Questions raised about background checks on former BHB chief of ctaff
Donald Thomas III was hired as King Edward VII Memorial Hospital's highly paid chief of staff without thorough checks being made into his background, according to the new Bermuda Hospitals Board.
BHB chairman Jonathan Brewin told Health Minister Patricia Gordon-Pamplin in an open letter that the board did not believe “sufficient due diligence was brought to bear during the hiring of Dr Thomas, given his pre-employment history, most of which exists in the public domain”.
Dr Thomas had previously been suspended from a senior position in Los Angeles and fined for practising medicine without a licence in Florida when he was vetted by BHB in 2007.
Yet he was hired and received a six-figure annual salary from Bermuda's taxpayers for five years — plus an ample financial settlement when he resigned last October after being placed on administrative leave due to concerns about his performance.
Former Opposition MP Louise Jackson once alleged in Parliament that Dr Thomas earned $700K, a figure denied by then Health Minister Zane DeSilva.
BHB won't reveal the exact amount he earned while here, or the details of his “separation and release” agreement, but Mr Brewin acknowledges in his letter that the board needs to strengthen “its internal processes, from recruitment to governance of individual activities, to ensure any mistakes in the past are learned from and not repeated”.
Meanwhile, Bermuda Medical Council, the organisation which granted Dr Thomas a medical licence here, has refused to discuss whether it checked his credentials.
Dr Thomas became KEMH's chief of staff in August 2007, was granted a medical licence in March 2008 and was placed on administrative leave in July 2012.
The concerns which led to his suspension, listed in Mr Brewin's letter (see separate story), were a “failure to follow directions, questions regarding financial stewardship, lack of attention to quality of care and a pre-employment background check”.
Mr Brewin indicates that the background check was part of an investigation launched into Dr Thomas's conduct when he was put on leave.
No information on what was uncovered is shared and the letter says, in relation to the inquiry, that “given the legal restrictions, to make further public comment would not be in the long-term interests of the community or the hospitals”.
Mr Brewin's letter is published on BHB's website as an addendum to a review of clinical governance at BHB conducted by Canadian consultants Howard Associates.
The Howard report does not discuss Dr Thomas's tenure at BHB “for legal reasons and at the request of the BHB”.
Ombudsman Arlene Brock, in her review of the Howard report, says the consultants told her that “not all of the former chief of staff's background checks came through clean” and that “they were 100 percent convinced that the decision to suspend him was good”. She asked for supporting evidence.
Ms Brock writes that “licence issues” were among the key reasons for Dr Thomas's suspension with other matters “subject to confidentiality provisions”.
BHB was aware of the LA and Florida issues for more than a year before the chief of staff was suspended — dismissing both in a March 2011 e-mail to this newspaper as “very old stories, which have no consequence on Dr Thomas's achievements in his role at BHB”.
We had asked the board to comment on the fact that Dr Thomas was fined $1,800 for practising medicine without a licence in Florida between January 1988 and June 1989.
A BHB spokeswoman said the fine “related to a simple, system-generated complaint regarding an out-of-date medical licence being renewed.
“The hospital employing Dr Thomas at the time was fully aware of this, and he continued to be employed and practise in the US in multiple jurisdictions. This was of a minor nature, not even requiring an entry in the national physicians' databank.”
Ashley Carr, deputy press secretary at Florida Department of Health, told us the investigation of the licence breach was not a criminal one and Dr Thomas would have been able to practise medicine again in the state once the fine was paid. His licence to practise in Florida expired in January 1998.
The LA matter concerned Dr Thomas's past position as associate director of Los Angeles County Health Department — a role mentioned by BHB in its announcement of his appointment as chief of staff in August 2007.
What the press release didn't say was that Dr Thomas was suspended from the associate director position in 2000 after being accused of allowing the illegal use of discounted drugs at private clinics in LA.
According to US media reports, he claimed he was discriminated against for being an African American.
The BHB spokeswoman said in March 2011: “The LA story is over ten years old. Dr Thomas resigned from his employer, the LA County Department of Health.
