A group of patients , upset by the recent and abrupt firing of Dr. Christopher Stubbs, from the Audubon County Memorial Hospitals and Clinics, attended Tuesdays hospital Board of Trustees meeting to voice their outrage and seek answers.

With Board President Pauyl Schulz, who is in Arizona for the winter, joining the meeting via conference call, Vice Chair Brett Irlmeier led the proceedings and explained that those signed in would have a total of 30 minutes to voice their opinions and put forth questions during the public forum part of the meeting. With eight people signed up to speak, each person was allotted four minutes.

Amy Petersen whose family has seen Dr. Stubbs for the past year or so, was the first to speak. Petersen laid out how she found out that Dr. Stubbs was no longer with ACMH and the reasons she was given for his dismissal, along with conflicting information she had discovered through her own research via a letter to the editor printed in the Feb. ## edition of the Audubon County Advocate Journal. During Tuesday’s meeting, she first  presented the Board with a packet of information containing; what she had found, letters of support from other patients, disciplinary action taken by various professional licensing boards against other physicians who have been on staff at ACMH and towards members of the current Board of Trustees, and financial reports that conflicted the information she was given by CEO Suzanne Cooner and other employees of ACMH. Petersen’s daughter McKenna and her mother Bernice Thobe forfeited their minutes, allowing Amy to speak for them for a longer allotted time.

Petersen then proceeded to read the mission statement of ACMH, focusing on certain words within the statement, and how she felt the treatment of Dr. Stubbs and subsequently his patients, and the actions of the Board and of Cooner were in direct opposition of what the hospital stands for.

“The values of the Audubon Hospital are stewardship through proper use of time, money and other resources we will create a more efficient workplace,” Petersen stated. “ With that, I’d like to give some insight. We will have to hire more doctors to cover the workload you have created by the firing of Dr. Stubbs and the consequent retiring of Dr. Cunningham.  Vivian Chance was paid just over $23,000 in a quarter to provide patient care, which brings in revenue.  Russ Cooner (Suzanne’s husband) was paid $38,000 in one quarter to provide IT services, when we already had an IT person on staff. I think that $38,000 would be better spent towards patient care. We have paid Russ $59,150 in just five months for IT services and virtually forced our currently IT person, Mike Card, from his job.”

The next part of the mission statement Petersen focused on was teamwork. Petersen said, “We had a young doctor with a young family who was an MD come to this community and he was abrupdtly fired. Thrown out like trash, and what for? What had he done so horribily wrong that during the January meeting you appointed him to three different in house responsibilities or positions and then turned around and fired him, with no explanation, 15 minutes later? What changed in those 15 minutes? What kind of open and honest communication and fostering of teamwork does that fall under? A few more examples include the early retirement of a longtime RN and DON and  Dr. Cunningham’s early and sudden retirement due to the disarray and mismanagement of this facility, not to mention the sudden firing of an office manager who had only been here for two months and is now scared to talk about her time her because she’s afraid of repercussions she may face from Ms. Cooner. You’ll find those statements from her in my packet. We’ve lost Carolyn Cunningham from the medical clinic after decades and why? That doesn’t sound like teamwork to me, it sounds like someone is bullying her way through this hospital.”

Petersen then talked about accountibilty and brought up the fact that the hospital has now let her daughter’s medication prescription expire and is no longer keeping on hand, due to the cost.

“Her medicine costs just $400,” Petersen said. “I don’t know about you, but when it comes to the health of a child, $400 seems like a pretty small number, especially when $19,000 is being spent on new flooring in this facilty. I don’t know what’s going on in this hospital.”

She also discussed the fact that Dr. Vampola, who McKenna went to see after the firing of Dr. Stubbs does not “feel comfortable treating” McKenna and that she would need to go see a specialist.

“For the past year  we’ve not needed to see a specialist in the city, we’ve been able to see OUR doctor, Dr. Stubbs, right here in town, because he could figure out what was wrong with McKenna and how to treat her,” Petersen stated. “She was told by Dr. Vampola that she needed to, “stop putting Dr. Stubbs on a pedestal, because he’d done things wrong with other patients. That’s not the kind of leadership I want to see or want my family affiliated with.”

