LOWVILLE — Lewis County General Hospital's CEO is under fire from the hospital physicians group, but he has maintained support from his board.

“It's a little premature to put the blame on one person,” said Legislator Michael A. Tabolt, R-Croghan, chairman of the legislative Hospital Committee and a member of the county-owned hospital's board of managers.

A majority of the active medical staff in late July cast a vote of no confidence in CEO Eric R. Burch, citing in a July 23 letter to hospital managers “the erosion of our trust in Mr. Burch's management and leadership skills.”

That letter, with a packet of other letters and presentations, was sent in late August to county legislators and board members of the new hospital local development corporation to give them “a clear understanding of the depth of the medical staff's concern,” according to an attached memorandum. The packet was just provided to the Times, as well.

The board of managers responded to the doctors' letter with a unanimous affirmation of support for Mr. Burch and doesn't plan to make any immediate change in management, Mr. Tabolt said.

County legislators recently decided to contract with the Bonadio Group, Syracuse, for $56,400 to recommend operational changes at the facility, given ongoing operating losses and a debt to the county that is approaching $6 million.

That group, which is expected to issue a report in a month or two, is to scrutinize all aspects of the operation, including administrators, managers and doctors, Mr. Tabolt said.

“We're all under fire,” he said.

The board doesn't plan any major changes until it gets the opinion of the consultants, Mr. Tabolt said.

Mr. Burch did not respond to a request for comments.

In response to a request for comment sent to the hospital's spokeswoman, she provided a pair of letters dated July 26 from hospital board President William H. Wormuth to Dr. David F. Rosner, president of the hospital's medical staff. In one letter, he expressed appreciation for a separate letter of support for Mr. Burch signed by Dr. Rosner and five other hospital-employed physicians. In the other, he noted hospital managers' continued support of Mr. Burch and expressed the hope that doctors “will continue to be contributing team members and work conscientiously with the CEO, administrative staff and Board to successfully address and ameliorate the current financial crisis.”

The physicians' packet included an August 2011 letter from Dr. Steven L. Lyndaker, then president of the medical staff, expressing concern about the unexpected firing of general surgeon Dr. James V. Stillerman. Dr. Stillerman was reinstated after pressure from hospital workers and the general public.

A statement from Dr. Lyndaker to the board of managers during the same time period also was included in the packet.

The doctor, who operates a private practice at the hospital's North State Street campus, indicated that Dr. Stillerman's firing stemmed from an “alleged contract violation” for referring a potential patient to another facility. He suggested that the situation was not unique and that the surgeon was not given a chance to defend himself.

“We need to significantly improve communication between medical staff, administration and the board and place a priority on clear, respectful and transparent dialogue, with the mutual focus of ensuring the provision of high quality medical care,” Dr. Lyndaker said.

He also expressed concerns about an erosion of respect between medical staff and senior administration, leading to a strained work environment. He recommended that a medical director act as an advocate for employed physicians and that a chief medical officer position be created to “help maintain the delicate balance needed between administrative and clinical considerations.”

Dr. Lyndaker, when asked to comment on the matter, said that those issues have not substantially changed in the past year and that some have contributed to the facility's fiscal problems.

Meanwhile, Mr. Tabolt said, a follow-up meeting Tuesday with state Department of Health officials in Albany was positive. A proposed change in hospital status to increase Medicaid reimbursement remains a possibility, and state funding may be available to help cover operational losses and undertake specific projects, like a proposed dialysis center.

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