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home : opinions : opinions February 5, 2016

4/2/2013 5:00:00 PM
GUEST OPINION: Medical staff attorney responds to allegations
By Dean J. Smith
Taylor Blessey, LLP

It seems that nearly everyone in Blythe has an opinion about Palo Verde Hospital. Under the circumstances that is certainly understandable. But there are a few misconceptions that seem to be driving much of the controversy which has surrounded the Hospital for more than a decade.

First of all, despite what has been reported in this newspaper, the doctors are not the bad guys. The bad guys are the ones attacking the doctors with a well orchestrated smear campaign which seeks to "take back the hospital," as though the doctors are "holding it hostage." The problem with that argument is that without the doctors there is no hospital.

There are some in town who wonder why the Board doesn't just "get rid of" the doctors (or at least one in particular). Well, it just doesn't work that way. Doctors are not employees of the hospital. They cannot be "fired." The reason for that is a matter of public policy. The State of California decided long ago that it is in the best interest of patients that their doctors' medical judgments are not subject to second guessing by people "supervising" them who have never gone to medical school and who have never completed a residency.

Doctors practice at a hospital, not because they are employees, but because they have been granted "staff privileges" after going through a process called "credentialing" or "peer review." Prior to being granted staff privileges a doctor is required to submit an application and his or her credentials must then be reviewed by other doctors (his or her "peers") who will then make a recommendation to the governing Board of the Hospital to either grant or refuse to grant the doctor the staff privileges he has requested.

California law actually requires that all "peer review" of doctors be done by doctors, and only by doctors. That includes the process required for assessing initial membership applications, the process for assessing applications for reappointment and any disciplinary investigations and actions which may come up from time to time. California law also provides that the only entity in a hospital which is legally authorized to conduct this peer review is the hospital's medical staff; not the governing Board and not the CEO.

That is not something the Medical Staff at Palo Verde Hospital just made up. It is the law in California and in every other state in the United States.

After reviewing an applicant's credentials, if the Medical Staff recommends that he or she should be appointed, or that an existing member should be reappointed, for the most part, the governing Board is simply not obliged as a matter of law to second guess that recommendation. It generally must accept it. And that is what usually happens. If the Medical Staff gives an adverse recommendation to an applicant physician, he or she is entitled to a hearing by a panel of physicians called a "Judicial Review Committee" or "JRC." The decision of the JRC is then only appealable under very limited circumstances. And again, for the most part, the Board is simply not obliged to second guess the decision of the JRC. And they usually don't.

In fact, in every other hospital in America, that is how it works. When the Medical Staff makes a recommendation, the governing Board follows it. Most of the time, that is how it has worked here in Blythe; but not always.

It has been reported in this newspaper that last year the old Palo Verde Healthcare District Board disregarded the recommendation of the Medical Staff and made the decision to renew Dr. Sahlolbei's privileges for only three months, rather than the standard renewal of two years as is called for by the Medical Staff Bylaws and the regulations of Joint Commission of the Accreditation of Healthcare Organizations. That decision by the Board was improper and when Dr. Sahlolbei appealed, a JRC composed of three well qualified outside physicians agreed that it was improper and they recommended that Dr. Sahlolbei should be given a full two year reappointment. The new Board recently agreed and approved Dr. Sahlolbei's reappointment for a full two year term.

That should really be the end of the discussion, because California law also makes physician peer review strictly confidential. That means no matter how much the public might wish to have an explanation of the reasons for a particular recommendation by the Medical Staff they are simply not permitted to know. Again, that is not something unique to Blythe. That is the way it is throughout California and every other state.

Secondly, there are those who have criticized the Medical Staff for being "greedy" and "litigious." Yet, bear in mind that while the Medical Staff has filed three lawsuits against the Hospital and its governing Boards in the past 10 to 12 years, they have never sought money damages and in each case the Medical Staff won. In each case, a Superior Court judge issued an injunction against the governing Boards of the Hospital who they sued. I cannot over emphasis how rare that is. The Medical Staff has prevailed each and every time they have gone to court.

So, ask yourself this question. If the Medical Staff is the "problem," why does it keep winning? If the Medical Staff is the problem, why has three different well respected Superior Court Judges issued injunctions against the governing Board? The truth is that this situation is so unusual that I am not aware of any other Hospital anywhere in the United States where the medical staff has successfully sued its governing Board even once in ten years; let alone three times.

