By Dan Hust
FERNDALE — July 27, 2010 — Two weeks before the 40th anniversary of his medical practice in Sullivan County, Dr. Donald Roth was fired by Catskill Regional Medical Center (CRMC).
Two days later, that termination was rescinded.
Two hours later, it was reinstated, and Roth was told to immediately leave his Liberty Medical Group practice in Ferndale, even though he owns the building – the Liberty Professional Plaza – in which it sits.
But by the time his anniversary swung by on July 7, Roth was back at work, thanks to a temporary restraining order granted by Acting Supreme Court Justice Mark Meddaugh.
That’s set off a court battle between two community institutions – Dr. Roth and CRMC – and led at least one patient to begin a petition drive.
Neither Roth nor CRMC would comment for this story, but documents filed in court shed some light on the situation.
A native of Swan Lake, Roth has been a practicing general physician for four decades, first with Dr. Alan Schwalb, now with Alan’s son, David, a fellow Sullivan County native.
Roth’s been employed with CRMC since 2001, as the hospital’s five-year contract with Liberty Medical Group was renewed in 2006 and stands to expire this coming February.
On June 21 of this summer, however, CRMC Vice President and Chief Medical Officer Peter Panzarino sent Roth a letter saying his services were no longer needed. No reason was given in the letter, and only Roth – not his practice – was being let go.
According to court documents filed last week, CRMC CEO Steven Ruwoldt indicated the firing was due to the hospital’s dissatisfaction with his activity level and cooperation.
“Since 2006, CRMC has been attempting to make changes in its Liberty Medical Group family practice in order to make the practice more economically viable,” Ruwoldt stated in a July 14 affidavit to the court. “These changes are needed because, with the number of patients seen by the practice, the expenses of the practice have consistently exceeded its revenues by a considerable margin.”
Ruwoldt noted the practice had lost more than $400,000 in 2009, with higher amounts in years prior. He also provided a report indicating Roth saw 785 patients from June 1, 2009-May 31, 2010, as compared to Schwalb’s 2,041 and similarly higher amounts for a physician’s assistant and nurse practitioner employed at Liberty Medical Group.
Ruwoldt alleged Roth was given the opportunity to increase efficiency and patient volume but resisted, preferring instead “to maintain a ‘boutique’ low-volume practice.”
Roth’s salary was lowered several times as a result, but by June 21 Ruwoldt felt further efforts would be futile.
“Shortly thereafter,” he stated, “I was urged by a member of the CRMC Board to reconsider Dr. Roth’s termination and attempt once more to come to terms with Dr. Roth about how the practice would be conducted going forward.”
Thus on June 23, a letter rescinding the termination was sent to Roth, personally delivered by CRMC Vice President of Professional Services Geraldine Orr.
Ruwoldt and Orr both alleged in court documents that Roth responded with an expletive, which they felt was directed toward Orr.
“Dr. Roth’s profane, abusive and insubordinate reaction to my June 23, 2010 letter eliminated my willingness to continue to attempt to work with Dr. Roth,” Ruwoldt told the court.
So another termination letter, worded the same as the first, was sent to Roth later that day.
Roth’s account to the court, however, paints a different picture, one that accuses hospital management of engaging in a personal vendetta.
“Mr. Ruwoldt knows that I have been persistent in my attempts to improve patient care at the hospital and to address the hospital’s HIPAA violations and other improper practices,” Roth stated in a July 22 response to Ruwoldt’s affidavit.
In an earlier court filing, Roth included performance evaluations from late last year indicating Panzarino – and thus CRMC – felt Roth was meeting or exceeding every standard.
“Excellent clinician – a pleasure to work with,” wrote Panzarino on August 25, 2009, according to Roth’s affidavit.
In addition, Roth sent the court four reports and an e-mail listing his concerns with care provided to his patients at the hospital’s emergency room in Harris. He alleged emergency room personnel misdiagnosed patients, missed important health conditions, and prematurely discharged those seeking care.
“In each case, I spoke with my supervisor, Dr. Panzarino, about the substandard care and expected that each of these matters would be investigated and corrected,” Roth stated. “Unfortunately, the substandard care rendered at the emergency room was not rectified.”
Roth also alleged “ongoing harassment” from CRMC Compliance Officer Marc Mendelsohn, stating he reported Mendelsohn’s conduct not just to CRMC management but to the Office of the Inspector General.
As for the efficiency concerns, Roth replied that CRMC, not he, has been resisting efforts to improve. He complained of “no movement” on electronic medical records, short staffing and lack of supervisory support.
“Despite this lack of support,” Roth stated, “I cannot leave my patients in the lurch because someone has retaliated against me because I have criticized what I consider to be improper practices.”
He added that, at age 67, he cannot keep up his former pace of seeing patients and has thus voluntarily reduced his working hours of late, claiming that is what led to the salary reductions.
Roth did admit to uttering a profanity when Orr delivered the rescission letter, stating he was “totally bewildered.”
“The fact that two hours later I was given another termination letter should speak volumes as to the vindictiveness and bad faith on behalf of the hospital administration,” he told the court.
Ruwoldt denied taking any retaliatory actions, explaining that he had already put the emergency room contractor, MedExcel of New Windsor, on probationary notice that its performance “was under review and would need to improve if the current group wished to continue to provide service to CRMC.” (MedExcel continues to be the hospital’s emergency room contractor.)
Currently, Roth remains employed with CRMC, thanks to a restraining order temporarily halting his termination. But in the interim, his salary has been cut even further by the hospital.
According to court documents, neither Roth nor CRMC anticipate keeping him past the February 2011 expiration of the Liberty Medical Group’s contract with the hospital.
So a judge will have to decide what that contract says in regard to Roth’s firing. At issue is the contract’s language pertaining to “optional termination,” whereby CRMC can fire Roth without cause so long as he’s given 120 days’ advance written notice. (Roth can also leave the hospital’s employ in this manner, also without cause.)
The hospital says that’s what the June 23 letter did, but Roth counters that, by telling him to vacate the premises, he would just be collecting a salary – currently $100,126 a year – for doing nothing.
Roth feels the contract allows him to work for those 120 days, while Ruwoldt said CRMC is worried Roth will simply use it to establish an independent practice at the hospital’s expense.
“Given the severity of the losses being experienced by CRMC’s Liberty Medical Group ... it is critical to the survival of this practice that CRMC be able to implement changes and improvements now rather than being forced to wait months for Dr. Roth’s notice period to expire,” Ruwoldt added.
“The four-month notice provision in the employment contract was put in for an important reason: to afford me sufficient time, if I was terminated, to establish an independent practice, to assemble a competent medical staff and find new space and equip my office,” Roth acknowledged. “It is unconscionable that the hospital should be allowed to have my patients be abandoned and to prevent me from conducting the general practice which I have enjoyed and relished and which is an intricate part of my life.”
Roth is being represented by Monticello attorneys Marvin Newberg and Stephen Lungen, while the hospital has retained William Murphy of the White Plains firm of Bleakley, Platt and Schmidt.
More papers are being filed in the case, so when a judge will make a determination remains uncertain.