can be terminated without cause within the first six months of their contract, with 30 days notice.
The physicians’ letter to the county Board of Supervisors also describes recent resignations by high ranking doctors who clashed with the health system’s executives, allegations of gender bias, and investigations of several physicians that the doctors claim were motivated out of retaliation.
According to interviews with several physicians who asked not to be named, morale among AHS doctors is low and AHS executives have pressured some physicians to resign from leadership positions after they disagreed with management about how to steady the health system’s financial footing and best respond to the pandemic.
For example, the physicians said that Dr. Rachel Baden, an infectious disease expert and the chair of internal medicine at Highland Hospital, resigned unexpectedly earlier this month. Baden was a leading figure on the frontlines of the COVID-19 response and was forthright in her criticisms of the administration’s handling of the pandemic, according to her colleagues. The Oaklandside was unable to contact Baden for comment.
Dr. Kelley Bullard, director of the surgical ICU at Highland Hospital and AHS’s top doctor, clashed publicly with administrators over the health system’s response to the pandemic during a July meeting of the Board of Trustees. Bullard said there had been numerous and serious failures by the administration to set up infectious disease safety measures. She alleged that staff and patients were frequently not wearing masks, that contact tracing at hospitals has been inadequate, and there was no system to properly screen patients before they enter the hospital, among other failures.
“Just building the process itself, we aren’t even there yet, they don’t exist,” said Bullard at the July trustees’ meeting, about the lack of adequate safety measures. “It’s just kind of flying by the seat of your pants.”
Days after the Board of Trustees meeting, Bullard resigned from her role as chief of staff. In a July 31 email she sent to AHS administrators, physicians, and many others, Bullard accused AHS executives of gender bias.
“Our CMO went around me, disrespecting my role as a leader and ignoring the basic courtesy of including me at the table in issues that directly concerned me. This and other dismissive behaviors feel like gender bias that I now call out. My hope is that this sacrifice (yes I will miss this role and serving you!) will add to the lessons learned at AHS while we work to bring truth to equity and diversity within our ranks. My hope is that this sacrifice can serve as a catalyst to attack gender bias at all levels of leadership,” Bullard wrote in an email to staff.
Other physicians who have stepped up to take a leadership role have also clashed with administrators. After Bullard resigned, Dr. Gene Hern, the vice chair of education in the department of emergency medicine at Highland Hospital, assumed the role of chief of staff. After about four weeks, Hern resigned from the position because of “irreconcilable differences” between his ethical duties to advocate for patients and staff and what he was being asked to do by AHS administrators, according to the letter that the group of anonymous physicians sent to the county Board of Supervisors. Both Bullard and Hern continue to work at AHS as physicians.
AHS physicians who spoke with The Oaklandside said the resignations have had a chilling effect on medical staff. The physicians added that it’s not just individuals, but also entire departments that have been retaliated against for criticizing the AHS administration.
“I know that tomorrow they are going to find any reason possible, if they don’t want me here, to get rid of me.”
One AHS physician said in an interview that they couldn’t speak openly, “because I know that tomorrow they are going to find any reason possible, if they don’t want me here, to get rid of me.”
Terry Lightfoot, a spokesperson for the AHS administration, told The Oaklandside he can’t comment on any particular staff member’s experience, including Bullard’s allegations of gender bias, because it’s a personnel issue. But Lightfoot did say the administration thinks the supervisors’ decision to remove the current Board of Trustees is a bad idea.
“Frankly, to dismantle the current board to replace it with interim, unknown leadership will jeopardize patient care at a moment where we are facing a public health crisis and critical health issues,” said Lightfoot.
Not all AHS staff agree that the hospital system is being mismanaged. A different group of physicians sent a letter to the Board of Supervisors ahead of Tuesday’s vote expressing support for AHS’s executive team and trustees. Some of the physicians we spoke with said they felt the doctors who signed the letter overstepped their authority and were giving an opinion not widely shared among staff.
But other healthcare staff told The Oaklandside that they have been subject to retaliatory investigations. For example, the entire AHS clinical nurse education department, the people who train nurses on best practices for new medical procedures, were placed on administrative leave for unknown reasons, according to several physicians. It is unclear if and when the department will be brought back, and some physicians interviewed said this leaves their staff more exposed to making mistakes.