These Are the Top Pediatric Care Providers in Westchester
St. Clare's Internal Medicine Doctors Give Mass Resignation Notice, Warn Of 'impending Crisis'
Five internists at St. Clare's Mercy Hospital say they'll walk away on Oct. 1, due to what they are calling unsafe working conditions. (Dan Arsenault/CBC)
Five doctors at a St. John's hospital have tendered a joint notice of resignation, saying their work environment has become "unsafe for both patient care and provider well-being," CBC Investigates has learned.
The doctors make up the internal medicine department at St. Clare's Mercy Hospital — responsible for a wide range of critical services provided for both emergency patients and those admitted to the hospital.
The letter says the doctors will not be performing any duties outside their contractual obligations — no evenings or weekends — starting on July 1, until their resignation takes effect on Oct. 1.
"It has become increasingly clear to them that continuing under the current model would further compromise patient safety and the already fragile well-being of the team," reads the letter, written by lawyer Kyle Rees of O'Dea Earle and sent to the provincial health authority's executive on Monday.
Rees declined comment when reached on Thursday, and stressed that neither he nor his clients provided the letter to CBC Investigates.
In a statement, Newfoundland and Labrador Health Services said it cannot comment on the resignation letter, but said it values relationships with all health-care providers, and seeks to ensure patient care remains unchanged by human resources challenges.
In the letter, Rees writes that multiple concerns have led to this point, citing a recent decision to remove the hospital's resident support.
The doctors feel NLHS has not done enough to find solutions to the reduction of patient coverage resulting from the move.
Lawyer Kyle Rees was retained by the internal medicine team at St. Clare's Mercy Hospital. (Olivia Garrett/CBC)"NLHS has consistently deferred responsibility and failed to provide any substantive plan to address this impending crisis," the letter reads.
The five doctors are Michael Jakovac, Olatunji Odumosu, Stephanie Genge, Sanampreet Gurm and Evan Wee.
Sources say two others — Leonard Phair and Alex Dias — had previously resigned.
Meanwhile, internists at the Health Sciences Centre in St. John's are warning the health authority not to shift the workload to their hospital if the team at St. Clare's resigns en masse.
Another letter was sent on Thursday, co-signed by the internal medicine teams at St. Clare's and the Health Sciences Centre.
"Transferring the workload to the Health Sciences Centre is also not an option," it reads. "HSC is operating at full capacity, and there is no infrastructure, space or staffing to absorb the additional burden."
According to that letter, St. Clare's routinely manages 100 admitted internal medicine patients, along with responsibility for 15 to 20 emergency room consults on a daily basis.
The letter also warns that once the resident physician coverage ends on July 1, St. Clare's will not have an effective team in place to handle Code Blue emergencies — cardiac or pulmonary arrest.
"Lack of a proper Code Blue team is unsafe and will have disastrous patient outcomes for medical and surgical patients."
The teams are calling for "immediate engagement" and want a written response "outlining how N.L. Health Services will ensure safe and sustainable internal medicine coverage at St. Clare's beyond July 1, 2025."
Download our free CBC News app to sign up for push alerts for CBC Newfoundland and Labrador. Sign up for our daily headlines newsletter here. Click here to visit our landing page.
Internal VA Emails Reveal How Trump Jeopardizes Veterans' Care - ProPublica
ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they're published.
Earlier this year, doctors at Veterans Affairs hospitals in Pennsylvania sounded an alarm. Sweeping cuts imposed by the Trump administration, they told higher-ups in an email, were causing "severe and immediate impacts," including to "life-saving cancer trials."
The email said more than 1,000 veterans would lose access to treatment for diseases ranging from metastatic head and neck cancers, to kidney disease, to traumatic brain injuries.
"Enrollment in clinical trials is stopping," the email warned, "meaning veterans lose access to therapies."
The administration reversed some of its decisions, allowing some trials to continue for now. Still, other research, including the trials for treating head and neck cancer, has been stalled.
President Donald Trump has long promised to prioritize veterans.
"We love our veterans," he said in February. "We are going to take good care of them."
After the Department of Veterans Affairs began shedding employees and contracts, Trump's pick to run the agency, Secretary Doug Collins, pledged, "Veterans are going to notice a change for the better."
