Hospital CEO tells hearing ‘I quit’ if specialist returns
Nephrologist refused to follow approved billing practice, executive testifies
Windsor Regional Hospital CEO David Musyj told a provincial hearing he would quit his job if kidney specialist Dr. Albert Kadri, who had his hospital privileges revoked last year, were to resume working there.
The Health Professions Appeal and Review Board hearing continued Wednesday in Kadri’s bid to have his hospital privileges reinstated after Windsor Regional Hospital indefinitely suspended them on June 1, 2018.
When asked by hospital lawyer Paula Trattner what would happen if Kadri were to resume working at Windsor Regional Hospital, Musyj said it would be “devastating” and would result in the resignation of several hospital employees including new nephrologists, front-line administrative staff and himself.
“I’m putting this on the record right now,” Musyj said. “If he comes back on, I quit — I’m out of here.”
Musyj has been in the hot seat as a hospital witness for the past three days of the hearing.
He spoke to “disruptive” behaviour from Kadri, such as refusal to follow hospital billing practices. The change had been implemented with the hospital’s new “model of care.”
Musyj said he had reached out to the Ministry of Health to inquire about a change to billing practices for the new model. A senior medical adviser responded that the doctor who is physically attending to the patient is the one who should bill for a “team fee” to OHIP when a patient is receiving in-hospital dialysis.
He sent the adviser’s recommendations to nephrologists, making them aware of the new practice and received replies from others agreeing to follow the new protocol.
Musyj said that Kadri instead stuck to an individual 2009 agreement he held with two other nephrologists with hospital privileges who agreed, regardless of who was on-call, the patient’s consulting doctor would do the billing.
He said this eventually resulted in nearly $13,000 being directed toward Kadri instead of a newer doctor who was the physician oncall.
The hospital’s new model of care for its renal program is at the centre of many issues addressed at the hearing. The hospital launched an external review in March 2016 and implemented its findings, including new billing policies and a requirement of nephrologists holding privileges at the hospital to refer patients to its multi-care kidney clinic.
Kadri had said in the past that the change in patient care policy would “interfere with established doctor-patient relationships.”
During cross-examination Wednesday, Kadri’s lawyer, Norm Assiff, suggested to Musyj the external review, which led to the new model of care, was launched in relation to funding, rather than patient care.
While Musyj said funding “has to be taken into account,” it is not the “driving force.”
He confirmed part of the reason the external review was launched was that the multi-care kidney clinic was underutilized at the time. He said that posed a risk to patients.
Assiff suggested the hospital acted in “bad faith” and tried to “monopolize” Kadri’s clinic, both of which Musyj denied.
Other nephrologists on staff played a part in the external review, while Assiff said Kadri was only involved in the process for “30 minutes.”
“He was involved as much as he wanted to be,” Musyj said. Assiff suggested that wasn’t the case.
The hearing will continue Thursday.