Residents challenge John Muir CEO and Exec. VP over firing of Trauma Director for letter questioning county health orders

See doctors’ letter to Dr. Chris Farnitano and Contra Costa County Supervisors; effort now challenges compensation of John Muir executives

By Allen Payton

Last Friday, Dec. 18, Dr. Michael deBoisblanc was fired as the Medical Director of Trauma and Regional Services for John Muir Health. One of the partners in his private practice, the Bay Area Surgical Specialists (BASS) Medical Group, Dr. Pete Mazolewski, who also works at John Muir, confirmed the firing and said it was done, “without explanation.”

However, according to an NBC Bay Area news report, deBoisblanc “was reassigned after questioning COVID-19 restrictions” and “in a phone call…the doctor said, ‘clearly the interpretation of my letter to the county … they felt the need to separate themselves and remove me from my position.’”

A phone call to John Muir Health’s Director of Corporate Communications, Ben Drew, on Friday, Dec. 18 was never responded to.

That Dec. 10th letter (see below), by deBoisblanc, Mazolewski and Dr. Brian Hopkins, also a member of the BASS Medical Group who works at their John Muir, was sent to Contra Costa Health Officer, Dr. Chris Farnitano and county supervisors. It questioned the impacts of the health orders on the mental health, and the need for it when ICU beds are impacted every winter, as well as the impacts on businesses.

In response, a letter writing campaign was begun through social media to question both Cal Knight, John Muir’s President and CEO, and Jane Willemsen, the Executive Vice President and President of Hospital Operations for both John Muir’s Walnut Creek and Concord Campuses, as well as John Muir Behavioral Health.

Resident’s Letter to John Muir CEO & EVP

As part of the campaign, the following letter was sent to Knight and Willemsen, and provided to the Herald anonymously:

“Dear Mr. Knight and Ms. Willemsen,

I am writing you as a very concerned Contra Costa County resident in order to address the recent news of what appears to be a retaliatory termination and/or reprimands directed towards three doctors at John Muir relating to a letter addressed to Contra County Health official – Dr. Chris Farnitano.  As has been reported on NBC Bay Area, KTVU, The California Globe and several other news agencies, it is incredibly concerning that it appears as if John
Muir took retaliatory measures against those doctors for what seems to be a very thoughtful and respectful letter addressed to Dr. Farnitano (California Globe posted the letter in its article).  Additionally, it does not appear as if any of the doctors listed any association with John Muir, or inferred that they were speaking on its behalf in the letter.  As a lifetime California and a 21+ year Contra Costa County resident I am very concerned that John Muir’s actions seem more focused on intimidation and retaliation rather than what is in the best interest of the hospital and our community. Please see three of my specific concerns below:

1. This is a global pandemic and there are countless well respected views that differ on best practices and treatment.  These differing views are widely articulated by county health officials, mayors, governors, state politicians, research institutions, doctors, nurses, etc.  Based on the doctors letter, I (and many others) feel it was a very thoughtful, well written and respectful letter in both tone and content. The tone was in no way disrespectful nor was there any mention of John Muir.  Additionally, it did not seem in any way out of line with medical questions/comments made daily by many, many well respected health leaders across the country on how to best respond to the virus taking into consideration both short term and long term impacts.
   

   Jane A Willemsen, Executive VP, John Muir Health. Photo: JohnMuirHealth.com

2. Recently there have been many doctors in print and on TV from Stanford, UCSF, Harvard, Johns Hopkins, and many other well respected institutions who have very publicly voiced conflicting points of views/opinions and openly included the names of their institutions (not just that they were doctors).  Stanford even recently posted that they supported some of their doctors conflicting views given the amount unknowns regarding the virus.  I have not heard of any retaliatory actions taken on any of those individuals.
3. Most concerning of all is that John Muir’s actions appears to be retaliatory/intimidating in nature and could seriously compromise staff at the hospital from speaking up in the future. If there is a culture of “don’t say anything or you risk termination”, then no one will ever speak up even when there are serious concerns regarding patient care, best practices or worse outright illegal/harmful activity. As a result, John Muir’s institutional credibility will significantly suffer even more over time and ultimately patient care will be compromised. This is not the type of environment that gives the community confidence in its hospital or its leadership.
   I fully understand that there are many differing points of view regarding best practices, treatment and long term impacts on all actions taken to address the pandemic.  That being said, based on all of the reporting and posted letter that I have seen it does not appear as if the doctors did anything wrong or disrespectful relating to their relationship with John Muir, the community and more importantly their Hippocratic oaths. To be honest, it really feels like the type of thoughtfulness and concern that you would encourage from everyone at the John Muir, including its administrators and executives.”

