The Valley Medical Board of Commissioners continued riding a roiling wave of discord Oct. 4 that has spanned three meetings.

The five commissioners and staff sparred over the statements made during the two earlier meetings.

The current contention has centered on Resolution 929, the 2010 incentive and goals program for the executive and management teams at Valley.

Commissioner Dr. Aaron Heide began asking questions about the program at the Sept. 7 meeting, which ended in a row pitting commissioners Don Jacobson, Carolyn Parnell and board President Sue Bowman against Commissioner Anthony Hemstad and Heide.

The members finally agreed to add an item on the Sept. 20 agenda allowing Heide to ask his questions.

Following a staff presentation at the Sept. 20 meeting, Heide asked questions, but stated he was not able to complete his queries.

At the opening of the Oct. 4 meeting, Board President Sue Bowman introduced a new board parliamentarian, Judge Robert McBeth. At the Sept. 20 meeting Bowman stated she was naming David Smith, the hospital’s general counsel, as her parliamentarian to help her with the Robert’s Rules of Order.

Hemstad and Heide objected to Smith. Hemstad stated he felt the board should appoint a parliamentarian who could be neutral.

The appointment of McBeth, a retired King County district judge who spent 24 years on the bench, settled the controversy and assisted the parliamentary procedure of the meeting.

Following the introduction of McBeth, the commissioners got into a 40 minute jousting match over the Sept. 20 minutes. Heide and Hemstad felt the minutes were inaccurate and slanted.

Commissioner Don Jacobson said he did not want to see the minutes with “long statements. I want our actions recorded.”

Hemstad said, “this remains a series of attacks on Dr. Heide and myself and no other context.”

The matter was finally settled by agreeing to cut the minutes down to only action items and the barest details, with the complete meeting available on video at the Valley website, www.valleymed.org/Newsroom/Board_Meeting_Videos.htm.

The middle rounds

The meat of the meeting came during staff presentations. Many of the staff members made presentations in reaction to comments made by Heide at the close of the Sept. 20 meeting. Heide read a statement that raised questions about the incentive payments stating, “those in charge of Valley Medical Center are driven by profit and not patient care.”

The first staff member to directly address this was Dr. Kathryn Beattie, chief medical officer. She presented a PowerPoint overview of the quality and health care of the facility.

“In light of Commissioner Heide’s comments at the last meeting of the board,” Beattie said. “I felt it was imperative I present this overview of the quality and performance improvement program at Valley Medical Center, to reinforce their integrity. Hopefully this information will serve to improve the understanding to the quality and patient safety priorities of the medical staff, the administration and every caregiver at Valley Medical Center.”

The Chief Financial Officer Larry Smith said, “Our financial goals express the fact we are not here to make a profit. We are here to take care of the people of this district.”

Scott Alleman, a registered nurse overseeing patient care services, began his presentation talking about difficult and disruptive people and a book titled “Dealing with People You Can’t Stand: How to Bring Out the Best in People at Their Worst.”

Alleman stated he would use Heide’s statement at the Sept. 20 meeting as a case study to illustrate his points.

After noting he respected Heide’s position and authority as commissioner, Alleman said he believed the commissioner’s comments were an “attack on my personal integrity.”

Alleman said Heide made a statement that, “we give ourselves huge bonuses. I don’t award myself a bonus. I was chagrined to read in the newspaper that those at Valley Medical Center are driven by profit not by patient care. Everyday I strive for a balance between financial stewardship and patient care.”

At this point in the meeting Heide and Bowman got into a spat.

Bowman said, “I’m surprised Dr. Heide isn’t listening to some of these comments.’

Heide countered by stating, “I’m glad you can read my mind. It’s amazing, absolutely amazing.”

Paul Larson, the vice president of the clinic network, spoke directly about the dynamics in the room when he stated, “I guess the elephant in the room has been addressed, but man, the tension and conflict that has ensued, that I experienced coming back to this organization after being gone for awhile.”

Larson said he felt the “impugning of Valley’s quality was really harsh…. I know there are big political splits on the board and I know there is conflict.”

Larson noted he and Heide have had personal conversations, “But for you to stand up in front of the group and then also to be quoted in the paper totally impugning what we do in relation to patient care, this was really upsetting.”

Heide said to Larson he appreciated his opinion and they would have an opportunity to discuss the issues.