Last November there was an election that changed the makeup of the Palo Verde Healthcare District Board. Elections are supposed to have consequences. They are supposed to reflect the will of the people. Yet, for apparently purely political reasons, the outgoing Board tried to thwart the will of the electorate by illegally trying to tie the hands of the incoming Board members in order to orchestrate their eventual failure, probably to begin jockeying for the next election.

First, they tried to lock the new Board out completely by illegally attempting to delegate essentially all of the Board's power to the former CEO. When the Medical Staff intervened and the courts prevented them from doing that, they tried to tie the hands of the new Board by claiming multiple conflicts of interest. At the same time, the old Board's legal counsel continued to pursue the old Board's political agenda by pursing litigation against Dr. Sahlolbei. Fortunately, all of those political "dirty tricks" have now been undone.

As the Medical Staff's attorney, I have read the recently dismissed complaint which was filed by the prior Board against Dr. Sahlolbei. I can tell you that based on what I read I am not surprised that Dr. Sahlolbei's demurrer was sustained. The new Board made the right decision when it voted to dismiss that case. In my opinion, the case was meritless. It was just another in a long line of "scorched earth" plans to try to get rid of Dr. Sahlolbei, who often says things that need to be said, even though some people do not want to listen.

It is time for everyone in this Blythe melodrama to put politics aside. It is now time for rebuilding. There is now a new Board and a new Administration and they both need to work with the Medical Staff for the good of the hospital and the people of Blythe. When that has happened in the past the hospital has prospered. It needs to happen again.

Related Stories:
• TIMES EDITORIAL: No justice for the residents of Blythe and the valley
• Healthcare District Board drops suit against Sahlolbei
• FPPC rules Hudson has conflict and can't vote on issues concerning hospital chief of staff, Sahlolbei
• TIMES EDITORIAL: Hospital's new interim-CEO might be too ethical to last
• Healthcare District files lawsuit against hospital surgeon, Hossain Sahlolbei

Related Links:
• Drop in patients and surgeries pushes hospital to financial brink
• Former DA warns board members of potential conflicts
• Sahlolbei no stranger to courtrooms: Hospital Chief of Staff has sued at least 17 people in Riversid

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Reader Comments

Posted: Friday, April 5, 2013
Article comment by: One objection

C'mon. "Haters", I hope, does not really apply to anyone here. Just because I, for one do not agree with you on an issue, please do not elevate that to hatred. It just is not true. If your reaction is hatred, I really feel sorry for you, as hatred will consume you. I do not respect YOUR OPINION on something. That is certainly not saying I hate you or even hate your opinion. Let's stop the emotional condemnation, as it solves absolutely nothing. It only shows us to be fools.

Posted: Friday, April 5, 2013
Article comment by: dale smith

Get Sandy and her friend Trina out of there. How did the people of Blythe get fool. Wow recall, recall . Come on People of Blythe make Blythe the Great Place it use to be.We can do it .

Posted: Friday, April 5, 2013
Article comment by: @ carrie cat

I got the same junk...The hospital is trying its best to convience people to use the hospital...The hospital is in need of patients...Not all will use it as long as the mec is in charge..I refuse to even go to my family doc.scence the last election..when I learned who and what he really is...I lost all trust and faith in him...

Posted: Friday, April 5, 2013
Article comment by: Carrie Catt

I just received the latest propaganda from Doctors Brooks and Paglinawan. It is the usual untruths and misrepresentations. Palo Verde Valley Times is the only entity willing to tell the true side of the story. The individuals cited in the letter currently have their hands tied due to legalities. Methinks, the current Board and Doctors protest too much. The more you stir a pot of feces, the more it stinks.

Posted: Thursday, April 4, 2013
Article comment by: @ Bill Brooks

I love your comment and so agree with you...

Posted: Thursday, April 4, 2013
Article comment by: The Shadow knows

If the medical doctors are not the problem why is the hospital still losing money? The three amigos fired everybody in Jan. this is April...Surely they are not going to keep blaming Mr. Klune and the old board! The people in Blythe are begining to come out of their coma and discover the real truth!

