Doctors in Southeast Halt Work Over Back Pay

A group of doctors who contend they are owed nearly three months' wages walked off the job Tuesday at an ambulatory care center run by Greater Southeast Community Hospital for some of the District's poorest residents.

The action, which has forced scores of patient appointments to be rescheduled or canceled, is another sign of the hospital's increasingly dire financial problems and their impact on care. A week ago, at a hearing on Greater Southeast, city health officials described staffing and supply shortages so severe this year that they had ordered some patients transferred to other facilities.

The testimony prompted the chairman of the D.C. Council's Health Committee, David A. Catania (I-At Large), to ask for an analysis of the hospital's conditions. Regulators expanded their inspection to the ambulatory care center yesterday, a Health Department spokeswoman said.

Officials "will monitor the physician coverage of the clinic operations," a department statement said. It did not mention any immediate concerns about patient safety. More than 100 people seek care daily at the center.

The situation there has been building for some time, though Greater Southeast's chief executive, Cyril Allen, disputes the magnitude of what is owed. Allen said less than a half-dozen doctors, employed as independent contractors, are due three weeks' compensation. The physicians assert that about a dozen specialists are out more than three times that.

The question, no matter the numbers, is why. The city pays Greater Southeast more than $200,000 a month upfront to run the program. Additionally, the hospital can seek reimbursement through Medicaid and other public health insurance for the care of many patients.

"Where is this money going?" asked cardiologist Nayab Ali, one of the physicians not reporting for work.

According to Allen, "billing issues" are partly to blame. "I want to get this cleared up," he said. "I'm doing everything I can."

He would not, or could not, say when the physicians would be fully paid. "I don't want to promise when it will be," he said.

The waiting room of the ambulatory care center was essentially vacant early yesterday afternoon. Its quiet was disconcerting: The center occupies the ground floor of the former D.C. General Hospital, the once-teeming public facility at Massachusetts Avenue and 19th Street SE that was closed in 2001 following months of bitter debate.

City officials had promised the community that an emergency room and urgent care would be maintained after D.C. General shut down. Instead, Greater Southeast's parent company, now known as Envision Hospital Corp., downgraded the emergency room after a few years. It cut urgent care last fall.

"There's been a pattern of attrition through neglect," said internist David King, another of the doctors who halted work at the center.

Envision's board chairman, Paul Tuft, was in town to meet with Catania about the hospital's hoped-for sale and the problems detailed in last week's hearing. Among those: the crisis triggered in early May when the emergency room closed for a weekend after nearly two dozen nurses walked out over late pay. Greater Southeast is the city's only hospital east of the Anacostia River.

Catania said he would expand his committee's inquiry to track the money appropriated for the ambulatory care operation.

"Greater Southeast and its parent company have a long and sad tradition of failing to pay [their] vendors," he said.

In a separate interview, Tuft said he had not known of the doctors' complaints and action.

"I will do my best to rectify the situation," he said.