Petersen then laughed when she reached the word “Integrity” in the mission statement. “We have employees who have told me that Suzanne had told them that Dr. Stubbs wasn’t even an MD, that he had flunked out of medical school, which isn’t true,” Petersen stated. “She’s also repeatedly told employees about her mission to ‘get rid’ of Dr. Stubbs and to ‘get rid’ of Stephanie, the former office manager and her intentions to ‘get rid’ of our affiliation with Mercy. You’ll find those statements in the packet, and I would be happy to give you the names of the employees I spoke to, when Ms. Cooner is not around, as they are truly afraid of being fired. She was also telling people that Kristen Stubbs, the wife of Dr. Stubbs has been having an affair. That is not the kind of talk or action our hospital CEO should be partaking in. That is not someone who is building a team, that is someone who is tearing this hospital apart.

Kolton Hewlett, who Ms. Cooner created a position for, we’ve never had a position like his before. She brought him along with her to this job. While in a previous management position, Kolton provided alcohol to an underaged employee. Is that the kind of person we want in a management position? Ms. Cooner knew this because he’s worked for her twice in the past. We shouldn’t have to hire her husband to be the IT person, because she’s the CEO. We already had an IT person in place.”

Petersen then pointed out that several former staff members and Board members had “skeletons in their closet” and also that according to Board minutes, Ms.Cooner had asked the Board to keep the details of Dr. Brokke’s leaving and Medical Board reprimands from the public and from the newspaper. Petersen distributed copies of disciplinary action taken again Board Chairman Dr. Paul Schulz by the Dental Board of The State of Iowa for improper record keeping and general incompetency, along with action taken by the state’s mortuary science board against board member Mark Kessler  and the disciplinary action taken by the Board of Medicine against Doctors Brokke and Sprague.

Carolyn Cunningham, wife of Dr. Cunningham, who has practiced at ACMH for more than 30 years also spoke out against the actions of Ms. Cooner and the Board and voiced her extreme displeasure with the situation as a whole and with the path the hospital is on.

“I feel that Dr. Stubbs was wrongfully terminated,” Cunningham stated. “He was never given an action plan. He was absent on occasion, but no one talked to him about it. If anyone had cared, which its obvious no one did, especially our CEO who told me numerous times that she was going to ‘get rid of him,’ since February of last year. If someone had talked to him about his absenteeism, he would have changed. Yes, when he was absent he was absent, but when he was here, he was here 110%. If we filled up his schedule, he would have gone in there and seen every one of those patients without complaint. I could have filled his schedule up every day. We have all of these Medicare patients and MCO patients, between those two insurances alone, there were more than enough patients for that man to see and more than enough other providers to service the 21% he could not. There was no reason, as long as it was in his hiring contract, which it was,  that he could not continue to practice as he was. This board knew his hiring conditions, yet you wait until one week before the birth of this baby to fire him? Its wrongful. I don’t know what kind of malarkey she is filling you with. If you have not yet hired her for the Jenny Ed, position, since we are no longer affiliated with Mercy, If I were on this Board I would do my due diligence and give it some time, because I don’t think this woman is who you want in that position. All that you know on this Board is what she tells you. What she comes and complains about or whatever. I am telling you, this hospital is going down the tubes. People who are not ready to go and who do not want to go are retiring because they just can’t take it anymore and the people who are left here? I feel sorry for them because they are worried about their jobs. I’ve seen it. I think she lies. I think she flies by the seat of her pants and I think she’s sold you a bill of goods.”

Several other people commented in support of Dr. Stubbs including Kyle Kjergaard, who asked that the Board be community minded in the decisions, they make and in what they do when it comes to staffing the hospital.

“I am one of the younger generation in this community, and we are getting more young people back here,” he stated. “I was certainly excited to have a young doctor with a young family move here to Audubon. He and his wife were both getting involved and the news of his firing certainly caught my attention, as we need to keep young people like this in our community. The more I am learning, the more I think maybe the wrong people are leaving and if there is a chance we can get Dr. Stubbs back, maybe we should look in that direction.”

Kenny and Rosemary Hess, who were patients of Dr. Stubbs also asked questions and made comments. Rosemary said, “It’s hard at our age to find a new doctor again and we really liked Dr. Stubbs.”

Once the Public Comment portion of the meeting was over, Irlmeier thanked those in attendance and said they would take their comments and questions into consideration, but no further statements were given by Board members or by Cooner herself during Tuesday’s meeting.

