Summa Health System is committed to finding new programs for its 21 emergency medicine resident doctors, who will not be able to train at Akron City Hospital after July 1.

Many of them should be able to stay in Akron, while others are looking elsewhere in Ohio and a few are looking at moving out of state, including California and Colorado, said Dr. Cindy Kelley, Summa’s vice president of medical education.

“Based on the outpouring of support I’ve already received and phone calls in the last 24 hours, I don’t foresee difficulty for residents finding programs, even though it’s very upsetting to think about the disruption that will be for their lives and their families’ lives,” she said.

Cleveland Clinic Akron General officials have said they could take up to 12 residents, Kelley said.

This week, a national accreditation council upheld its decision to strip Summa’s ability to run an ER residency program after an abrupt changeover of ER physician groups on Jan. 1. The Accreditation Council for Graduate Medical Education (ACGME) also upheld a probation on Summa, prohibiting the health system from starting new residency programs or increasing the size of those that already exist.

While 10 first-year ER residents and 11 second-year residents need to transfer, nine third-year residents will graduate, said Kelley.

Summa has pledged to provide the funding to the new programs to cover the cost of educating the transferring residents, Kelley said. Residents can transfer as soon as paperwork is done, but Kelley said she anticipates that most will leave at the end of June.

Addressing concerns

Summa, meanwhile, is working on changes to address the violations cited by the accreditation group, she said. The national group has asked to return in June to re-evaluate Summa for consideration to lift the probation in October, the next time the committee will meet, she said.

Summa would not be able to re-establish its ER residency program until its hospital probation status is lifted, Kelley said.

Among other things, violations included Summa patients being sent home from the ER after being seen by residents and not the supervising emergency room physicians, even after some of the residents sought their supervisors’ help. The accreditation group also found delays in care for trauma patients and possible stroke victims and said new teaching staff lacked the expertise needed to train new doctors.

The group also cited a culture of intimidation and fear of retaliation among the residents.

Kelley said she has met with residents to address their concerns, and “if those were concerns they had because of any action of mine, I have owned those actions and apologized for those actions and we’ve had good conversations about that.”

Kelley said she now also directly reports to Interim CEO Dr. Cliff Deveny instead of Chief Medical Officer Dr. Vivian von Gruenigen. Von Gruenigen is married to Dr. Dominic Bagnoli, the CEO of US Acute Care Solutions, the Canton-based physicians group that took over Summa’s five ERs after last-minute negotiations fell through between Summa and its longtime provider of ER physicians.

Looking to hire

Bagnoli said USACS disagrees with the withdrawal, but accepts it.

“The loss of the residency is a big thing, and unfortunately, we weren’t able to get ACGME to see it differently. But this is not going to affect patient care,” he said. “It seems like there’s this concern that when the residents are gone, there’s no way to take care of the patients. That’s not true. Patients of Summit County will get the same high quality care they got for the last 30 years.”

Bagnoli said USACS is working to hire more doctors, physician assistants and nurse practitioners to prepare for July 1.

“We staff 160 of our 170 programs without residents. It’s done everywhere and it can be done and it will be done.”

While the program will lose 30 residents, Bagnoli said not all are on duty in the ER at one time. Typically about eight are rotating through the ER in one month and Summa will still have other programs’ residents rotating into the ER, he said.

Recruiting challenges

Separately, the Emergency Medicine Residents’ Association issued an open letter after the ACGME’s decision.

The letter called on hospital administrators and physicians groups nationwide to take heed of what happened at Summa when looking at staffing changes or contracts.

Dr. Robert McNamara, a Temple University emergency medicine chairman who has served on ACGME accreditation teams, said it may be hard for USACS to recruit.

“It’s not to say they’re not going to be able to get anyone, but people will be aware the program lost its support and there were issues with the hospital dealing with prior faculty and residents,” he said.

Bagnoli acknowledged a shortage in ER physicians nationwide, but said USACS has a successful business hiring qualified physicians and having the ACGME decision final — while it’s not the one he wanted — will make it easier to recruit.

“This is a great opportunity to come in and help re-establish a program,” he said.

When Summa would reapply for its ER residency program is unknown, Kelley said. According to ACGME rules, if Summa reapplies within two years, the history of what led to the withdrawal will be included. Kelley said that could be a factor in the timeline to wait, but “the goal would be we would submit when we are ready.”

McNamara, also the former president of the American Academy of Emergency Medicine, said the loss of a top-notch ER residency program is unfortunate. The last time an ER program closed was probably in the 1980s, he said.

New board members

Summa’s board of directors also announced three new members: Dr. Peter Bittenbender, a cardiologist with Summa Health Medical Group, and Dr. Costas Kefalas, a gastroenterologist with Akron Digestive Diseases Consultants Inc., will be physician members, replacing von Gruenigen and Dr. Scott Wilber, who left Summa.

A new civic member is Barbara Faciana, president and CEO of FEI Properties Inc. Her company’s real estate holdings include more than 4 million square feet of professional, retail and medical offices. The board has 14 members, from 13, with Summa seeking to fill one more seat, a spokesman said.

Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ  on Twitter.