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6 October 2022

Stephen Kiefer: New BMH CEO under attack. Why?

Dr. Stephen Kiefer, MD

The following are solely my own views and opinions. I am a retired physician who practiced approximately 30 years at Blount Memorial Hospital as well as in the Knoxville hospitals. I’m currently serving my third three-year BMH Board of Directors term having no intention of opting for a fourth term. My political aspirations are zero. I plan on continuing spending much of my time in voluntary community services. I hope the following offers some objective clarification to the citizens of Blount County.

The appointment of Blount Memorial Hospital’s new CEO Dr. Harold Naramore has precipitated striking public criticism, in large part directed at BMH Board of Directors. Here are the facts as best I know them. It is no secret that the hospital has encountered financial distress over the last 15 months in large measure due to the COVID pandemic: taking care of a sicker, more costly resource-consuming patient population, decreased utilization (and thus revenues) by the non-COVID population, a bear stock market hammering our investment fund, all the while experiencing the universal staffing shortages that necessitated using many high-cost contract health care workers. A new direction was needed to survive as a health care organization. We are not alone in this predicament as over half the hospitals in the U.S. have experienced significant financial losses over the last year. Some have closed. Many surviving are reorganizing to become better financially viable.

The president and vice president of the board of directors confidentially interviewed all the top hospital executives, and it was a consensus that Dr. Naramore become the new CEO. As the hospital’s chief medical officer, he had already spearheaded all of our very successful efforts in confronting the COVID pandemic and was very actively working on improving the hospital’s financial situation. He was promoted from within just as the previous two CEOs had been. He is eminently well qualified by being a doctor, a lawyer, having an MBA degree, and having administrative experience in our hospital system for the last 13 years. A possible new CEO search was discussed in strategic planning sessions but was deemed totally impractical given the urgency of our situation and the fact that it would take many months with considerable costs to make a selection. Also, outside outstanding candidates were very unlikely to want to come to a midsize hospital in financial distress and new hospital CEOs pan out successfully very unpredictably. Such a search process would clearly have evolved with many uncertainties too late to really help. In reality, there was only one avenue and one choice, Dr. Naramore as an outstandingly qualified person for the job. Any assignment as “interim CEO” was unnecessary and would have been counterproductive, indicating uncertainty rather than confidence in our health system at a critical time when we needed strong decisive leadership. In fact, things already do appear to be improving. An outside legal review of our bylaws concurred that we had selected in a new CEO in accordance with our antiquated bylaws that need updated.

Objections to our new CEO selection are being couched as an improper selection process but in reality, seem to really be objections to who we selected, not how. Dr. Naramore has had the unenviable task over the last 13 years of having to make many decisions within the medical staff and other vital clinical operation areas. His consistent, sound business approach has been to identify problems or underperforming areas in our Blount health care system and then issue clear objective goals that need to be met. Providing excellent health care in a financially responsible manner is not an easy task and requires making tough decisions. Such decisions may be difficult to completely understand by external audiences and it appears to have prompted nonsupport and attempts to undermine Dr Naramore and the BMH board of directors’ efforts. In an effort to promote transparency, attempts to reach out to various community organizations and leaders with meetings and civil discussions have been rebuffed too often.

Current board of directors members David Pesterfield and David Cockrill have been loyal, hard-working volunteer hospital board members acting in the best interest of the hospital for many years. They have witnessed and helped direct many positive changes at BMH with in-depth knowledge regarding BMH operations and issues. Isn’t that what is desired in a board of directors member? Some of the current public criticism and calls for removal have been unfairly focused on them driven by this negative innuendo about our new CEO.

Other board members may face similar criticism and calls for replacement in the future as well. Political influence and personal agendas seem to be factors here, which are exactly what our Blount forefathers who wrote the original charter for Blount Memorial Hospital strived to avoid. These are distractions from very real hospital issues that need to be solved and ultimately hurt our hospital’s mission of providing the best medical care possible. All Blount County residents would be much better served if our collective energies were spent working together to try to help and support our outstanding medical institution of 75 years, rather than working to undermine its leadership.

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