When asked for a statement regarding the public comments, the following day, the Board issued this statement, “The Hospital Board of Trustees understands some members of the community are upset regarding a recent personnel decision made by the Board.  The Board stands by its decision and believes it was in the best interest of the Hospital.  We have confidence in current hospital administration and believe we are well positioned to serve the health care needs of Audubon County and the surrounding communities.”

 Stubbs was hired in the summer of 2016, as the first MD ACMH had had on staff. He and his wife and two small children purchased a home in Audubon and had plans to raise their children here and become active members of the community. He did not attend last night’s meeting but provided a summary of his time at ACMH and the details surrounding his firing.

“Very shortly after she started working at ACMH, Dr. Cunningham and I began having serious concerns about Suzanne Cooner's ability to lead our hospital. We felt that her decision making skills were poor and her interpersonal skills were even worse (spreading gossip, singling out and then insulting people she intended to fire, dividing rather than unifying the different departments in the hospital, etc.) Our grumbling about her turned to action when she made an abrupt change to my practice without telling me. Under Tom Smith, the hospital had agreed to make up the difference between the in-network and out-of-network copay for my Wellmark patients. My understanding is this was an unspoken policy that was not advertised. I was very grateful to Tom for doing this, as it allowed me to see anyone who wanted to see me, regardless of their insurance plan (I hate, HATE having to tell people I can't see them because of their insurance). At some point along the way Suzanne went behind my back and changed this. She began telling the front desk to never schedule any Wellmark patients with me no matter what, even patients who were previously established with me. This finally came to my attention when a Wellmark patient I admitted to the hospital was removed from my care (without consulting her, or me for that matter) and was given to Vampola so the hospital could make more money on her admission. I was quite upset about this and I sent Suzanne several messages asking what was going on. As I recall she gave me a one sentence reply (something like, "Now that we have three physicians again, we no longer need you to see Wellmark patients") and she ignored my follow up questions. Several weeks later there was a meeting with Mindy Alt, Cristy Knudsen, Heather Toft and myself (note: no Suzanne Cooner) where I was officially told about this new policy for the first time. It's worth noting that Suzanne and I had had a total of two conversations about Wellmark since she started as CEO:

 Conversation #1: Early in 2017 I asked her if we should appeal Wellmark's decision to not accept me as an in-network provider (they have a blanket policy that only board certified physicians can be in their plans, and since I didn't complete the last year of my residency I could never be "board certified" in Family Medicine, despite the fact that I have a full and unrestricted license to practice medicine in the state of Iowa). I received several different responses from her (all via email, of which I have copies). First she said she would look into it. Then she said there was some window of time that Tom Smith had to appeal the decision, and he didn't do it, so now that window was closed and there was nothing we could do about it. At my insistence she said we could go ahead and try, but she wanted her daughter to help draft up the letter (odd...). Several weeks went by without word from her, and when I emailed to check in, she appeared to have forgotten what she told me about her daughter and the letter and she again said we missed the window of opportunity. I FINALLY got her to go ahead and attempt the appeal, which we did and it was denied. 

 Conversation #2: We didn't discuss Wellmark again until maybe six months ago, during a medical staff meeting, when the topic came up and I asked her something like, "How big of a problem is the Wellmark thing for the hospital? Are we still using Tom's policy of making up the difference in copays for my Wellmark patients?" She didn't really answer the first question, and she replied in the affirmative to the second question, stating the hospital had checked with their lawyer on the legality of this policy and was told, "What you do for one, you do for all," meaning that if the policy was in place it must be applied to all patients, not just a select few. I thought that was great; it seemed nothing had changed. I didn't hear about Wellmark again until the above mentioned patient was removed from my care. 

