Chief of homosexuals' clinic resigns Medical staff exodus had been threatened


Elizabeth Kaeton, under fire for allegedly mismanaging Baltimore's only gay and lesbian health-care clinic, resigned as the facility's director yesterday -- thus averting the threatened mass exodus of the clinic staff.

"There have been enough threats, ultimatums and innuendoes that it's time to take my good integrity -- and the good name I've established for myself -- and move on," said Ms. Kaeton. "I am real clear the real problem at the clinic is the crisis of AIDS."

Ms. Kaeton, who is an Episcopal priest and a nurse, had become the focus of problems at the Chase-Brexton Clinic in recent weeks.

On Dec. 6, members of the clinic's medical staff gave the clinic's board of directors a four-page memo detailing their concerns with her performance -- including, they said, an inconsistent management style, failure to delegate responsibility and a lack of provisions for workplace safety.

When the board voted in support of Ms. Kaeton, several doctors and staff members at the clinic announced that they would consider resigning. But when the city's acting health commissioner, aware of mounting problems, requested a meeting with the board, alliances began to shift.

"Clearly, the clinic is at the stage where it has to restructure," said Garey Lambert, a member of the board who has supported Ms. Kaeton. "Elizabeth, whether right or wrong, is taking the fall."

Of the clinic's $600,000 annual budget, $470,000 comes from the city. Health Department officials said yesterday they expected a meeting between Acting Commissioner Elias Dorsey and the Chase-Brexton board before year's end.

The clinic in the Mount Vernon area is the only local health-care provider dedicated to serving male and female homosexuals. Its 27 staff members -- only nine of whom work there full time -- test, counsel and care yearly for more than 1,000 people with acquired immune deficiency syndrome 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. Ms. Kaeton has overseen the clinic from its start -- watching its patient list grow from 200 to 700 a month.

"It's time for a different kind of leadership," Mr. Lambert said. "We need someone with medical experience to handle a clinic this large."

The clinic's medical staff agrees.

"The doctors are concerned there has been nobody running this thing with medical experience," said Dr. Carla Alexander, the clinic's medical director for illnesses from human immunodeficiency viruses. "But the doctors won't be satisfied just with [Ms. Kaeton's] resignation. We want to know how the board will be revised to include people who are knowledgeable about health care."

Dr. Alexander, who wants half the board's 15 members to be medical professionals, said the biggest challenge facing Chase-Brexton was providing care for a growing number of severely ill patients.

She said clinic physicians would make a final decision about their plans after the board met today.

During that meeting, the board is expected to accept Ms. Kaeton's resignation and to discuss restructuring its membership.

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