Fearful that medical care is being compromised by administrative mismanagement, several doctors and staff members at Baltimore's Chase-Brexton Clinic say they are considering resigning since the board of directors has refused to fire the head of the gay and lesbian health-care clinic.
"I am reluctant to practice medical care there," said Dr. Mary Bolton, a part-time physician at the clinic. "There's no backup."
Dr. Bolton was one of six clinic employees attending a news conference yesterday at the Gay and Lesbian Community Center of Baltimore. The employees called the meeting after the Chase-Brexton board, which held a seven-hour emergency meeting Thursday night, voted 7-3 not to fire the clinic director, Elizabeth Kaeton.
"Elizabeth Kaeton has performed admirably for 18 months," said Gary Lambert, a member of the Chase-Brexton board. "That doesn't mean there aren't serious problems to be addressed, but I don't think we should make decisions based on unsubstantiated, conflicting claims."
The Chase-Brexton clinic, the only area health-care provider dedicated to serving the gay and lesbian community, tests, counsels and cares for several thousand people yearly with AIDS, and other sexually transmitted diseases. The clinic began more than 10 years ago in the Gay and Lesbian Community Center but became an independent organization 18 months ago.
Of its $600,000 annual budget, $470,000 comes from the city.
"At this point, we are concerned about the situation, but we are not taking any action until further investigation," said a spokeswoman for the city's Health Department.
On Thursday, members of the clinic's medical staff gave the board a four-page memo detailing their concerns with Ms. Kaeton's performance.
Among their concerns were an inconsistent management style, failure to delegate responsibility and a lack of provisions for workplace safety.
At the news conference yesterday, Dr. Bolton described shortages of supplies including antibiotics, syringes and swabs. She also said she could not be certain clinic personnel always followed through on physicians' orders.
Other staff members said Ms. Kaeton hurt morale through threats and intimidation.
"She has done her best to discredit anyone who attempts to speak out," said Bonnie Charon. "The whole atmosphere is such [that] we can't talk about what's going on. It's very upsetting."
Ms. Charon, the clinical coordinator for sexually transmitted diseases, said she had submitted her resignation effective Dec. 14.
Ms. Kaeton, whose appearance at the news conference caused organizers to walk out and change locations, denied specific charges against her. She also said patient care was never jeopardized by inadequate safety procedures.
"I think the real crisis is AIDS, and the staff as well as the administrators and board are overwhelmed," she said in an interview yesterday. "We are overwhelmed and understaffed."
Ms. Kaeton and Mr. Lambert said they would not take action until an independent investigator reviewed the situation and the staff went on retreat, scheduled for Jan. 5.
That may not be soon enough for some.
Ruth Singer, the physician who directs the clinic for sexually transmitted diseases, said she is "trying to figure out how to disengage from the clinic without compromising patient care."