Health clinics undergo shakeup under new top executive

What a difference six months have made for the Golden Valley Health Centers.

Since Tony Weber took over as chief executive officer in May, the top executive has:

▪ Fired Dr. Silvia Diego, the former chief medical officer and a respected physician.

▪ Terminated the former manager of Golden Valley’s west Modesto clinic and cut ties with a well-regarded mental health counselor.

▪ Accepted the resignations of former interim CEO Christine Noguera, former Nursing Director Connie Diers and a former grants manager.

▪ Appointed a physician’s assistant as interim chief medical officer to oversee doctors and other health providers in Golden Valley’s 20-plus clinics, which serve 100,000 patients in Stanislaus and Merced counties.

Former executive director Michael Sullivan led the Merced-based organization for 40 years, developing clinics and health services for farmworkers and the uninsured in the Valley. The nonprofit’s nine-member board never had to hire a CEO until Sullivan retired.

Weber has not been popular with many employees, judging from complaints detailed in letters to the board of directors.

In a blistering letter this week, Dr. Liza Marie Pham charged that Weber has created a hostile work environment and “culture of oppression.” She claimed that staff members risk being fired or are asked to resign if they don’t fully support the CEO’s directives. Her letter recounted heated exchanges between Weber and provider staff at a meeting last month.

According to Pham, staffers are divided between those who support Weber and those who were outraged by Diego’s termination.

“There is a prevailing sense of fear,” Pham wrote. “There is no freedom to express oneself, without fear of retaliation from the leadership team.”

Weber did not return calls or an email from The Modesto Bee requesting comment. Before he was hired by Golden Valley, he held positions with San Ysidro Health Center in Southern California and Family Healthcare Network. Vocal employees have criticized Weber for hiring a friend as Golden Valley’s chief operating officer.

Diego confirmed she was fired Nov. 17 after 17 years with Golden Valley. She said she had raised concerns about Weber’s goals to open the clinics to thousands of people who enrolled in Medi-Cal through the Affordable Care Act.

Diego said she supports greater access to care but the clinics do not have the medical staff to safely care for so many new patients. “It was because I was the one who was saying, ‘Slow down, we just can’t do it this way,’” Diego said. “The doctors are overwhelmed with the patients they have. If you give access to a lot of new patients, you have to take away access from current patients.”

Employees say the new management wants health care providers to take on six new patients each day, or 30 per week. For a full-time physician, the total would be 1,440 new patients in a year, Pham said.

The pediatrician, who is on medical leave, said she heard from one provider this week who saw 11 new patients in one day in addition to current patients.

Diego, a graduate of Stanford Medical School, is the president of the Stanislaus Medical Society and was the first Latina appointed to the California Medical Board. Diego’s talents and her sense of purpose were the reason many doctors decided to work for the health clinics, said Alex Abarca, Golden Valley’s director of behavioral health.

Abarca said he has aired concerns about the new management in a letter to the board and is not certain about his future when he returns from medical leave this month. “The morale around the clinics before I left on leave was already breaking down,” Abarca said, estimating that 20 doctors want to leave the organization.

The Latino community group El Concilio is looking into the shakeup at Golden Valley.

“We are trying to gather some information to ascertain what is going on,” President Jose Rodriguez said. “That institution has had such an important role in health care for the underserved in our community.”

According to Pham’s letter, Weber said during a contentious meeting with provider staff last month that Diego was a “terrific clinician” and a “fantastic chief medical officer.” But as an executive team member, she needed to support the board and the CEO, he added.

Pham is asking the board to investigate the circumstances of Diego’s termination and possible violations of state and federal regulations.

Dr. Peter Broderick, a Golden Valley board director and key figure in residency training in Stanislaus County, said the board could not comment on employee issues at Golden Valley. When asked about a physician’s assistant serving as chief medical officer, Broderick said it was his impression those duties are being divided among more than one practitioner.

Diego said she was locked out of the computer system the day she was fired, which prevented her from sending prescriptions or transitioning her patients to other providers. She kept insisting and was allowed back into the system two days later, she said.

Marni Haller, one of her former patients, said she and her mother have tried without success to get appointments with other doctors at Golden Valley. Her 63-year-old mother takes medication for pain and a thyroid problem, Haller said.

“They didn’t even call and tell us (Diego) was gone,” Haller said. “None of us have a new doctor and I have called every day. They said call back and they will put us on a list.”

This story was originally published December 5, 2014 at 8:07 PM with the headline "Health clinics undergo shakeup under new top executive."