Grady CEO rethinks firing after objection

The recent struggle between two of the most powerful officials at metro Atlanta’s safety net hospital raises questions regarding the chief medical officer, who oversees patient care, as well as the managerial style of the hospital CEO, who was hired in 2008 as a change agent at the cash-strapped Grady.

CEO Michael Young had already dismissed several top-level officials by the time he presented a letter of termination dated Nov. 24 to chief medical officer Curtis Lewis. But in taking aim at the 52-year-old Lewis, who has worked for more than 20 years at Grady, Young drew fire from the Grady corporate board and the medical staff.

The Rev. Joseph Roberts Jr., a member of the Grady corporate board, said that after board members learned of Young’s action, they informed him that he had overstepped his authority. Only the board can fire the chief medical officer, he said.

“The big issue here is that protocol wasn’t followed,” said Roberts, a former pastor of the historic Ebenezer Baptist Church in Atlanta. “It had to come before the board.”

Young reversed his dismissal of the chief medical officer in a two-sentence letter dated Dec. 16, which said: “We look forward to Grady continuing to move forward in 2010 and wish to have you assist us in these endeavors.”

It remains unclear why Young wanted to replace the chief medical officer. It is not uncommon for new CEOs to want to bring in their own teams.

Lewis, for his part, said he was unaware that Young had any discontent regarding his performance. He told The Atlanta Journal-Constitution that he is happy that he has been reinstated and he intends to foster a good relationship with Young.

“I hope that it’s over,” Lewis said. “The good news is that I remain chief medical officer, and I’m obviously committed to Grady.”

Lewis has served as Grady’s chief medical officer for about a decade.

Some of Grady’s medical staff say they suspect the conflict may not be over, and that Young may attempt to oust the chief medical officer again. Moreover, some medical staff say they see this incident as part of a larger problem with the CEO’s management style.

“Most of the medical staff is very supportive of Dr. Lewis, and they worry that this is a symptom of an increasingly tense relationship between the administration — Mr. Young and his group — and the medical staff,” said Dr. Carlos del Rio, an Emory infectious disease specialist who works at Grady.

He said Young needs to temper his “I’m the boss” attitude with more collaboration with the medical staff.

At the same time, Young has strong defenders who say he is not only working well with the staff but producing major results to improve the hospital’s performance and finances.

“Mike Young has been impressive,” said Richard Teters, a member of the Fulton-DeKalb Hospital Authority, the board that oversees the Grady corporate board. “He has his style and he gets things done, and there have been a lot of improvements over a short period of time.”

It remains unclear whether the conflict over Lewis is finished or the degree to which Young might be in hot water with the Grady board. Young declined to comment on the matter. Board chairman Pete Correll could not be reached for comment, and several other board members either could not be reached or declined comment.

Roberts, the Grady board member, said he thinks the Lewis conflict is in the past. He said he does not believe Young will raise the issue again, having seen the level of support for Lewis.

“[Lewis] has a lot of talent and a lot of attributes,” said Dr. William Casarella, the executive associate dean for clinical affairs at Emory. Emory provides many of Grady’s doctors, and Casarella works on clinical issues with Grady. He said Lewis has been a stable, positive force through “all this turmoil at the top.”

Casarella was referring to the high rate of turnover among Grady CEOs. The hospital has churned through a half-dozen CEOs in recent years.

Young arrived after a major restructuring of the hospital leadership. Essentially, the Fulton-DeKalb Hospital Authority was largely replaced by a corporate board of directors who took over the hospital. The authority retained ownership of the real estate and a level of oversight over the new board. That shift was made possible by the promise of millions of dollars in support from the Atlanta charity community, which based its financial support on the promise of new leadership.

Young quickly took the reins firmly in hand, and by March 2009, he announced 150 job cuts, including several top managers and the executive director of the Georgia Cancer Center for Excellence at Grady. At the time, some of Grady’s top physician managers criticized Young for not discussing the layoffs with them before dropping the ax.

Young also said that he was intent on remaking the so-called “Grady culture,” which critics say tolerates inefficiency and hampers patient care.

In an Oct. 24, 2008, memo, Young bluntly expressed his frustration when the deadline for a lab installation was pushed back about four months.

“This is an example of the dysfunctional operations of the Purchasing Department, lack of leadership and the failure to meet Grady’s goals and targets,” he wrote. “This lack of response is the old Grady way, making Grady a laughingstock.”

Fulton County Commissioner Emma Darnell said she has received letters from Grady staff and patients complaining about Young’s “disrespectful” attitude. She said she has asked the Fulton-DeKalb Hospital Authority to review them.

Matt Gove, Grady’s spokesman, defended Young’s style of management. He said Young has produced $60 million in savings, efficiencies and new revenues since coming on board. Grady’s annual budget is about $750 million. Patient satisfaction is also up.

“You cannot produce those kinds of results if the employees are not working with you,” Gove said. “The employees are working with Mike Young to make the hospital better.”

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