Physician Steps Down as Head of Kaiser’s Sleep Medicine Clinic

The physician came to Dr. Jeffrey Weisz’ rescue after he refused to authorize consultations with physicians outside the Kaiser system.

As the lawsuit against Kaiser Permanente’s executive medical director, drags on, the health system appears to have lost a department chief who sided with Dr. Jeffrey Weisz.

Dr. Praseeda Sridharan, chief of Kaiser’s sleep medicine department, submitted her resignation, telling colleagues she planned to remain in the department but, “four years of being chief was more than enough for my family.” She actually started Kaiser’s sleep medicine program. These details come from a memo Sridharan sent to her colleagues  obtained by The Lund Report.

Her decision to step down from a leadership role came at the same time that Weisz left Kaiser to become an independent consultant earlier this month.

Sridharan has been named in a lawsuit filed by Dr. Radhika Breaden, who worked in her department. Breaden alleges that Sridharan told her not to blame Weisz for cutting back on outside referrals, saying, “We as an organization have been irresponsible in loosing [sic] dollars at outside cost and providing poor care at outside facility and bleeding large amount of $$ to physicians who are trying to milk out of Kaiser …. We also are great at reimbursement and hence made several folks like Dr. Gaber [sic] millionaires.”

Working Conditions Under Weisz

Details are emerging about the working conditions at Kaiser Permanente under the leadership of Weisz. Other former employees have started coming forward saying that Weisz reduced staff to increase profits at Kaiser, including enforcing strict attendance policies that pushed out “employees in droves.”

Part-time employees and working parents, in particular, were discriminated against, they told The Lund Report, which put patients at risk. Employees were only allowed two absences during the year; any other absences led to corrective action, resulting in that person losing their job.

When this policy did not reduce payroll enough, a new twist was added. If an employee called in sick, their manager was told to call the employee back on their home phone. If they didn’t answer the phone or return the call, that absence was considered fraudulent. Also, chronic understaff11ing led to vacation time being regularly denied, while this management style led many staff -- nurses, respiratory therapists and laboratory scientists – to leave Kaiser.

And, when the new hospital in Hillsboro Oregon was built new jobs were created, but most of these positions were considered “variable shift,” making it difficult for working parents, while the unions were powerless to help since these were considered new positions.

“Employees targeted by such harsh policies were left to fend for themselves without the ability to be compensated for unfair dismissal,” one employee confided in The Lund Report. “Many, many employees with exemplary records were pushed to resign or dismissed. Many whistleblowers without dramatic, unquestionable cause and effect relationships were harmed. Management knows people with careers in healthcare don't exactly have another industry where their skills can be applied without starting at the bottom of the pay scale and career ladder. They also know that employees chose these careers, because they genuinely care about their patients.”

Ted Mathews, the San Francisco-based attorney who represents Drs. Breaden and Jennifer Lycette, called these allegations “absolutely consistent with what our clients have experienced.”

Kaiser lost the first round of these multi-million dollar lawsuits after Multnomah County Circuit Court Judge Youlee Yim You determined there was evidence of gender discrimination, wrongful discharge and sufficient facts to support a whistleblower retaliation claim.

‘These are great victories for patients in Oregon and for women in Oregon,” Mathews told The Lund Report. “This case is going to give these two fine doctors the opportunity to provide they were victims of retaliation for patient advocacy and victims of systematic discrimination against women.”

In her ruling, the judge said the term emotional has been historically used to castigate women, which, “is akin to saying she is hysterical,” adding, “This remark combined with the elimination of part-time positions held only by women constitute sufficient facts to support a hostile work environment theory.”

Breaden contended that Weisz shouted at her, humiliating her in front of her peers, taking away vacation time, attempting to deny her corneal transplant and excluding her from department activities.

For her part, Lycette had reported concerns about understaffing and was told by the chief of medical oncology that she was being emotional and her part-time position was being eliminated. This occurred after she had been highly praised for doing well at her job, had a high patient load, was highly productive, had high patient satisfaction cores and never received discipline, according to her lawsuit.