But dozens of internal emails obtained by ProPublica reveal a far different reality. Doctors and others at VA hospitals and clinics across the country have been sending often desperate messages to headquarters detailing how cuts will harm veterans' care. The VA provides health care to roughly 9 million veterans.
In March, VA officials across the country warned that a critical resource — databases for tracking cancer — would no longer be kept up to date. As officials in the Pacific Northwest explained, the Department of Government Efficiency was moving to kill its contract with the outside company that maintained and ran its cancer registry, where information on the treatment of patients is collected and analyzed. DOGE had marked it for "immediate termination."
Officials at the VA centers in the Pacific Northwest said funding for their cancer research was "updated for immediate termination" after a review by the Department of Government Efficiency. Credit: Obtained by ProPublicaThe VA in Detroit raised a similar alarm in an email, warning of the "inability to track oncology treatment and recurrences." The emails obtained by ProPublica detail a wide variety of disruptions. In Colorado, for instance, layoffs to social workers were causing homeless veterans waiting for temporary housing to go without help.
The warnings, sent as part of a longstanding system at the VA to alert higher-ups of problems, paint a portrait of chaotic retrenchment at an agency that just three years ago was mandated by Congress through the PACT Act to expand care and benefits for veterans facing cancer and other issues after exposure to Agent Orange, burn pits or other toxins.
Doctors and other health care providers across the VA have been left scrambling and short-staffed amid an ever-shifting series of cuts, hiring freezes and other edicts from the White House.
VA officials in Pittsburgh sent warnings about studies being impacted by a hiring freeze. These included studies on cancer, suicide prevention and exposure to toxins. Credit: Obtained by ProPublicaThe upheaval laid bare in the emails is particularly striking because the cuts so far would be dwarfed by the dramatic downsizing in staff and shift in priorities the administration has said is coming.
The VA has cut just a few thousand staffers this year. But the administration has said it plans to eliminate at least 70,000 through layoffs and voluntary buyouts within the coming months. The agency, which is the largest integrated health care system in the U.S., currentlyhas nearly 500,000 employees, most of whom work in one of the VA's 170 hospitals and nearly 1,200 clinics.
Despite an expanded role mandated by Congress through the PACT Act, administration officials have said their goal is to trim the agency to the size it was before the legislation passed.
"The Biden Administration understood what it meant to pay for the cost of war; it seems the Trump Administration does not," said Rep. Mark Takano, a California Democrat and chief author of the PACT Act.
Documents obtained by ProPublica show DOGE officials working at the VA in March prepared an outline to "transform" the agency that focused on ways to consolidate operations and introduce artificial intelligence tools to handle benefits claims. One DOGE document proposed closing 17 hospitals — and perhaps a dozen more.
VA press secretary Pete Kasperowicz told ProPublica that there would be no hospital closures. "Just because a VA employee wrote something down, doesn't make it VA policy," he said in a written statement. But he did say that use of AI will be a big part of what he called VA's "reform" efforts.
Kasperowicz dismissed the idea that the emails obtained by ProPublica show chaos.
"The only thing these reports show is that VA has a robust and well-functioning system to flag potential issues and quickly fix them so we can provide the best possible care to Veterans," he wrote.
DOGE did not respond to requests for comment.
Have You Been Affected by Changes at the Department of Veterans Affairs? Tell Us About It.
Have you experienced setbacks in your care or benefits amid the changes at the Department of Veterans Affairs? ProPublica wants to hear from you.
The White House released a budget proposal last week that calls for a 4% increase in the VA's budget. That total includes more money for medical care, though a portion of that would be used to pay for veterans to seek care outside the VA medical system.
More answers to the VA's larger plans may come today, when Collins is scheduled to testify before the Senate Veterans Committee, his first hearing on Capitol Hill since coming into office.
David Shulkin, who headed the VA in Trump's first term, said the administration is too focused on cuts rather than communicating a strategy for improving care for vets.
"I think it's very, very hard to be successful with the approach that they're taking," Shulkin told ProPublica.
One way local VA officials have tried to limit the damage has been by sending warnings — formally known as an issue brief — to higher-ups. And sometimes it works.
After officials in Los Angeles warned that "all chemotherapy" would stop unless Washington backed off killing a service contract, the VA reversed its decision.
