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CHI St. Alexius Docs Still Unsatisfied Despite Tweaked Chain of Command

Analysis  |  By Steven Porter  
   June 15, 2018

A two-week détente ended Friday, with medical staff deciding to oppose the reinstatement of three committees amid talks about system leadership.

A tense relationship still simmers between physicians and system leaders at CHI St. Alexius Health in North Dakota, where long-term talks have failed to produce an agreement on how the organization should be managed.

It's been a month since a group of doctors in Bismarck resigned in protest from their committee roles, calling for the ouster of four regional leaders. They also sought to have their regional leadership office moved about 200 miles, from Fargo to Bismarck.

In the weeks since, unrest has spread to other facilities in the state, and the organization's board has voiced support for the current leadership team while still calling for dialogue to address the physicians' concerns.

The system said in a statement June 1 that the medical staff had decided to reinstate three committees while talks were underway. That two-week détente ended Friday, however, when the parties failed to reach a compromise.

"Leadership has worked hard and in good faith to find common ground and accommodation with the medical staff. We have the utmost respect for our physicians and have made efforts to compromise," CHI St. Alexius Health said in a statement Friday afternoon. "However, we understand that a difference of opinion continues to exist but we believe that it is not insurmountable and will continue to confer with physician leaders to find a path forward."

Related: CHI St. Alexius Board Meets Amid Doctors' Revolt

Related: Board Backs Leadership In Clash With CHI St. Alexius Doctors

Related: Unrest Spreads Among CHI St. Alexius Physicians

This impasse persists despite a tweak to the system's chain of command. Rather than reporting to the Fargo office, the facilities in Bismarck, Garrison, and Turtle Lake began reporting this week to CHI's Nebraska division overseen by Cliff Robertson, MD, MBA, according to the system's announcement. This arrangement was described as indefinite but interim.

Tony Jones, interim executive vice president and chief operating officer for CHI, also told physicians earlier this week that leaders had decided "after careful review" to keep the North Dakota division offices in Fargo.

The three physician leadership panels affected are the medical executive, peer review, and credentials committees.

Charles Allen, DO, FACOEP, FACEP, an emergency physician who had been serving as president of the medical executive committee, told HealthLeaders Media in an email that he considers the dispute at hand to be "an internal issue" that he never intended to be brought to the attention of news media.

"I will say the issue is not about power and control, but of leadership, vision and trust," Allen wrote. He did not respond to follow-up questions.

Noting its disappointment in the medical staff's decision, CHI St. Alexius Health suggested that the current disagreement may be best understood in a broader context that accounts for the pressures plaguing providers nationwide.

"The entire industry has had to reevaluate how it cares for patients, how patients want to be cared for and how it does business," the statement said. "We need a way forward for CHI St. Alexius Health, for the community, for our patients and for our employees—and for our physicians."

“I will say the issue is not about power and control, but of leadership, vision and trust.”

Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.


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