Hellzapoppin In The Anderson Valley!

A community meeting will be held this afternoon, October 22nd, 5:30pm, at the Philo Grange to discuss recent events at the Anderson Valley Health Center. The Center's board of directors meets on Monday, the 27th of October, presumably at the Center, and also at 5:30pm.

The tumult was precipitated by the arbitrary firing of the young, bilingual Dr. Logan McGhan, only last week feted at a meet and greet by the people who fired him the next day, and the resignation of nurse Cindy Arbanovella, both of whose letters are affixed below.

Dr. McGhan was fired Friday without explanation, and unceremoniously marched off the premises in the same ‘Give me your keys, take your stuff’ manner that befell another popular but long-time staffer, Kathy Corrall, last year.

The Anderson Valley is buzzing, and it's an angry buzz. Although McGhan had only been on the job since August 23, he and his wife, a native of Michoacan, were instantly embraced by the community.

It's not yet known if the Center's inept and secretive board of directors signed off on Dr. McGhan's dismissal, which was conducted by another relatively new hire, Shannon Spiller, whose thin resume nevertheless got her installed to oversee Anderson Valley's financially struggling health center two years ago.

Spiller and McGhan had clashed, reportedly over Spiller's objection to McGhan wearing jeans under his medical smock and a dispute about the witnesses required during examinations of minors, among other similarly resolvable things.

Monday, it was learned that Kathy Cox and Claudia Jimenez had been appointed to the Health Center's board of directors. Both women have strong links to the Spanish-speaking community. The Center provides the many immigrant Mexican families employed in the proliferating vineyards and wineries of the Anderson Valley with much of their medical care.

In another major blow to the reeling Center, Cindy Arbanovella, family nurse practitioner, a key member of the Center's staff, has resigned. She writes:

"It is with great disappointment that I inform you of my resignation from the position of Family Nurse Practitioner at the Anderson Valley Health Center, effective today. I have worked at the health center in my current role since August of 2007. I have served generations of families in Anderson Valley, from newborns to patients in their 90s. I’ve shared my patients’ struggles and successes, and they have watched me lay down roots in this community and start a family. I have tried to serve our patients to the best of my ability.

"I can no longer work for an administration that does not respect or value its employees. The recent termination of Dr. Logan McGhan was yet another rash decision made by AVHC administration without discussion or negotiation. It was not too different from what occurred with Stephanie Long, RN, who was hired after searching for qualified RNs for almost a year and then forced to leave after only a few months. It was also similar to the firing of Kathy Corral, who had served the community well for over a decade. But it took 3 years to find a full-time doctor who not only was qualified to work at AVHC, but also was interested in becoming an active part of our community. It is completely unacceptable to me that AVHC could terminate Dr. McGhan in what amounts to a temper-tantrum after so much public praise over his skills and talents.

"Meanwhile, AVHC has only one RN on staff, Michelle Ambrois, who only works part-time at the clinic as she has been directed to spend most of her time working in the schools. This puts excess pressure on the medical assistants to fill Michelle’s role and as well as for the providers to work without a nurse. At the same time, I’ve repeatedly witnessed AVHC administration micromanaging employees to the extent that it interferes with their ability to perform regular tasks, including: requiring medical assistants to complete daily duty check-lists; interrupting Dr. McGhan while with patients to make sure he was doing his job; and, for the first time in my seven years at the clinic, enforcing a dress-code on the providers, a matter of trivial significance compared to the pressing systemic problems AVHC management has made zero progress solving.

"I hope that AVHC can find a way to bring back Dr. McGhan and restore our faith in its administration’s intentions, but at this time I cannot work at the Anderson Valley Health Center."

The community is often told that the Center is financially struggling, but no one in the wider community knows if it is or isn't struggling because the board of directors won't reveal financial information. Meanwhile, the Center continues to spend money on expensive new hires, including the costly Dr. Gorchoff, who functions essentially as a consultant, and a public relations person based in Ukiah.

Given the recent personnel turmoil, and the shockingly peremptory and brutal firings of popular employees, added to the long rumored insulting treatment endured by other staffers, all of it causing enormous bad feeling in the Anderson Valley, the survival of the Center, in its 38th year, is in doubt.

Just last Thursday it was all smiles at the Boonville-based Center as McGhan, and the freshly appointed "medical director," David Gorchoff, were warmly introduced by Ms. Spiller and board chair Bonner.

The next day McGhan was fired, although he'd been highly sought after by both Anderson Valley and the Gualala clinic.

No public announcement was made about McGhan's dismissal by the Center's board of directors, who don't seem to have been made aware of it before it was carried out.

McGhan himself, late Sunday, made his feelings public. He had prepared the following letter for Center board chairman Ric Bonner, but was fired before he could mail it:

"Dear Ric, I hope this find you and your family well. I realize I have been here only a short time, but I have some serious concerns about the clinic and its future that I would like to bring to your attention. There exists an utter lack of administrational [administrative] organization, communication, and leadership combined with blatant and open disrespect of all medical staff on a level that I have never witnessed before.