“But if you read that (statement), it had nothing to do with the quality of the personnel working at this hospital,” Heide said. “It had nothing to do with the providers, nursing personnel or any level, other than the highest levels of this administration and board members do I have any criticism.”

Dr. Robert Thompson, who is a vice president for physician relations, read a statement concerning the commissioner’s remarks, however Heide was not in the room during the presentation.

“The real truth of the matter is Valley Medical Center has a really strong culture of volunteerism with a remarkable record of providing hundreds of hours of volunteer time,” Thompson said.

He stated Valley develops programs “designed to provide medical care to the poor. Does that sound like an organization driven by profit over patient care?”

Thompson said he has seen medical practices that are driven by profit, “and those are the ones who are typically align themselves with for-profit hospitals and do all they can to take advantage of the current fee for service reimbursement model.”

The last round

The commissioner comments presented the final rounds of a steamy club fight showing wide fissures between the three member majority of Jacobson, Bowman and Parnell and the two in the minority, Hemstad and Heide.

Hemstad began the comments period by directing his statements at the staff and Rich Roodman, Valley superintendent.

The commissioner noted many of the staff members were commenting on Heide’s statements from Sept. 24. He said one of Heide’s points was the “pack mentality” at Valley.

“Here, I think, we’ve had three or four staff members, I think, make ad hominem attacks on Dr. Heide tonight,” Hemstad said. “And Rich, I would ask you try to control that in the future. It is inappropriate. You wouldn’t see it at any other governmental institution.”

At that point Roodman broke in and stated, “Excuse me, but if someone calls someone a thief or corrupt on my staff I will not stand in their way if they want to respond direct. If I’m out of order I’m out of order.”

Hemstad said, “Yes, and you are out of order, and again it partly is the problem, because I don’t know if this commission has ever taken its oversight role seriously and kept staff from not attacking commissioners as you’ve been doing all night here against Dr. Heide.”

Parnell said during her comments, referring to Hemstad and Heide, “there is something going on between the two of you. You keep bringing up the past, the past.”

The commissioner said “you are attacking the staff. You don’t use your power to do that.”

Parnell said, “When I decided to run for office more than 12 years ago, it wasn’t political. I ran because I wanted to make a difference in my community. I may be part of politics, but politics is dirty and low down and the people who try to rise above to get to higher position should be ashamed of themselves. In the end they are going to fall flat on their behinds.”

Bowman said, “I’m appalled about the last meeting. I thought a lot about this and I read it over (Heide’s statement). But Dr. Heide this is for you, what you did at the last board meeting was just bullying people and bullying from a commissioner is unfounded and just plain mean spirited.”

Bowman said Heide’s “behavior constitutes a misuse of power and creates a hostile work environment.”

Once Bowman completed her comments she stated as president she would not allow Heide to give his closing comments because he was not in the room when she first called on him to give his statement.

Heide responded to her by stating, “You’re talking about me coming to the table and working together when you won’t even let me speak.”

Bowman said it was Roodman’s time to speak, but the board members decided to take a five minute recess. Following the recess, Bowman reconsidered and said Heide could give his comments.

“It is unfortunate people sit and close their mouths, eyes and ears to everything going on around here,” Heide said. “But I also have the right not to sit and be attacked indiscriminately like a bunch of bullies sitting around this table, 20 to one. You talk about bullying, Sue, that’s bullying, picking on the minority.”

Heide went on to state, “Allowing people to speak, I think, is a right regardless whether you agree with it or not. Allowing them to speak is the right thing to do. Especially when I’m asking questions that truly do not disrupt the matter of business.”

The commissioner said, “I’m not able to change this organization by myself, so I’m not sure what people are fearful of in regards to me asking questions. It is so easy to just let me ask my questions and move on with business…. There is no personal vendetta here, Sue, absolutely not. I know people think there is. I just want to get my opinions across and have my questions answered. That is all I’m asking, really, that’s all I’m asking. So if you can compromise with me in that sense, there really shouldn’t be any difficulties.”

Roodman closed the meeting directing many of his comments at Heide who stated he had to leave to see a patient.

Roodman said he may give his statement again at the next meeting when Heide is present.

He reiterated his statement at the close of the Sept. 20 meeting.

Roodman said any allegation the management team at Valley has been “corrupted by financial motives in exchange for compromised patient care, employee well being and or physician relationships is upsetting, wrong and bizarre. I don’t know how more plain to be – upsetting, wrong and bizarre.”