SCRIPPS HEALTH: Board Makes Concessions to System Doctors

      As part of its attempts to quell mounting criticism, the Scripps Health board of trustees Thursday unanimously approved a "60-Day Action Plan," which includes pay raises for nurses, reassignment of one administrator and a contract concession for physicians, the San Diego Union-Tribune reports. Physicians have recently aired numerous complaints against the health system, including a decline in the quality of care at Scripps Health's five hospitals, non-competitive salaries for nurses and other staff members, a lack of necessary equipment and sub-standard hospital sanitation. Under the plan, 2,400 nurses and support staff will receive a combined $5.5 million annual pay raise, beginning June 18. Additionally, Dr. Brent Eastman will resign as head of Scripps Physicians, but will retain his position as chief medical officer of Scripps hospitals. Some doctors had argued that Eastman was unable to represent their interests as CMO. Further, the board agreed to alter its policy that allowed doctors joining Scripps Physicians to get better rates if they admitted their patients to Scripps hospitals. To protest that policy, two physicians groups sent their patients to non-Scripps hospitals, causing a decline in revenue for Scripps Health. The board also decided that "contracts between Scripps and its affiliated medical organizations will be successfully negotiated and implemented in a fair and timely manner," a concession to physicians at Scripps-Mercy who have been angered by six months of contract talks. Even with the board's concessions, some doctors are not pleased. Dr. Kevin Glynn, chief of staff at Scripps-Mercy, said that the plan does not address all of the doctors' concerns, especially about Scripps Health CEO Dr. Stanley Pappelbaum, who doctors believe is "making ... many administrative snafus" (Clark, 5/26).

Opening Communication Lines
      Improving the relationship between doctors and the health system is one of the board's major priorities, board President Frank Panarisi wrote in a San Diego Union-Tribune column appearing the day before the board made its decision. He wrote that the board understands "there had been disagreement regarding the tactics and implementation guiding Scripps' future" and is "extremely sensitive to the difficulties and concerns that have resulted." He added, "We remain committed to the reality that Scripps must change in order for it to continuously improve." Among the other priorities for improving the health system are attracting and retaining competent staff, reinvesting in core service areas and establishing "active participation, cooperation and flexibility from all parties to ensure that the true intent of continuously improving the quality of patient care is met." Panarisi points to the Physicians Relations Committee, which the board created to "develop a fair, open process through which [the board] will examine the significant issues" doctors have raised. Panarisi also defends Pappelbaum, who he argues is "committed to opening new channels of communication between management and physicians and staff." Panarisi concludes, "Now and in the days ahead, Scripps has rededicated itself to working with its physicians and staff to take the necessary action to ensure that changes in the health care delivery system all point toward one common goal -- the highest standards of health care for our community" (5/25).