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Standing Together- A Collective Voice Triumphs

By Robert M. Blumm, MA, RPA-C, DFAAPA President, American College of Clinicians

People standing together for an idea that they believe is as beautiful as a budding rose on Valentine's Day. Friday, February 14, Valentines Day, the Medical staff of Mercy Medical Center, with the support of PA's, NP's, nurses, administrative PA's from other hospitals and health care systems, faculty from Hofstra University, NYSSPA and ACC and APACVS officers and other parties "met the press" on behalf of a Medical Center, a PA and a Profession.

At 1 PM, the auditorium of the Mercy Lounge was filled to capacity with cameras from all of the major news channels and the reporters from all of the major news agencies that had printed previous articles on this unfolding drama. A procession of PA's in white lab coats came down the middle aisle and took seats at the side of the auditorium and near the front. These were followed by administrative PA's from other hospitals and health care systems who were seated on the platform facing the audience. Officers from the ACC, NYSSPA and the APACVS were seated on the left front of the room along with the faculty from Hofstra University. In the center of the room was a table with five microphones that were then occupied by the executive committee of the Medical Board and the vice president of the State PA Society, NYSSPA.

Xenophon Xenophontos, M.D., president of the Executive Committee of the medical staff, a vascular surgeon, opened the conference with a statement of purpose for this unprecedented event. Dr. Xenophontos explained that the medical staff is not the administration of the hospital and added "the medical staff wanted the public to be aware of their strong feelings concerning the false information that has been disseminated about patient safety and clinical care at Mercy Medical Center." Dr. Xenophontos made it clear that their purpose was neither to respond on behalf of the hospital to allegations that had been made nor to address any particular patient. He clearly stated "we will not do any patients the disservice of commenting publically on their confidential medical information or the care they received."

Robert Curran, M.D., vice president of the Executive Committee of the medical staff, an internist, was next to comment. "In the nearly 100 years of its history of service to the Long Island community, there has never before been the need for physicians,--supported by nurses, physician assistants, and other hospital staff-to gather together for the purpose of confronting the defamation of this institution. Over the decades Mercy Medical Center has provided safe, high-quality medical care for countless people. The allegations that patients are in danger at Mercy Medical Center is simply not true! As physicians who treat our patients here, we see every day that at Mercy Medical Center, close attention is paid to patient safety and to providing the highest standard of care in a compassionate environment. Unfortunately, that fact has been swept away in a storm of sound bites, photo-ops and baseless accusations." Dr Curran continued with this closing remark which looked towards the future: "In the fullness of time, the truth will become clear. But for now, we stand behind Mercy Medical Center. We put our reputations next to its name." Pointing to those assembled around him, Dr Curran commented: "We are proud to be associated with the people in this room who come here every day for the sole purpose of helping people to get better. We are proud to be associated with the Mercy Medical Center."

The next speaker was Jan Koenig, M.D., Director of Orthopedics and a well-known total joint replacement surgeon. Dr. Koenig stated that he "works in a Mercy Medical Center that is a state of the art community hospital that believes in, and lends every effort to provide safe, quality medical care, healing, comfort and exceptional service with dignity and respect for all." In speaking concerning advanced practice clinicians, Dr. Koenig said "I believe as most of my profession does in the team approach to patient care. One man or woman cannot do it alone. Physicians rely on physician assistants, who are well trained, qualified and licensed professionals. Many hospitals rely on physician assistants to maintain the high level of quality care their patients deserve. I want to thank all of our physician assistants for the vital role they play in patient care. It is a pleasure to work with these talented and well trained professionals." In speaking of the events that have surfaced this past week, Dr Koenig commented "the false allegations that have been publicized so widely have hurt the entire staff at the Mercy Medical Center. And I am personally ashamed of the behavior of this physician who portrays himself as a 'healer' but whose unfounded allegations have hurt so many innocent patients and families." Part of his closing remarks focused on the fact that perception is not always reality. Dr. Koenig forcefully commented that "I don't practice in the same Mercy Medical Center that's been in the news this past week. I practice in a Mercy Medical Center where everyone is dedicated to patient safety and high-quality care." He commented on the skills and superior training and expertise of the physician assistant in question. As did all of the other physicians, he recognized that compared to the national average, the PA mentioned, when compared to the national average of central line insertions, has a lower rate of complications than the national average, which includes lines placed by physicians.