Posted: Thursday, April 4, 2013
Article comment by: Once Again

This is just another example of the lack of talent available to us in Blythe. We have very little experienced people in our community to manage complex systems. We wonder why we feel like we are continually being taken advantage of by greedy outsiders and sketchy old timers. The fact is we can't take care of ourselves and we have no intention of educating ourselves to the level needed to manage any of our locally governed agencies. Relying on attorneys to explain the laws that we should be following clearly signals we have no business attempting to run a hospital. So, we'll continue to be guided by bullies that have no business assuming the responsibility they have.

Posted: Thursday, April 4, 2013
Article comment by: Bill Brooks

"So, ask yourself this question. If the Medical Staff is the "problem," why does it keep winning?"

Because not all of us here just fell off a hay truck and we do try to exercise some insight after reading your words. So, it would appear 'the system' is set up to stack the deck in favor of doctors no matter what, counselor. Lovely. 'It's just the way things are, and there ain't nothin' you can do about it' is the theme I got from your long-winded screed. Aside from law and medicine, you must realize there are very few industries afforded the luxury of an 'our way or the highway' mentality. Most of us choose to exist on this planet as contributing members of society, not in one of our own egotistical creation, where I believe many doctors and lawyers prefer to live.

You imply a doctor is a profession of complete self-employment. Fine. Some may have a private practice, while others work in hospitals where they have a board of directors. Mileages vary.

You also state California law (and every other state) says board members have little to no authority over the doctors. Thus, outside of malpractice and the hippocratic oath, the doctors can't and won't be held accountable to anyone but other doctors, even if they are egotistical jerks and have the personality, demeanor and bedside manner of children most of the time.

Nothing you have explained here really instills any resolution, positivity or new confidence in this situation or the medical industry in general. You must be a lawyer because you seem incapable of comprehending simple concepts like small-town drama and common sense.

You only wish for the drama surrounding this situation to cease because you won. This is akin to a drug dealer expounding on the finer points of abstinence right after unloading a whole bunch of his product on the streets. It's hypocrisy at its finest. Thanks for the source of amusement, though.

Posted: Thursday, April 4, 2013
Article comment by: @ To the Blythe HATERS

"when you do not have a hospital, don't baaaa to me"
We won't blame your, we will blame the MEC and their board Sam Burton, Trina Sartin and Sandra Hudson!!

Posted: Thursday, April 4, 2013
Article comment by: @ to the Blythe Haters

Yes you are so right.. God loves each and every one of us...But you have to remember God does also disipline us for our wrong doings..And you or his supporters can't say that he hasn't done wrong in so many ways ..His day is ahead of him..Watch he will fall...People say he is a good doctor ...Good doctors in my opinion never get mal practice law suits againest them so rave on about what a good doctor he is..PVVT keep us informed please..

Posted: Thursday, April 4, 2013
Article comment by: EL PICA BUYAS

@Tweety if your feathers were to be plucked would we see the real you or a Board Member masquerading as a citizen of Blythe.

Posted: Wednesday, April 3, 2013
Article comment by: just me

To guest opinion...Do you not know the Bible tells us clearly to be aware of Lawyers and Doctors..Your not so awesome information leads me to believe you and that great Doctor you mentioned are the ones we need to pay close attention to and avoid you and ignore your write ups..He has been the hospital's problem all along and wiil continue to be as long as he is here..You think this will bring patients back to the hospital think again ...There are alot of staff members and three board members that look like and are like the letter S

Posted: Wednesday, April 3, 2013
Article comment by: AJ McKay

And the complaining continues. Yaaawwwwnnnnn.......

Posted: Wednesday, April 3, 2013
Article comment by: To the Blythe HATERS

Never have I read a more foolish group of comments. You choose to believe The Times (deleted) Be like sheep if you like, when you do not have a hospital, don't baaaa to me. Can none of you open your mind ? You talk of God, he loves Dr. Sahlolbei too.

Site Administrator's note: A portion of this comment has been removed because it violated our Terms of use Agreement.

Posted: Wednesday, April 3, 2013
Article comment by: Anon ymous

Before you all go any more crazy commenting, why don't you inform yourselves?

If you are just complaining, to complain, then go ahead and continue.

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