Physician leaders at three hospitals run by Saint Thomas Health Services in the Nashville area have cast votes of no confidence in management over concerns that an ongoing budget review may lead to deep cuts that damage patient care and alter how the hospitals' medical staffs operate. The hospital system's top administrator, Chief Executive Officer James P. Houser, responded by putting the review process on hold for 30 days, until early March, to allow for better communication of the reasoning behind it "to all our stakeholders." The recent votes by the medical leadership at Saint Thomas Hospital, Baptist Hospital and Middle Tennessee Medical Center called into question Houser's leadership and amount to an attempt by top doctors to influence the hospital system's board before any budget cuts are made.