“He resigned after being reinstated following an investigation that revealed nothing of substance backing up accusations that had been made. Dr Thomas then moved on to other substantial positions in the US healthcare industry and hospitals before coming to BHB in 2007.”
She added: “We are surprised that very old stories, which have no consequence on Dr Thomas's achievements in his role at BHB, are being raised.”
Michael Wilson, a spokesman for LA County Health Services Department, confirmed that Dr Thomas was reinstated before resigning as associate director. He said: “Because of the passage of time we no longer have records on this former employee.”
Health Ministry permanent secretary Kevin Monkman told a member of the Bermuda Healthcare Advocacy Group in an e-mail on July 30, 2012 that “Dr Thomas was not hired under false pretences in August 2007”.
Mr Brewin's letter suggests BHB may not have known about the two issues when it recruited him — even though a simple internet search would have revealed both.
In March 2008, then Premier Ewart Brown told MPs the hospital had an excellent leader in Dr Thomas.
He joked in Parliament that though the chief of staff was a fellow Howard University graduate “he's not a crony of mine”.
Later that month, Bermuda Medical Council (BMC) granted Dr Thomas a medical practitioner's licence, making him the only doctor on the Island whose training was listed as “administrative medicine”.
He'd been performing the role of Chief of Staff without a licence since August 2007 — even though the Bermuda Hospitals Board Act requires the postholder to be a registered medical practitioner.
Asked why, the BHB spokeswoman said: “According to our records, the application [for Dr Thomas's licence] was made to the BMC in February 2008 following a delay in the receipt of paperwork. The full application was made and registration was approved shortly thereafter.”
The Medical Council's role, in law, is to “secure high standards of professional competence and conduct in the practice of medicine and surgery in Bermuda” and it must appoint a credentials committee to assess each application for medical registration.
We asked the Council 15 questions about Dr Thomas in July last year, including whether he disclosed the LA and Florida issues in his application and whether the licence category of “administrative medicine” was created for him.
A spokesman said: “The Office of the Chief Medical Officer and the Bermuda Medical Council do not provide information to the media on matters involving individual physicians.”
The spokesman confirmed last week that the Council was still not willing to answer questions.
When Dr Thomas was hired, under then BHB chief executive officer David Hill and then board chairman Herman Tucker, the board trumpeted Dr Thomas's “extensive experience” and promised he'd be a “valued medical leader and an extremely well-qualified mentor” who would ensure “fair and consistence policies and processes” were in place at the hospital.
Its announcement said he had the support of the doctors at the hospital, where he had been working as a consultant brought in to improve physician relations.
But Mr Brewin's letter, as well as the Ombudsman's review, suggests that support from physicians and others in the medical field waned over the years.
Mr Brewin writes: “During his tenure, Dr Thomas was responsible for implementing a number of board initiatives which in the eyes of the Bermuda public were controversial, in particular, HPL [Healthcare Partners Ltd], the hospitalist scheme, and medical tourism.
“These initiatives made him unpopular with certain stakeholders who did not endorse the policies that he initiated. Dr Thomas's management style was not viewed favourably by some staff and external stakeholders.”
The full truth about how Dr Thomas was hired and granted a medical licence and why his behaviour prompted such concern may never be known, since the investigation into his conduct was abandoned by BHB after he resigned.
A separate investigation launched by Bermuda Medical Council, after a complaint from plastic surgeon Dr Christopher Johnson about Dr Thomas's past, was also dropped when the Chief of Staff left the Island and returned to St Petersburg Beach, Florida.
Attempts by this newspaper to reach him at his home there or at his business, Mentat Systems Inc, were unsuccessful.
Mr Brewin, appointed earlier this year as part of an entirely new board, says in his letter that lessons have been learned from the five-year episode and promises a “restructure of the chief of staff office and improved due diligence in the area of recruitment”.
American doctor Michael Weitekamp was appointed new chief of staff on May 1.
* Useful websites: www.bhb.bm and www.ombudsman.bm.
* Read the BHB's open letter in full on pages 10 and 11 of today's newspaper.