Doctor’s Orders

One of the most senior doctor-professors at the county‘s Martin Luther King Jr. Medical CenterCharles Drew University Medical School has been accused, in a union grievance, of ordering faculty physicians to work, sometimes without pay, in his own private clinic.

A top county Department of Health Services official acknowledged the grievance this week, and assured the Weekly that “at this moment,” the questionable activity has been stopped. DHS Assistant Director Donald Thomas added, “We’re still in the process of investigation.” Both county and Drew University officials are handling the investigation, he said.

The complainants are being referred to by some county-health insiders as the “Imperial Heights Eight.” The grievance was filed with the Los Angeles County Employee Relations Commission by Joe Bader, who heads the Union of American Physicians and Dentists (UAPD), which early this year won the right to represent the county‘s public-health physicians.

The UAPD grievance emerged this autumn, after the involved physicians and several colleagues -- in all, eight fully qualified teaching doctors employed by Los Angeles County for upward of $100,000 per year at the Imperial Heights Health Center -- said they were admonished by Dr. Ludlow B. Creary and an administrative assistant for protesting to county Department of Health Services Director Mark Finucane about some of Creary’s work assignments.

These assignments allegedly were sometimes scheduled either for regular county work hours or for the doctors‘ days off to be carried out at a private clinic run by Creary, according to documents filed with the grievance.

According to an unsigned memorandum from the doctors to Finucane, dated August 10, the doctors initially believed that the Drew Family Practice Medical Group at Daniel Freeman Medical Center in Inglewood was a public King-Drew facility, “with the sole purpose of providing [medical] residents and students with an educational experience in a managed care environment.”

The memo said that several of the doctors gradually grew disillusioned with the arrangement, “because they were not paid in a timely manner, or were not paid at all.” Nevertheless, the memo asserts, other doctors continued to work at Creary’s clinic on their days off, without pay, “because they believed that this type of sacrifice was necessary to insure that our resident [physicians] obtained proper supervision.”

But this enthusiasm flagged, according to the memo, mainly “due to the paradox of what appeared to be a lucrative private practice that apparently had no resources available for physician compensation.”

Creary, who for nearly 25 years has chaired the Department of Family Practice at the controversy-plagued King-Drew hospital, termed the doctors‘ allegations against him “false and slanderous” in his own responding October memo. He further used language that the complaining doctors said they found threatening to their careers.

According to an unfair-labor-practice charge also filed by the union, “On Sept. 1, the [eight] physicians were threatened with loss of their MLK-Drew jobs . . . as the result of their disclosure of the illegal activity.”

This document further alleges that Patricia Mathews-Juarez, the executive coordinator of Creary’s department -- who is also an administrator of Creary‘s private clinic at the Freeman Medical Center -- “threatened [them] with the loss of their jobs as the result of their disclosure.”

The incident is but the latest example of the discord that has occasionally marred operations at King-Drew. Founded in the aftermath of the Watts Riots under the guidance of late 2nd District County Supervisor Kenneth Hahn, the King-Drew medical center was created to serve the then largely African-American population of South Los Angeles County, as well as to provide opportunities for medical education for minority students. Its founding responded to complaints by 1960s black-community leaders that their community lacked its own medical services.

In the nearly 30 years since King-Drew’s completion, the surrounding population has become mostly Latino, while several competing private hospitals have also moved into the area.

Perhaps the most publicized problem at King-Drew over the past decade has been an alleged pattern of discrimination occurring between some senior African-American staff and their subordinates, many of whom are Hispanic.

Alan Clayton, of the Los Angeles County Chicano Employees Association, said that at least twice, the county‘s civil service board has found in favor of such employees.

Other problems have included a high rate of county malpractice lawsuits and claim payouts for patient deaths and other patient-care mishaps -- $1.32 million in 1994 alone, the year an official county “bed audit” also found the hospital seriously behind in collecting its patient accounts due. But King-Drew has also had a persistent issue involving the ongoing private practices of senior staff members, many of whom are employed by the county on a full-time basis at the hospital, its associated medical school, or both.

Hospital insiders suggest that this situation leads both to treatment delays at King-Drew and, in some cases, to fatal mistakes in the treatment of patients. It has been suggested in court documents that some of these mishaps might have been avoided if young physician interns and residents were working under the proper supervision of their seniors.

It has also been suggested that the private-practice-vs.-public-service problem is not unique to King-Drew within the county’s health-care system.