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The top physician executive at Detroit Medical Center Heart Hospital and three of its cardiologists were barred from leadership roles at the health system in retaliation for complaints about quality of care at the DMC, two of the doctors said Tuesday.

The controversy started Monday night when the DMC said it asked Drs. Mahir Elder, Amir Kaki and Tammam Mohamad to resign their cardiology leadership posts for unspecified violations of the hospital system's standards of conduct. The problems were outlined in complaints by fellow doctors and team members, the hospital system said.

Dr. Ted Schreiber, DMC's executive director of the cardiovascular service line, resigned Friday. In 2011, U.S. News and World Reports named Schreiber among the top 1 percent nationwide of interventional cardiologists. 

"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," Schreiber said in a Tuesday statement. 

"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," Schreiber added. "The unfortunate consequence of such efforts is to place into jeopardy the outstanding results we have achieved for our patients and to adversely affect the health of the citizens of the City of Detroit and Southeastern Michigan." 

The three cardiologists are being allowed to continue to treat patients. 

Elder, who was director of the cardiac care program at Heart Hospital, said he and the other doctors sent numerous emails to the health system's leaders complaining about problems, including poor care by one doctor employed by the hospital that resulted in a patient death.

"We received complaints from other physicians and team members about these physicians, and we took it seriously; we then conducted a thorough review and we are taking appropriate action," the DMC responded in a Tuesday statement. "We expect our physician leaders to demonstrate the highest level of ethical and appropriate behavior."

Elder said he did not receive anything in writing from DMC or its owner Dallas-based Tenet Healthcare that lists specific violations he is alleged to have committed. The state's Verify a Physician website lists no formal complaints lodged against any of the physicians forced to step down. 

"In our contract, it says 'standard of conduct' is to be determined against Tenet, that's it," Elder said. "They were saying it's been a hostile work environment because physicians didn't get along and staff didn't get along.

"If that's the case, then there (would) be no physicians (left) at the hospital." 

Complaints prompt shake-up

Schreiber, Elder, Kaki and Mohamad were asked to step down from their leadership roles "after an extensive review of complaints received from physicians and team members," according to the Monday announcement by J. Scott Steiner, CEO of the the DMC's Detroit Receiving, Harper University and Hutzel Women's hospitals. 

No additional details were provided in Monday's news release or in a letter to DMC employees announcing the resignations. 

Dr. Safwan Badr, chairman of the Department of Medicine, will assume direct oversight of the section of cardiology, according to the letter to DMC employees, which added that "DMC is moving quickly and thoughtfully to appoint new physician leadership."

"We expect no disruption in service to patients, and we will keep you updated as we move forward."

The shake-up follows a scandal over dirty surgical instruments at the DMC's downtown Detroit hospitals that stoked doctors' concerns over patient safety and was uncovered in a six-month Detroit News investigation published in August 2016. The health system failed state and federal inspections at several of its hospitals and were threatened with the loss of federal funding before the problems were corrected. 

"They did not fix the sterilization (of surgical instruments)," Elder said. "A surgeon opened up a tray just over a month ago and found nothing but blood matter."

DMC spokeswoman Tonita Cheatham did not immediately respond to an email requesting confirmation or comment about the incident. 

DMC said in May 2017 its dirty instrument problems were resolved after the health system spent $1.6 million on new and replacement equipment, hired additional sterilization staff, fine-tuned the chemicals used to clean instruments, and reconfigured the processes that govern when, how and by whom surgical instruments travel from operating rooms through various stages of cleaning and back again.

Why doctors spoke up

Elder shares a private practice with Kaki and Mohamad, and said that's one of the reasons the three have spoken up about problems at the DMC. Doctors who are full-time employees of the privately owned health system have been afraid to speak out of fear they'll be fired, he said. 

"We were outspoken against the changes, the firing of staff and physicians, and outspoken against some of the poor quality outcomes," Elder said. 

The cardiologist were more secure to complain because DMC was not their only source of income, he said.

"Any physician who is employed by the DMC is reluctant to speak up, because ... they get fired," Elder said. 

 

 

 

Other doctors have privately thanks the cardiologists, he said.

"Since this has happened I've had just a plethora of phone calls from physicians who've said 'Thank you for speaking up, but I can't send you an email.' Or they've sent me emails (of support) on their private email accounts," Elder told The News.

Elder wrote a letter to staff outlining his concerns, but said he was not able to send it out as a group email Tuesday morning because his email credentials were revoked. 

"When I tried to send it, it came back that my credentials were expired,' he said. 

kbouffard@detroitnews.com

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