"I've worked in many clinics, with many different organizations, some bad, some good, none perfect. However, the AVHC currently is far and beyond the most frustrating place I've ever set foot in. The clinic morale is on the floor. Since my arrival the CMO and the CEO had been extremely evasive and condescending toward me. I have been hovered over, nitpicked, called insubordinate, and have had several shouting matches with Shannon [Spiller] in the past weeks. In all of these encounters she has been completely out of line and proven to be wrong, having to apologize afterwards. I have spoken in group and individually with the entire staff and it is my conclusion that I am receiving the best treatment of anyone at the clinic.

"There is no clinical manager; there is no designated referral staff (which is ridiculous as this job requires one person to constantly follow up on all our communications with consultants. It is currently being done ad hoc by Medical Assistants who literally have well over 50 other assignments to do beforehand.) The medical assistants are lost, threatening to quit constantly. There is no nurse most of the time as Shannon has her in the high school on most days (after firing the last one who sounded fairly competent). All the while, the Chief Operating Officer (who should be in constant contact with the mid-levels and who should also have some medical credential), the CEO and the CMO hide in their office all day only to emerge to harass the staff and retreat. I have brought all these concerns since my arrival to Shannon [Spiller] and David [Gorchoff] and feel I have been lied to at every turn. There are no working computers in the exam rooms which I have mentioned continuously and was told many times that they had something on order which they lied about. Eight weeks in, I still have no computer.

"I was actively recruited against joining [i.e., told not to take a position at] the Anderson Valley Health Center by Diane Agee (who was on hand throughout most of the negotiations) and David Turner repeatedly asked me to join the Redwood Coast Medical Clinic, saying the Anderson Valley Health Center would not work out most likely in the future. As I am now told, Diane Agee threatens the entire staff and their licenses upon leaving the clinic, and seems to have left Shannon in her stead as her surrogate. Shannon, as a physician's assistant, has absolutely ZERO qualifications for her position as director or leader. And [Dr.] David [Gorchoff] is the only rural family medicine medical director who takes no part in patient care and has no desire to do so. As a result he has no idea of the myriad of problems facing the medical assistants and providers on a daily basis. He responds to these concerns with only more obfuscation. He is likewise often unavailable during his two weeks in the Pacific each month and has been constantly terrorizing the other providers during the few days he is actually present.

"I love the Anderson Valley, the medical staff and everyone I've come to meet here. It is my desire to stay here for the rest of my life. However, the aforementioned problems are actively burning the last remaining trust of the staff and the community. After much deliberation I have come to the conclusion that I cannot continue to work at the Anderson Valley Health Center while Shannon Spiller and David Gorchoff remain on staff.

Please call when you get the opportunity.

— Logan James McGhan, MD."

Dr. Mark Apfel, the Center's doctor since its inception, and also embattled by the vague authority presently in charge of the Center, published this letter Sunday:

"To the Anderson Valley Community

This evening, I met with Cindy Arbanovella, Logan McGhan and Jessica McIninch to discuss the recent events at the AVHC and to see how we could take this opportunity to make substantial changes in the organization in order to meet the mission statement of the AVHC which is to provide excellent and affordable health care to the people Anderson Valley.

First of all, I want to thank all the community members for their remarkable show of support for the providers at the AVHC. This support is a major factor in why we have all chosen to live here provide healthcare in this community. I want to say that I understand that the Board of Directors of the AVHC has been under a lot of pressure lately and I would like to give them a chance to reevaluate the direction that the Health Center has been heading in. The Board Members are community members who have volunteered their time to the Health Center and Community and deserve this opportunity.

The Board will be meeting in closed session on Tuesday evening to discuss the events of the past week as well as make certain decisions regarding the running of the Health Center. I believe that it is in the best interest of the entire community to allow them this opportunity and therefore I would encourage people NOT to demonstrate on Monday morning at the Health Center and to postpone the proposed community meeting until after the Board has a chance to meet and present their plan to the community, either after their closed session or at their next Board meeting which is scheduled on Monday, October 27. At that meeting, Cindy, Logan, Jessica and I will be presenting to the board our vision of where the health center needs to go in order to continue to be responsive to the needs of our community. I encourage all interested people to attend the meeting on October 27. I hope that you will join me in this effort to take a thoughtful break and allow decisions to be made in a spirit of cooperation and for the benefit of the Anderson Valley community.

Thank you all for your support and friendship,

Mark Apfel."

Community reaction is focused on an immediate reinstatement of Dr. McGhan, the return of Cindy Arbanovella, fair and decent treatment of Dr. Apfel and all other staff, and the firing of Shannon Spiller and Dr. Gorchoff.

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PERSONNEL CLARIFICATIONS: Shannon Spiller was hired as a Physician's Assistant two years ago, but was then appointed CEO in June of this year after Diane Agee and the CFO and COO resigned. Those three were 'volunteer' consultants until February. David Gorchoff, the now former CMO (that's chief medical officer) was hired in July and began work part time in July and August, but fully assumed his position in September at 20-24 hours a week.