And, amid growing scrutiny, the administration also made some researchers in Pennsylvania and elsewhere exempt from cuts. The laid-off social workers who helped homeless vets in Colorado were also brought back after about a month away from their jobs. Kasperowicz said that four social workers were affected but "their caseload was temporarily redistributed to other members of the homeless team."
The warnings from officials across the country underscore how the comparatively modest cuts so far are already affecting the work of the VA's medical system, with the study and treatment of cancer cited in multiple warnings to agency leadership.
"We have absolutely felt the impact of the chaos all around us. We're already losing people," said one senior researcher, who spoke to ProPublica anonymously for fear of retaliation.
Referring to studies, he added: "We're going to be losing things that can't restart."
And while Kasperowicz told ProPublica that the issues in Pennsylvania have been resolved, locals there said that's not the case and that the impact is ongoing.
In Pittsburgh, two trials to treat veterans with advanced head and neck cancer, which officials in March had warned were at risk because of hiring freezes, have still not started, according to Alanna Caffas, who heads a Pittsburgh nonprofit, the Veterans Health Foundation, that partners with the VA on research.
"It's insane," Caffas said. "These veterans should be able to get access to research treatments, but they can't."
VA employees in Pittsburgh sent a warning that they had lost research staff because of the hiring freeze. Credit: Obtained and highlighted by ProPublicaA third trial there, to help veterans with opioid addiction, wasn't halted. Instead, it was hobbled by layoffs of key team members, according to Caffas and another person involved in the research.
Regarding the issues with cancer registries, Kasperowicz said there had been "no effect on patients." He added that the VA is moving to create a national contract to administer those registries.
Rosie Torres, founder of Burn Pits 360, the veterans advocacy group that also pushed hard for the legislation, called the emails showing impeded cancer treatment a "crisis in the making" and "gutwrenching."
States Fear Critical Funding From FEMA May Be Drying Up
That the decisions are being made without input from the communities of vets they affect is worse, she added.
"If they are killing contracts that may affect the delivery of care, then we have a right to know," she said.
Last week, as the second Trump administration marked its first 100 days in office, Collins celebrated what he described as its achievements.
In a recorded address, he said that under his stewardship the VA processed record numbers of benefit claims, ended "divisive" spending on diversity initiatives and redirected millions of agency dollars from "non-mission-critical" programs back toward services to benefit veterans.
"We will not stop working to put veterans first," he wrote in an accompanying op-ed.
Others say Collins has done no such thing. Instead of focusing on veterans, said one VA oncologist, "we're spending an enormous amount of time preparing for a staffing catastrophe."
"Veterans' lives are on the line," the doctor said. "Let us go back to work and take care of them."
Alex Mierjeski contributed research, and Joel Jacobs contributed reporting.
UnitedHealth Accidentally Emails Internal Talking Points To ReporterSTAT
An internal document drafted in advance of UnitedHealth Group's shareholder meeting this week reveals how the company's leadership — facing an extraordinary series of financial and legal challenges — sought to downplay complaints about its business practices and assure jittery investors that it will soon return to maximum profitability.
The 18-page document, marked in red "privileged and confidential,'' offers a rare, behind-the-scenes look at the nation's most powerful health care conglomerate as it endures arguably the most difficult stretch in its nearly 50-year history. The last six months have been punctuated by government investigations, a tanking stock price, and the brazen killing of a top executive on a Manhattan street before the annual investor conference last December.
UnitedHealth's document, labeled as a draft and dated May 29, runs through manicured talking points apparently intended to coordinate the response to shareholders' questions. Specifically, the document shows how Stephen Hemsley, the company's longtime CEO and board chair who shies away from publicity, is navigating the leadership shakeup since retaking the reins last month. Investors have raised pointed concerns over his $60 million pay package.
It also discusses missed revenue targets, a litany of lawsuits and federal investigations, and concerns revealed in reporting by STAT that the company uses artificial intelligence and bureaucratic barriers to delay and deny care.
STAT+ Exclusive Story
Already have an account? Log in
Unlock this article — plus in-depth analysis, newsletters, premium events, and news alerts.Already have an account? Log in
Individual plans Group plans View All PlansTo read the rest of this story subscribe to STAT+.
Subscribe
Comments
Post a Comment