Detroit Medical Center doctors fired after speaking out for patient safety

By Joseph Lorenz
9 October 2018

Last week, the Detroit Medical Center (DMC) announced that it would be removing three of its top cardiologists from their leadership positions, citing undisclosed “complaints from other physicians and team members” that they had violated the hospital’s standards of conduct.

But according to Mahir Elder, one of the three doctors, the change in cardiology leadership was retribution from the DMC for the doctors’ having spoken out about cost cutting, short staffing and threats to patient safety.

Crain’s Business Detroit published statements from Elder, who was formerly medical director of the cardiac care unit at DMC Harper Hospital. The doctor said, “Now that I refuse to stay quiet about safety concerns, they respond in a highly inappropriate and unprofessional manner.”

Besides Elder, the other two doctors removed from leadership positions are Amir Kaki, who was formerly medical director of the cardiac catheter lab at DMC Cardiovascular Center, and Tamam Mohamad, who was chief of cardiology and medical director of the cardiac care unit at DMC Detroit Receiving. News outlets reported that the doctors, while being relieved from their leadership positions, would continue to practice medicine at DMC.

A fourth doctor at DMC resigned from the medical staff, citing both patient safety issues and the retaliatory actions of the hospital. Ted Schreiber, who was head of Cardio Team One and who has been nationally recognized for improving the quality of care at the DMC cardiovascular center, issued a scathing open letter announcing his resignation.

“Allegations made by DMC executives and distributed to all DMC employees are an orchestrated attempt to silence me and my colleagues from continuing to raise legitimate concerns over safety and the quality of care provided to our patients,” wrote Schreiber. “I refuse to be silenced on issues of quality and safety for my patients and for all patients treated at the DMC.

“Unfortunately, the current focus of some in health care is on profits and stock holder value. Those of us who raise concerns over service, safety and the quality of care provided to our patients are bullied in an attempt to keep us quiet.”

The Detroit Medical Center is a for-profit hospital system in southeast Michigan owned by Tenet Healthcare, a large multinational health corporation based in Dallas, Texas. In 2017, Tenet Healthcare reported revenues of nearly $20 billion. According to International Business Times, the company paid more money for lobbying the US government than it did in federal taxes between 2008 and 2010.

Dr. Elder told the Detroit Free Press that the risky practices against which he was protesting originated at the corporate level. “Everyone is working with a skeleton crew and now patient care is being jeopardized. The decisions are not made at the Detroit level. They are made in Dallas, and Dallas (does) things just based on what they think the bottom line is.”

Elder gave a statement to Crain’s pointing to Tenet Healthcare’s poor practices. “It is Tenet, not me, that is subject to DOJ (Department of Justice) supervision; it is Tenet, not me, that has paid hundreds of millions of dollars for misconduct, inducements, Stark violations and fraud (in a recent Georgia case); it is Tenet, not me, who blames others instead of their own failed leadership.”

Tenet Healthcare made headlines for paying off Florida state legislators to eliminate safety standards the company had been found to be violating. Tenet-owned St. Mary’s Hospital was found to be in breach of standards of practice for pediatric surgery. Tenet responded by contributing $200,000 to Florida legislators, who proceeded to withdraw the pediatric surgery standards.

Elder told Crain’s that it was “highly inappropriate and literally unprecedented for Tenet to issue a press release to 5,000 employees notifying them of alleged code of conduct violations by any physician, let alone directors.” He added, “This is nothing more than an attempt to confuse the DMC community.”

The three doctors have not been told what standards of conduct they supposedly violated.

This development comes in the midst of a contract dispute between nurses and the Michigan Medicine hospital system in nearby Ann Arbor. One of the major concerns of nurses intersects with those of the DMC doctors—short staffing.

The current mayor of Detroit, Mike Duggan, established his reputation and won the support of business interests in the city and the state by carrying out a ruthless cost-cutting operation at DMC, where he was a top executive prior to his election in 2013.

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