Salem Physician Believes Salem Hospital Breached Court Settlement

August 23, 2011 -- A native Oregonian, Dr. Elizebeth Harmon moved to Salem in 1988 to practice medicine.  She didn’t know that decision would be fraught with conflict.

With obstetric and gynecology privileges at Salem Hospital, Harmon was an outspoken advocate for patient safety and respect as well as innovation, and her ideas were often met with resistance. 

 “I was always at odds with them,” Harmon said.  “I always wanted to go one step further for patients.  I like things to be safe, and I like things to be fair.”

After working a few years at a large multi-specialty clinic, Harmon tired of corporate medicine and opened Salem Women’s Clinic in 1991, a practice for women by women.  “It was wildly successful,” Harmon reflected.  “We were the only women in town doing women’s health.”

Eventually, Harmon hired midwives because she thought she was doing too many c-sections in the hospital. At the time, there was one other group of midwives serving women in the area, Salem Nurse Midwives, which later moved to Silverton.

For nearly 20 years, Harmon was on the medical staff of Salem Hospital. Then in January 2007, her obstetrics credentials were suspended, leaving her midwives without back-up coverage if something went wrong. The future of Harmon’s practice was at risk.

In a pinch, she found back-up coverage for the rest of that year but eventually had to let the midwives go.  She sensed the hospital wanted to deliver more babies on their own turf. Her suspicions were confirmed when she let her midwives go on a Friday, and Salem Hospital hired them the following Monday. 

To Harmon’s dismay, after the hospital suspended her obstetric privileges, not a single physician would speak out on her behalf.  “I was told their lawyers advised them not to get involved,” said Harmon who believes doctors were fearful of retaliation by the hospital. According to Harmon, Salem Hospital has rules that prohibit doctors from saying anything negative about the hospital. That could not be confirmed because the hospital said they could not comment on legal issues.

After losing her obstetric privileges, Harmon didn’t close her practice; she just redesigned it, and stopped delivering babies.  Now she wonders if the hospital thinks she’s trying to build an empire.  “What they (the hospital) didn’t understand was that I was successful because people came back, not because they came in the first place.”

Harmon, who still has gynecology privileges at the hospital, said she’d never go back to delivering babies – nor can she.
 

In 2007, she brought suit against the hospital, alleging it was using monopoly power to shut down her clinic. In 2009, she settled out of court. According to the terms of the settlement,

• Harmon would not ask to have obstetric privileges in the hospital again
• Neither the hospital nor Harmon would “bad mouth” each other
• The hospital would buy out the contracts the midwives had with Salem Women’s Clinic (they had a non-compete clause)
• The hospital would credential any doctors Harmon hired for her practice just like everyone else

Harmon says she didn’t lose the case; she just decided there was no point in fighting the hospital any longer. “The real losers are the community,” Harmon said.

Recently she rescinded the agreement based on her belief the hospital didn’t hold up its end of the bargain.  “I was following the agreement to the letter, and Salem Hospital violated the agreement multiple times,” Harmon explained. “The agreement was basically not in effect for the hospital only for me.” 

Last year, Harmon hired Dr. Karyn Tapley, who completed her residency at a prestigious program, Christiana Medical Center in Delaware, and had a spotless record.  “You couldn’t have asked for a better doctor,” added Harmon, who said the hospital didn’t accept Tapley’s application and wouldn’t explain why.  

Tapley and Harmon were dumbfounded by the rejection.  Discouraged, even after starting to appeal the decision, Tapley leaves the Salem Women’s Clinic the end of August after finding a different position.

From Harmon’s perspective, this is not only a breach of the contract from the court settlement, but an unfair trade practice.  Especially since Salem Hospital credentialed four OB/GYNS for their own practice at the same time they denied Dr. Tapley’s application and also credentialed two OB/GYNS for Salem Clinic.  Now Salem Clinic has eight OB/GYNS, the hospital has eight OB/GYNS and Salem Women’s clinic has one -- Dr. Harmon. 

“They’re using their power as the credentialing body for the hospital to prevent my practice from growing while they grow their own practice,” Harmon asserted. “I should not need a contract for fair business growth in our community.  The fact that I had to try and negotiate fair treatment is a problem in itself.”

Salem Hospital declined to comment. “We can’t discuss legal issues,” said Julie Howard, the hospital’s spokesperson.

By undercutting her practice, what does this mean for women’s healthcare in Salem? Harmon asks. “Who’s going to offer good care for the women of Salem (if she doesn’t)?” 

Despite her personal experience, what’s at stake is much bigger than her own practice, Harmon said. “The real issue is that all of the physicians on staff at Salem Hospital are working in an environment of fear and distrust. This environment is not conducive to good patient care for doctors, patients or the hospital.  In the end, the environment of fear hurts us all.”