 Suzanne has stated to the Board of Trustees that she had multiple conversations with me about the Wellmark issue, and that simply is not true. Changing this aspect of my practice without notifying me or my patients was the last straw, and Dr. Cunningham and I decided the time had finally come to express our concerns about Suzanne to the Board. We started meeting with board members individually, starting with Paul Schultz. We discussed our concerns extensively with him, including the fact that she ramrodded a terrible computer system into our clinic that we felt put patient safety at risk (we emphasized this point). We made it clear we felt she needed to be replaced as CEO. Paul seemed like he took our concerns seriously, and he said we should continue meeting with the board members one by one. He promised he would not mention anything about our meeting to anyone. We next met with Marlene Ballou, and had a similar experience with her. We again talked about how we were concerned for our patient's safety with our clinic's awful computer system, and how we felt Suzanne had to go. She too promised not to mention our meeting to anyone. We met with Marlene on Sunday, Jan. 21st, and on Tuesday, Jan. 23rd I found myself fired. I want to reiterate that I had absolutely no warning that this was coming. I had never received a single piece of negative feedback about my performance as a physician by anyone, ever. No concerns were ever discussed with me about any aspect of how I was doing my job (Suzanne claimed to the contrary during the Board meeting, but simply smiled and blinked when I asked her to produce documentation of this). I worked there for over a year and a half and I never had a formal performance evaluation with either Tom Smith or Suzanne Cooner, which I found odd.

 I was present at the Board meeting on Jan 23rd, and the motion to terminate my contract was proposed by Paul Schultz and seconded by Marlene Ballou. During the meeting, the Board did not feel they owed me any explanation regarding why they were firing me; they told me it was a "without cause" termination. The only substantive issue anyone would mention was Wellmark. Let's not forget that the Wellmark issue was so important to Suzanne that I had to twist her arm just to get her to appeal their decision in early 2017. Let's also not forget that Tom Smith knew, or should have known, that I wasn't going to be able to take Wellmark when he hired me. The Board told me Wellmark made up 21% of our patient base (Suzanne has since given different numbers, as high as 35%, in answer to this question) and apparently this was a perplexing problem that they just couldn't figure out how to solve. [100% divided by 3 physicians = 33% each]. I asked why I couldn't focus on the other 79% of our patients. [33% < 79%]. I asked why I couldn't focus on the nursing homes and the 65+ crowd who are all on Medicare. My questions were met with silence. It was around this time that I realized Suzanne had been teeing me up for this for a long time, and indeed after it all went down I was told by multiple people that she had been saying I "had to go" as early as February of 2017, after being on the job for about two months. I can only assume this is because I wasn't as useful to her as a physician since I couldn't accept Wellmark. Nevermind that I had relocated my family to Audubon and we had become part of the community. Nevermind that I had hundreds of patients who liked me and came to depend on me as their physician. Nevermind that in the last 6 months of 2017, the net revenue I generated for the hospital was within 16.4% of Dr. Cunningham's, who has a 35 year established practice in Audubon. Nevermind that Suzanne hired her husband as a grossly overpaid IT tech and created a "Director of Organizational Excellence" position for her sidekick Kolton, who moved with her from her old job and lived in her basement. Nevermind that Suzanne fired the St. Anthony's surgeons that had served our community well for many years and hired our own personal surgeon, at great cost, that we don't need. None of that matters. Obviously I had to go. 

 By the end of that Board meeting on Jan 23rd I was getting desperate and a little emotional. I asked how they could do this to me. I had never been treated so coldly by a group of fellow human beings in my entire life; I felt like a piece of trash by the time that meeting was over. I reminded them that my wife was giving birth to our third child in two weeks. No one would look at me. Before the meeting adjourned, Paul Schultz made a comment that erased any ambiguity about what had just happened. He said, "Let it be noted that this Board fully supports and trusts in the leadership of our CEO, Suzanne Cooner." It sounded like her words coming out of his mouth. This statement delivered its intended message to myself and Dr. Cunningham loud and clear: "We told Suzanne about the mutiny, and we choose her." As you know, Jim put in his notice of retirement by the end of that week. 

 After reading this, I have no doubt that those with egg on their face will attempt to spread misinformation to discredit me and counter what I've said. It's certainly happened before. I would encourage people to be skeptical of what they hear, and instead judge me by their personal experience, or by how I treated their family member or friend when I saw them as a patient in clinic. And to my former patients, I'm sorry we didn't get a chance to say goodbye properly. We were robbed of that. There are countless people in this town that I genuinely care about, and I'm incredibly sad that our relationship was ended as abruptly as it was. It's worth remembering that the practice of medicine, especially in a small town, is about more than just treating illness or making money. It's about the relationships you form with those you are privileged enough to call patients, and who trust you enough to call you doctor. 

 Some people understand that, and others never will. If anyone wants to contact me, please feel free at 785.231.7824 or christopher.f.stubbs@gmail.com. “