Both cases now proceed to the discovery phase, Mathews said.

When reached for comment, Michael Foley, Kaiser’s communication manager, said “We are not going to comment on the court pro

Allegations Against Weisz

Weisz “found ways to minimize payrolls by shrinking staff while patient loads skyrocketed, often leaving the remaining staff members trying to cope with impossible patient care demands, which ultimately harmed Kaiser’s patients,” according to both physicians.

Breaden joined Kaiser as an internist in 2000, and started focusing on sleep medicine in 2007.

Her lawsuit alleges that Weisz’ decision to maximize profits by decreasing outside referrals created a zero-tolerance policy for patients needing to be seen by physicians outside the Kaiser setting, and that decision jeopardized the lives of many patients.

“Before Dr. Weisz’ arrival, Kaiser had a culture of open dialogue and putting patient care first,” her lawsuit alleges. “The primary goal of all discussions was preservation and improvement of the quality of patient care.”

Breaden found it difficult to help her patients find adequate treatment at sleep medicine clinics because they were restricted to the Kaiser facility and often had to drive long distances after being evaluated and treated were in danger of getting in sleep-related vehicle accidents.

Sharing her concerns led to Breaden being “retaliated against, humiliated and ostracized for interfering with Kaiser’s attempts to make as much money as possible at the expense of patient care,” her lawsuit alleges, yet Breasen refused to remain silent.

Kaiser’s reluctance to allow patients to seek treatment at outside clinics led, she says, to at least one motor vehicle accident where a sleep medicine patient fell asleep while driving home to Salem from Kaiser Sunnyside Medical Center, resulting in severe injuries.

Breaden’s suit claims she was retaliated against after encouraging another physician, Dr. Alistair Scriven, to appeal a decision after Kaiser denied a request to allow his patient to seek outside care for a sleep disorder.

As a Kaiser member, Breaden was also denied a corneal transplant procedure by a local ophthalmologist outside the Kaiser system that had been approved prior to Weisz joining the medical group. Later, her appeal was successful.

Breaden insists she was repeatedly humiliated, forced to provide substandard care and was put in a position where she could have violated the law. In August 2012, she lost her job and is asking for $5 million in non-economic damages and $4 million in economic damages.

Profit margin paramount

The lawsuit filed by Lycette who specializes in hematology and medical oncology, shares many of the same issues, saying Weisz was more concerned with maximizing profits.

Before joining Kaiser’s staff in 2006, Lycette’s colleagues had assured her that they had never experienced any limitations on treatment protocols and could refer patients for outside expert consultation or to clinical trials. Lycette says she needed such assurances after fearing “Kaiser would reject her patients from life-saving clinical trials or expert consultations just to increase profit,” but was told that was not the case.

After Weisz came on board, however, things changed drastically, she alleges, and he demanded that medical oncologists perform bone marrow biopsies during a patient’s initial consultation, telling Lycette she should rush through the patient on their first visit to maximize profits.

When Lycette challenged his authority, saying his demands were not feasible and were outdated, Weisz began shouting at her in angry and threatening manner which led Lycette to tell Weisz she had more knowledge than he had about the current practice of medical oncology, and had the highest patient satisfaction rating in the department at 89 percent.

Later, in February 2013, Weisz announced that all part-time positions in the department would be eliminated even if that would disproportionately affect the number of women in the department – among them Dr. Phoebe Trubowitiz and Dr. Kathleen Kemmer. Since then, Lycette claims that other outstanding female physicians have resigned rather than be forced to endure further humiliation and pain or be fired – including Kemmer, Trubowitz,and Drs. Tarun Bains and Michele Chernesky.

Lycette, who resigned in April 2013 because of her oath to do no harm and her belief that Kaiser policies were "making patients suffer," she alleges, is asking for $5 million in noneconomic and $2 million in economic damage.

Diane can be reached at [email protected].

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