The next powerful advocate for the PA profession and for the institution was its Chief of the Emergency Department; Dr. Daniel Murphy, M.D. Dr. Murphy immediately commands the attention of the room of participants because of his clear, strong and dynamic message. This is a physician who depends on excellent advanced practice clinicians in order to command the "heart" of the hospital. After explaining that this is an extraordinary situation he said" not because physicians and physicians assistants have gathered to show support of the hospital where they practice, but because of the reason for all this effort and stress-and time spent away from our patients- results from the actions of a physician who has issued a series of false allegations that have raised baseless fears about patient safety at our hospital. Dr. Colantonio has in fact completely-and I pray only temporarily-corrupted the quality improvement process at Mercy Medical Center which is based upon self-reporting, surveillance and oversight, confidentiality and peer review.- just like every other hospital in the United States." Passionately Dr. Murphy explained that "the unsubstantiated claims of this man are part of a calculated effort to damage the reputation of the Mercy Medical Center by a lawyer-physician who portrays himself as a hero, but in reality has no insight about his own weaknesses and is seeking retribution for disciplinary action that came from his fellow physicians-his peers." Dr. Murphy mentioned that he was told that in the last decade only 3 have warranted the severe disciplinary action received by Dr. Colantonio. "As a lawyer as well as a physician, Dr. Colantonio understands precisely what he can allege without having to stand up to the scrutiny of facts and documentation. And he knows full well that the hospital cannot respond with details that would reveal his accusations to be false, because the hospital must abide by confidentiality laws. As important as the law, the professionals before you- who have sworn the oath of Hippocrates-would never do our patients or their loved ones the disservice or the dishonor of describing their precious, personal and private health issues in a public forum." In addition, "Dr. Colantonio has taken advantage of a lack of public understanding of the role of very valuable members of the hospital care team-physician assistants or PA's. He would have people believe that these dedicate professionals-many of whom stand behind me-are unqualified and under supervised, when the fact is, that they are highly trained and perform their tasks after an order by a physician and under the supervision of physicians-such as me." He commented that he works side by side with these professionals every day and they are very valuable team players in the care provided by this physician, allowing him to provide better care to his patients. "Indeed, Dr.Colantonio has directly insulted thousands of highly trained , credentialed and licensed PA's in this country with his self serving and false manipulations-it's exactly the same as insulting this country's firemen or policemen or military-all for his personal gain and retribution."

His final words, "So let me wish you a Happy St.Valentines Day. Look around this room." (The reporters looked carefully.) "There is a collective integrity here that is not found in Dr. Anthony Colantonio. We will not be silent in the face of this character assassination. We will not allow this hospital to suffer the actions of a single individual whose agenda has nothing to do with medicine and everything to do with inflicting pain. For the love of mercy, we stand here together as one." At this time there was a spontaneous clapping and ovation from all present, including many of the reporters. Truth is a very difficult wall to assail.

The final participant of the conference prior to the reporters themselves was John Hallowell, RPA-C, a chief PA in his institution and the vice president of NYSSPA. John was the delegated PA to speak for the 8,000 PA's in New York. Usually quiet and mild mannered, he seemed to have the mantel of authority and of righteousness as he made his remarks. "These allegations have caused quite a stir, not to mention quite a bit of public speculation about the medical training, credibility, and capability of physician assistants. Whether intended or not, many readers and viewers may have been left with less than a positive perception of physician assistants. The New York State Society of Physician Assistants represents the interests of PA's throughout New York State, a state in which more PA's work than in any other state in the country. We want to express our concern about such a misrepresentation of our profession, especially when our profession is dedicated and committed to working with physicians and providing nothing but the highest quality medical care to our patients and their families." John continued by giving the audience an overview of the Physician Assistant profession, its education, training, rotations, demonstration of competencies and re-evaluations. He delineated the role as prescribed by state law and the relationship that exists between a PA and her/his supervising physician. He described the PANCE and the PANRE. He mentioned that we are nationally certified and are the only profession that voluntarily retakes their boards every six years. John explained the total scope of practice and specialty training. For the sake of those who were not present, he summarized with these powerful words that sounded like the voice that Charleston Heston heard in The Ten Commandments. "The New York State Society of Physician Assistants and over 8,000 PA's in our great state are very proud of the care we provide. We are highly trained professionals here for our patients and their families. We care about quality healthcare. We care about positive outcomes. We care about "doing the right thing." We care about our positive role in the healthcare system and we know that many, many people are living healthier, longer and more satisfying lives because they were treated by a physician assistant." And for a second time that afternoon, the room was shook by applause from those gathered.

I'm an old salt in this profession, having been a Vietnam era combat medic who became a PA upon his return from Vietnam. It is rare that I felt the pride that I felt this Valentine's Day after hearing the remarks by these dedicated physicians and this PA leader. I only wish that the PA who was falsely accused would have been present to personally see this demonstration of support. When asked by the reporters if Mr. - was working today, Dr. Koenig said, "I hope so." Upon reading the Newsday the following morning, I saw a far more fair representation of the truth and of the meeting I attended. What also made me personally proud was the reasoning behind the presence of so many. Anne Bozzarelli, PA Program Director of Hofstra was present with her faculty because this was the least she could do for an institution who was so gracious as to allow her students the privilege of being taught by these fine physicians and PA's. The administrative PA's from the other hospitals and health care institutions mentioned that this was not an option, as when one of us is attacked we are all attacked. They also stood by the PA whom they know to be an excellent representation of our profession.

What can we all learn from this catastrophic situation that created this personal and institutional pain? Perhaps it's that not everyone with whom we work has the same integrity as ourselves. Perhaps it's the fact that regardless of our skills, our education, and our personal track record (this PA has an excellent reputation among his peers) we can still become targets and victims of selfish, unfair and corrupt individuals. Perhaps it is that the news community can report in an unethical and unsubstantiated manner, destroying confidence in a profession or an institution. Perhaps it is that if you are a PA or NP or DO or MD who earnestly is committed to quality care, your peers will stand by you, your hospital will stand with you and your patients will still be proud to receive treatment from you. Perhaps there will be a recognition and an understanding that when a profession is attacked by the press that this can initiate a "witch hunt" where another similar profession can be brought into the spotlight also. Perhaps we learn that there is strength when we stand together regardless of the initials after our name. Yes, it's the power of one that can still reconcile us to the world.

I appreciate the comments of all who were present and I hope that my readers take this situation to heart. I would like to summarize this article with a comment from another physician. "Next to the promulgation of the truth, the best thing I can conceive that a man can do is the public recantation of an error." Joseph Lister 1827-1912. Can you hear me, Dr. Colantonio?