EAST MACHIAS, Maine — A public forum Thursday evening to discuss ongoing issues at Down East Community Hospital seemed less telling than the posturing that led up to it.
Dr. Lawrence Huntoon, a New York neurologist and expert on medical ethics and peer review, spoke to about 75 area residents who gathered at the Elm Street School in East Machias.
He began with a disclaimer that he was not an expert on the turmoil involving DECH, but he spoke generally about power struggles at hospitals and about how the peer review process often eliminates competent physicians.
Noticeably absent from the public forum was anyone representing the hospital, although many administrators and members of the board of trustees were extended invitations.
Instead, board Chairman Walter Plaut sent a letter.
“As a board, we believe that respectful dialogue is the only way to solve controversial issues, especially those involving responsibility and trust,” he wrote. “We feel that the meeting as it is proposed will not foster the respectful dialogue the community deserves.”
The letter went on to criticize Huntoon and his background, citing his ideologies as the reason the hospital declined to participate. Plaut wrote that Huntoon’s connection to the Association of American Physicians and Surgeons was cause for concern because, he said, the group has a longstanding agenda to eliminate government-subsidized health care such as Medicare and Medicaid.
“Given that approximately 75 percent of the individuals seeking care at DECH rely on these programs to cover their health care costs, we feel his organization’s platform is dangerous to the health and well-being of communities like ours,” the letter read.
If Thursday’s forum was any indication, the animosity between hospital leaders and some members of the community is not getting better.
The forum was sponsored by the Committee to Save Our Hospital, a group that formed recently to speak out against what members called a growing trend of doctors and other staff being fired or forced to resign.
While Huntoon did address problems he saw with Medicare and Medicaid, his comments about “sham” peer review, something he called rampant throughout the country, had more resonance.
“Physicians who are strong patient advocates are often labeled disruptive or seen as whistle-blowers,” he told the audience, which was made up largely of elderly residents. “The peer review process helps eliminate these doctors much easier.”
Huntoon said “good faith” peer review furthers quality health care while “sham” peer review is malicious and designed to legally get rid of doctors who disagree. He said from what he has heard, the latter is what’s going on at DECH. However, because peer review is protected by the Health Care Quality Improvement Act of 1986, he said, it’s difficult to investigate whether reviews are done in good faith or not.
“But, absolute immunity invites abuse,” he said.
Since this summer, at least two physicians who are no longer at the hospital — Dr. Lowell Gerber and Dr. James Whalen — have challenged the institution in court. Others have said privately that they too are considering legal action. Still others have left quietly under less-than-clear circumstances.
Wayne Dodwell, CEO of DECH, and Dr. David Rioux, head of the medical staff, told the Bangor Daily News recently that peer review is an essential tool and that any resulting action is not taken lightly.