On September 5th, 128 faculty from the UVA Physicians Group—consisting of personnel that tend to patients and educate students—drafted a letter of no confidence in UVA Health CEO Craig Kent and School of Medicine Dean, Melina Kibbe. This letter, delivered to the Board of Visitors, raised concerns for one of the top-rated medical schools in the nation, challenging their administrative practices and the quality of care provided to patients at the UVA hospital.
“Culture of Fear and Retaliation”
The five-page letter alleges serious misconduct in patient care paired with a toxic system of management. The accusations detailed can generally be described as falling into three main categories: care, finance, and education. Kent and Kibbe are implicated directly and have been accused of fostering “culture of fear and retaliation” which contributes to “an ongoing exodus of experience” and damages “excellent-and safe-patient care.”
The first section of the letter alleges of administrative malpractice threatening patient health. Staff have allegedly been discouraged from using the “Be Safe” system meant to resolve issues during care such as improper practices, which is employed across the entire hospital- including the MICU (Intensive Care Unit). Additionally, the letter mentions the hiring of certain doctors with “concerns regarding integrity and quality” despite vocal opposition. Meanwhile, those who do raise issues surrounding patient care quality have allegedly been “threatened” and “ridicule[d]”, with important professional processes turned against them to “silence and intimidate faculty.”
Alongside allegations relating to patient cares, financial challenges were also mentioned. First, the letter claims the number of executives and managers has ballooned at the cost of funds needed to resolve important staff shortages, followed by allegations of “fraudulent billing” and “audit performance.” Lastly, the concerns have been raised over the treatment of trainees by more senior staff, challenging the educational branch of the UVA medical system.
Response from the University
These concerns immediately generated a significant amount of attention within the local media and student body, resulting in a response by UVA President Jim Ryan. In his statement issued to the faculty of the School of Medicine, he strongly denounced how the letter “besmirched the reputations of not just Melina and Craig,” but on the entire UVA medical system. President Ryan refused to remove the Dean and CEO as demanded by the letter, criticizing the lack of due process requested by the letter.
Instead, he stated that the number of signatures reflects a fairly normal percentage of dissatisfied faculty among medical institutions. Of note, President Ryan indicated that at least some of these issues have been raised previously in a more private setting, as talks have been ongoing since before the letter’s publication. Despite close door talks, the published letter significantly brightened public attention on these allegations. Furthermore, President Ryan assured the 128 signees that no action would be taken against them, and that all allegations of misconduct raised in the letter would be fully investigated.
President Ryan has not been the only high-profile voice to back Kent and Kibbe, with Bill Crutchfield, a long-time member of the UVA Health board, expressing support for the two administrators. In a statement, Crutchfeld noted the extremely high level of care and professionalism among UVA’s medical staff which has resulted in very low mortality rates, outstanding ratings, and national recognition. Both Crutchfield and President Ryan noted the relatively small number of signatures compared to the overall staff of the institution, and the outpouring of support from other staffers for Kent and Kibbe.
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