The accrediting agency for physician training programs nationwide has denied Summa Health's request to restart its emergency medicine residency program.
In a short memo sent to employees Tuesday, Cindy Kelley, vice president of medical education for the Akron-based health system, said the full letter detailing the reason for the denial will come within 60 days.
"At that time, we can address the areas for improvement and look forward to submitting the application again," she wrote in her memo.
"While this is disappointing news, we know that we are building the core faculty and infrastructure for a strong emergency medicine residency in the future. We look forward to continuing this journey," she wrote.
In February 2017, the Accreditation Council on Graduate Medical Education (ACGME) revoked the hospital's ability to train resident emergency department doctors because of problems resulting from an abrupt ER physician staffing change on New Year's Day. Negotiations failed between the health system and Summa Emergency Associates, the group that had staffed the Summa emergency rooms for more than 40 years.
The switch to Canton-based U.S. Acute Care Solutions (USACS) resulted in upheaval at Summa, including the resignation of then-CEO Dr. Thomas Malone within weeks after hundreds of doctors voted no confidence in his leadership.
In revoking Summa’s emergency medicine residency program, the accreditation council determined there were delays in obtaining specialized care for patients with possible strokes and that first-year residents and rotating residents were seeing patients without supervision and patients were being sent home without ever been seen or examined by an attending physician. There also were allegations of intimidation of resident doctors and a ruling that the new teaching staff lacked the experience to train new doctors.
The demise of the emergency medicine residency program, effective in July 2017, meant 21 trainees in what was to be a three-year program had to find new programs. Most left the area, with a few going to Akron General.
In a statement to the Beacon Journal, Summa Interim CEO Dr. Cliff Deveny said: "We have made a great deal of progress in our emergency departments during the past year. And while we would have liked a different outcome from the residency application process, we remain fully committed to working with our colleagues at USACS to start a new Emergency Medicine Residency Program at Summa. To that end, we look forward to receiving additional feedback from the ACGME so we can understand why the decision was made and how to best incorporate that feedback as we move forward."
Summa has been working to rebuild its program.
In the fall of 2017, U.S. Acute Care Solutions hired Dr. David Seaberg and he was named Summa’s chairman of the emergency department. Seaberg came from the University of Tennessee, where he chaired the emergency medicine department and was former dean of the college of medicine. He also established five emergency medicine residency programs.
When Summa turned in its 326-page application to the national accreditation council this April, Seaberg said he had almost finished recruiting new physician faculty members for the program. The health system had a site visit in June and hoped to get approved by the accreditation council's special subcommittee at its meeting last week to be eligible to participate in the national match of medical students to begin next July.
U.S. Acute Care Solutions recently hired a physician from cross-town rival Cleveland Clinic Akron General to serve as the program director for the emergency medicine residency program. The two rivals also went through a court battle this summer regarding Dr. Michael Beeson's non-compete contract. They settled out of court and Beeson was allowed to work at Summa, though not work clinically for one year.
U.S. Acute Care Solutions spokesman Marty Richmond said Beeson will continue with the company.
"We have the foundation of an excellent program in place," Richard said. "This decision by the ACGME only changes the timeline. It does not change the plan to re-constitute an emergency medicine residency program at Summa Health."
With the ACGME’s denial, there is no appeal process and Summa will have to wait another year to apply, meaning the earliest it could bring emergency medicine residents back would be July 2020, said Dr. Robert McNamara, Temple University emergency medicine chairman who is past president of the American Academy of Emergency Medicine and has sat on ACGME accreditation teams in the past.
McNamara said it was hard to comment about Summa’s denial without knowing the reasons.
"One fact that they had going against them is their prior history," said McNamara, referring to ACGME’s previous revocation of the residency program.
According to ACGME rules, if Summa reapplied within two years, the history of what led to the withdrawal would be included in the review.
"The last thing anyone wants to happen is what happened before," McNamara said. "That was a major trauma of a residency and throwing lives of young physicians in disarray. I think they (Summa) were probably under pretty intense scrutiny and there was the kerfluffle about the program director."
McNamara said whether Summa can successfully reapply and reestablish its program "is really going to depend on the severity of the citations" for the current denial of the application.
"Are these things that can be overcome by the institution? It’s not just the emergency doctors being scrutinized. It’s the institutional support and leadership," he said.
The accreditation group is looking for a program with "adequate institutional support. The environment for residents is not one of service but education," McNamara said.
Beacon Journal consumer columnist and medical reporter Betty Lin-Fisher can be reached at 330-996-3724 or firstname.lastname@example.org. Follow her @blinfisherABJ on Twitter or www.facebook.com/?BettyLinFisherABJ and see all her stories at www.ohio.com/?betty