DS: You can’t get credentialed to be on staff at Summa in the emergency department if you’re not a board-certified emergency physician; all of our physicians who have worked there and are on staff are board-certified in emergency medicine. There was a rumor out there at some point about an internal medicine–trained doctor. That’s untrue.

KK: What about patient safety issues that might have been created because of the transition?

DS: There were no patient safety issues. We had all of the shifts covered, and we have qualified physicians. Some of the low-acuity patients experienced slightly longer waits because the physicians weren’t as facile with the EMR, but there were no patient safety issues. Within two days, all of the wait times were back to baseline.

KK: Did you ever have to use a different documentation system other than the EMR system that was in place?

DS: The first two days, the hospital used their downtime procedures, which do involve the physician documentation being on paper. The nurses were using the EMR for some of their charting, but they did use their downtime procedures for the first approximately 40 hours. They didn’t have enough trainers to do the transition that quickly, but within 40 hours, we were back on the EMR. This was the hospital’s plan for the transition.

KK: There’s been a lot of conversation and discussion about the optics of conflict-of-interest with friends or family members who may or may not have been involved with some of the negotiations. Any thoughts or comments?

DS: We all know in medicine that there are conflicts of interest at times. The issue in my mind is how they are dealt with. In this case, the conflict had been disclosed in the past and was well-known. The person that we’re talking about, [the wife of the USACS CEO], has been on the board of [Summa] hospital in the past, and she’s the CMO currently. That conflict had been disclosed. She was recused from any part of this decision making. In fact, there was no decision. As we said, we didn’t get notified until the 24th, so the idea that this was some type of a plan just simply isn’t true. She was recused from the negotiations and any part of that conversation. Clearly, the hospital knew that this was an issue that would be brought up, and they handled it as any large organization handles potential conflicts. I don’t have any concerns about it.