THE CAVALIER DAILY REPORTS: UVA HEALTH NO CONFIDENCE LETTER
128 UVA Physicians Group-employed faculty call for the immediate removal of Craig Kent and Melina Kibbe due to an urgent matter of patient safety and public concern.
By Grace Thrush and Ford McCracken September 5, 2024
September 5, 2024
To: The Rector and Board of Visitors of the University of Virginia
Robert D. Hardie
Carlos M. Brown
Robert M. Blue
Daniel M. Brody
U. Bertram Ellis Jr.
Marvin W. Gilliam Jr.
The Hon. Paul C. Harris
Stephen P. Long, MD
Paul B. Manning
John L. Nau III
David O. Okonkwo, MD
The Hon. L.F. Payne
Amanda L. Pillion
Rachel W. Sheridan
David F. Webb
Douglas D. Wetmore
Porter N. Wilkinson
Michael J. Kennedy
Lisa R. Kopelnik
Cc: University of Virginia Peer-Elected Faculty Leaders
Stephen H. Culp, MD
James H. Lambert
Michael Ragosta III, MD
Jeri K. Seidman
Megan C. Tracci, MD, JD
Re: UVA Faculty Letter of No Confidence in Craig Kent and Melina Kibbe
Please see the enclosed letter signed by 128 UVA Physicians Group-employed faculty.
For security and authenticity, signatures were obtained via face-to-face interaction; there was no electronic dissemination.
As indicated in the letter, the signatures are being protected from public disclosure. The letter itself remains open for more signatures.
To protect the faculty, we will arrange for the exclusive, limited audience named below to view and verify the signatures should this be requested by the Board of Visitors:
• Ms. Rachel W. Sheridan and Ms. Porter N. Wilkinson in their capacity as Chair and Vice Chair of the Audit, Compliance, and Risk Committee.
• Dr. Stephen P. Long and Dr. David O. Okonkwo because they have both worked at academic medical centers and can understand the rank and specialties of those signing.
UVA faculty expect the Board of Visitors to take measures to ensure there is no attempt by UVA Health leaders to retaliate against those who signed (or are suspected to have signed) this letter.
Peer-elected faculty leaders have been Cc’d to ensure further accountability and governance.
The Board of Visitors is now on notice of this urgent matter of patient safety and public concern.
URGENT MATTER OF PATIENT SAFETY AND PUBLIC CONCERN
LETTER OF NO CONFIDENCE IN
CRAIG KENT, CEO OF UVA HEALTH
MELINA KIBBE, UVA SCHOOL OF MEDICINE DEAN
"...any leader—at any level—depends on the trust and support of the people he or she represents. If that trust is lost, for whatever reason, it is exceedingly difficult to continue to lead."
– University of Virginia President James Ryan
To the Rector and Board of Visitors of the University of Virginia:
We sign this letter of no confidence as ethical, principled, and dedicated professors and health care professionals committed to our patients, colleagues, community, and the University of Virginia.
It is our duty to protect the safety of our patients and community, as well as the quality, welfare, honor, and reputation of the University of Virginia and our medical profession.
Craig Kent and Melina Kibbe have not only undermined but also directly attacked the values that inspired us to study, teach, and work at the University of Virginia School of Medicine and UVA Health.
Craig Kent and Melina Kibbe foster a negative environment that is contributing to an ongoing exodus of experience and expertise at all levels that contravenes our mission to provide excellent—and safe—patient care.
This environment has led to egregious acts, which must no longer be tolerated:
COMPROMISED PATIENT SAFETY
• Pressuring physicians, nurses, and other staff to abstain from using the Be Safe process to report patient safety concerns.
• Hiring doctors despite concerns regarding integrity and quality known in the medical community and communicated to leadership.
• These actions threaten the safety of our patients and reputation of our health care programs.
CULTURE OF FEAR AND RETALIATION
• Using explicit and implicit threats and retaliation—often relayed to faculty via their chairs and chiefs—against those who have raised concerns about patient safety, capacity constraints, and moral distress.
• Responding to concerns and questions raised by faculty in open forums with ridicule and disrespect.
• Subverting the true intent of credentialing, quality review, and professional support processes to silence and intimidate faculty.
DEVALUING THE ACADEMIC STANDARDS OF PROMOTIONS AND TENURE
• Using delays and denials of promotion and tenure as retaliation against respected faculty for speaking out about patient safety concerns, a culture of fear and retaliation, and unethical behavior by UVA Health senior leaders.
• Implementing non-transparent and inconsistent standards regarding academic rank and compensation for new hires relative to existing faculty.