Letter From Three Doctors

Following is the text of the letter sent by the three John Muir doctors:

“December 10, 2020

Dr Farnitano and Contra Costa County supervisors,
We are writing to you with deep concern regarding more lockdown measures for our county. We feel the science is clear that more lockdowns lead to much more non covid morbidity and mortality as supported by the CDC.
We are confused as to why this is happening as we are often overcapacity in our hospitals and ICUs every winter and we have never done this previously. We also run our ICUs normally at a high rate of occupancy as this is most cost effective.
Here are the issues in a nutshell:
1. Excessive PCR testing is leading to numerous false positive results.  The specificity of PCR testing is really unknown but I have seen many authorities claim it is no higher than the low 90% range because of the attempt to be 100% sensitive using cycle threshold standards of 40. (sensitivity is inversely related to specificity)
2. For the sake of illustration, I will assume a 97-98% specificity which is likely far too high. Back in March when the county could only perform 300-400 tests per day, a 98% specificity would only lead to 6-8 false positive tests. Now we have reached up to 8000 tests per day. With a 98% specificity, that would lead to 160 false positive cases a day in our county. With a population of 1.1 million that would put us at 14.5 positive cases per 100,000 population and we would find ourselves in the worst possible tier based solely on false positive tests!!! This is absolutely a fact of epidemiology/science.
3. Again we have normal ICU and hospital winter surges that happen every winter and we never had any county lockdowns.  Our county figures on your website show essentially a stable ICU occupancy from July 1st to today. In addition on your website, we only have a minimal surge in hospitalized patients as compared to last year.
4. When you test like this for everyone that comes into your hospital, ‘hospital covid patient” numbers will rise simply because you are capturing more asymptomatic disease in patients who otherwise are visiting the hospital for other reasons.
5. Public policy is being based on these erroneous numbers and assumptions.
6. Public policy with shutdowns (various closures) leads to excessive non covid related deaths. Please see attached CDC article which shows clearly that these excessive deaths are most pronounced in the 25-44 year old age range with numerous weeks during this year that 40-50% excessive deaths are seen in this age group. When you measure in terms of life-years lost as compared to life-years lost with actual covid deaths, it is not even close. We are harming more people in our community who do not have nor are at risk of having significant covid disease with senseless closures of businesses and schools. This is data supported.
7. The CDC and pediatric societies across America have voiced their support of opening all schools. School age children are not significant vectors of the disease.
With this information above, can you answer the following questions:
1. How do you account for these high numbers of false positives with the county tiering system? Do you throw these numbers out so that only true positives are counted?
2. Why did you not intervene with any type of community closure in the past winters when our hospitals were at overcapacity? What is different now?
3. What data do you have that supports closures of businesses like gyms and outdoor dining while keeping other businesses open like walmart? What data do you have that supports that we stay indoors as opposed to outdoors? (all the science that we have reviewed supports a predominantly 99% indoor vehicle of transmission).
4. Why have you gone against the medical experts in not recommending the opening of our schools?
5. What about our county’s ICU figures caused you to trigger a closure? As you can see on Contra Costa County website, ICU occupancy has been stable between 75 and 80% since July 1st despite changing covid admissions. Please be specific here. When we run normally at 75% occupancy, why is 85% so terrible? We handle these surges every winter. It is expected.
We look forward to your reply.
Sincerely
Pete Mazolewski, MD, FACS, USAR
Brian Hopkins, MD,
Mike deBoisblanc, MD, FACS, USAR”

John Muir Responds to Letter

In what appears to be a response to the doctors’ letter, on Dec. 11, John Muir Health issued the following statement regarding Stay-at-Home Order and COVID-19 response

“John Muir Health continues to work closely with the Contra Costa County Public Health Officer and Contra Costa County Health Services in support of their efforts to manage the COVID-19 pandemic. We fully support the health orders, including the most recent Stay-at-Home order, implemented by County Health Services to prevent the spread of COVID-19. We have great trust in the County Health Department and appreciate all they have done to support the safety of our community under very difficult circumstances.