EXCESSIVE SPENDING ON C-SUITE EXECUTIVES AND SUPPORT
• Continued significant expansion of the number of C-suite executives, Chiefs of Staff, Special Advisers, other supporting personnel, and resulting expenses not allocated to patient care that could otherwise address ongoing clinical and technical staff shortages.
• In parallel with this expansion, sustained expenditure and reliance on consultants.
FAILURE TO BE FORTHCOMING ON SIGNIFICANT FINANCIAL MATTERS
• Concerns include audit performance, the communication regarding the recent transition of the Chief Financial Officer, Community Health acquisitions, Revenue Cycle, and UPG funds flow.
CONSISTENTLY VIOLATING THE BOARD OF VISITORS APPROVED CODE OF ETHICS IN THE UNIVERSITY OF VIRGINIA FACULTY HANDBOOK
• Failure to protect confidential reporting and internal whistleblowing.
• Disregarding valid reports of fraudulent billing and requests by senior leaders to fraudulently modify patient records in order to obfuscate adverse outcomes and boost productivity metrics.
• Systemic disregard of policy, procedure, regulation, and fiduciary responsibilities including but not limited to the following UVA Faculty Handbook Professional Conduct and Ethics Codes:
1. Compliance and Ethics: We perform our responsibilities ethically and honestly, in compliance with all University policies and applicable to federal, state, and local laws.
2. Use of University Resources: We use University resources only for their intended business purpose, as aligned with the University’s mission. We promote accurate financial reporting, protection of the University’s assets, and responsible fiscal management. Our expenditures are reasonable and necessary.
7. Respectful Workplace: We treat every individual with kindness, dignity and respect, regardless of position or status. We provide a safe and healthy environment for working, living, and learning. We collaborate with others in a positive and respectful manner.
8. Honesty and Integrity: We act and communicate honestly and with integrity, upholding the University’s values at all times. We do not condone dishonesty by anyone in any form, including fraud, theft, cheating, plagiarism or lying.
9. Reporting Without Fear of Retaliation: We report all violations of law or University policy, without fear of retaliation for reports made in good faith. We investigate all concerns and determine corrective action. We will cooperate with all investigations into suspected wrongdoing.
WEAPONIZING ASPIRE VALUES
• Senior leaders of UVA Health have and continue to use ASPIRE Values to punish and intimidate faculty—often in the form of letters placed in Human Resources and Departmental files that have been referenced as cause to withhold recommendations for promotion and tenure.
SUBJECTING RESIDENTS TO BULLYING AND HARRASSMENT
• Repeated instances of abusing the power dynamic between UVA Health senior leaders and trainees which culminated in disturbing and heartbreaking Graduate Medical Education reports that were suppressed, minimized, and subsequently altered.
For over a year, these concerns and egregious acts were reported via UVA's official reporting processes including emails, a resolution by the School of Medicine Faculty Senate Representatives, and multiple meetings with UVA leadership.
Many faculty, doctors, nurses, and staff who have shared these legitimate concerns have been silenced, intimidated, and/or punished for following recommended UVA reporting protocols.
Some leaders have dismissed many of these concerns as those of a disgruntled few. This letter and these signatures demonstrate that these leaders are disconnected from the organization that they have been entrusted to lead.
We sign this letter of no confidence as a last resort out of urgent concern for our patients, colleagues, community, and the University of Virginia.
We call for the immediate removal of Craig Kent and Melina Kibbe.
We urge the Board of Visitors to select new leaders for UVA Health and the UVA School of Medicine who are committed to upholding UVA's cherished values; defending academic freedom and free speech; and most importantly recommitting to exceptional patient care, safety, and the well-being of our doctors, nurses, and staff.
Sincerely,
(Signatures signed, verified, and maintained under seal.)
What is going on at UVA Health?
We are Concerned Citizens of Charlottesville and Patients of UVA Health who are troubled by what we have heard from many UVA Health professionals over the past year.
These professionals are not only our doctors and nurses but also our friends, family and neighbors. They are not willing to use their names out of fear of retaliation by UVA Health senior leaders. We believe our community should value and protect its health care workers who have dedicated their lives to helping UVA patients.
A Parrhesiastes is someone who speaks the truth in a clear and honest way…
It's about the courage to speak one’s mind even when it's difficult or unpopular…to prioritize truth over social niceties or personal gain...
But speaking the truth can be dangerous. A Parrhesiastes understands this risk and is willing to face the consequences, from social disapproval to vindictive employers or even violence...
Because ultimately Parrhesiastes act out of a sense of duty.
They believe speaking the truth is necessary for the greater good and to protect the people and institution they love.