We realize there are a number of opinions on the Stay-At-Home order, including within our medical staff, but these views do not represent the views of John Muir Health. This is not a normal winter season. We have significantly expanded our ICU capacity to care for more COVID and non-COVID patients. Every day, we see the devastating effects of COVID-19 on patients and urge our community to wear a mask, not to gather with people outside their home and to limit any non-essential activities.

We will get through this pandemic, and it will take all of us working together. If you need health care, please do not delay seeking care. We are here to safely care for our patients and the community. Our courageous medical teams, who have displayed tremendous resiliency and compassion in the face of unrelenting challenges, appreciate the community’s support.”

Executive Compensation

In addition, the effort is also, now challenging the compensation of the non-profit healthcare organizations executives. According to John Muir Health’s 2018 tax return, Knight was paid nearly $4 million and Willemsen earns almost $1.9 million. (See page 85).

No Response Yet from County Health Officer or Supervisors

As of Thursday, Dec. 24, 2020 the doctors have yet to receive a response to their letter. Efforts to reach Farnitano, county health communications staff and the five members of the Board of Supervisors, Thursday afternoon, were unsuccessful.

12/24/20 6:17 PM UPDATE: However, according to Kim McCarl, Communications Officer for Contra Costa Health Services, following “is the statement that the department released on Dec. 11.”

“Contra Costa County and all of California are in the grip of a deadly pandemic. The number of COVID-19 patients in our county’s hospitals has more than tripled in the past 30 days. The number of intensive care unit beds occupied by COVID-19 patients during the same period has more than doubled – and we do not believe the full effect of local transmission during the Thanksgiving holiday has reached our hospitals at this point. Also, flu season, which sends many people to the hospital, hasn’t peaked yet.

This wave is neither seasonal nor is it normal. It’s illogical to look at what happened at hospitals in prior years to predict what we can expect now. In years past, we weren’t dealing with a once-in-a-lifetime global pandemic.

We cannot afford to wait until our hospitals are actually full to make policy changes to reduce the spread of this deadly virus.

It would be irresponsible to suggest that universally accepted, proven-effective public health prevention measures to promote physical distancing are not in order at this time.

It would be dangerous at this moment to promote unfounded, unsupported theories about the efficacy of the standard test used to detect COVID-19, or to deny the reality that hospitals across California are rapidly filling with people who are very ill because of this virus.

We are now nearly a year into this pandemic. We have learned a few things along the way. We know from experience that stay-at-home orders, as challenging as they are for everyone, flatten the curve and save lives.”

Yet, when asked if the county staff had sent that letter to the three doctors, one of the three, Dr. Hopkins, replied, “No. They did not respond.”

“I saw this but it wasn’t sent to us directly,” he continued. “Lots of problems with this.  It all ‘sounds’ good and appeals to those not trained in science or medicine or statistics . They still haven’t been able to show that the ICU and/ or hospital numbers are different from prior years. Also “case” numbers are up compared to Spring, but the numbers don’t translate to the same numbers of deaths proportionally as the Spring wave for a ton of reasons.”

“Additionally, the data shows lockdowns have not been effective anywhere in the world at stopping the spread in areas where the virus is established,” Hopkins explained. “Finally, they missed the boat entirely on our message:  that the lockdowns are more destructive than the virus itself. This is an epidemiologic disaster from the standpoint of suicides, missed medical appointments and cancer screenings, depression, drug overdoses, etc.”

“So, they actually didn’t address anything in our letter. This response looks like it was written by a junior high school student.  Pathetic,” he concluded. “We are right about this just like we were in April and May when we said kids need to be back in school. Now, that is undisputed. The data backed that up back then, as well.”

“Ian Miller has some very nice graphics on lockdowns, mask mandates, and their lack of relationship to case numbers and deaths. See: https://rationalground.com/mask-charts/ or his Twitter feed is even better: Twitter@ianmSC,” Hopkins added.