When Mt. Ascutney Hospital urologist Michael Curtis received an email on July 7 telling him that the hospital’s CEO, Matthew Foster, planned to meet with him at the end of the day, Curtis was glad.
A few weeks before, news had broken that Curtis had received regulatory approval for a stand-alone surgery center in White River Junction. The urologist hoped that Foster’s visit would allow Curtis to explain how he thought the Windsor hospital and the surgery center might collaborate.
But when it came time for Foster’s arrival, Curtis spied through his window that the CEO had someone else with him: the head of HR.
“I just turned to the people around me — I said, ‘Oh my gosh, I think I'm about to get fired,’” Curtis said in an interview.
He was right.
His dismissal letter, which Curtis provided to Vermont Public, said his employment was being terminated without cause. The only stated explanation was that the hospital had determined “a different approach (was) needed to support its current operational and clinical objectives.” Because the contract required 90 days notice from the hospital, Curtis will keep working at Mt. Ascutney through September.
Curtis said his part-time employer had given no indication he wasn’t performing his duties correctly. The month before they fired him, his bosses even gave him an award for high patient satisfaction. The urologist believes there’s an obvious reason why he was let go: the ambulatory surgery center.
“That’s my personal theory,” Curtis said.
The surgery center wouldn’t compete with the services Mt. Ascutney offers. But it would compete directly with Dartmouth-Hitchcock, the flagship hospital for Dartmouth Health, the regional health system which includes Mt. Ascutney.
In the past, state regulators were more hesitant to allow stand-alone surgery centers, which perform lower-risk outpatient procedures. But as prices rise — and waitlists grow — in Vermont’s hyper-consolidated healthcare marketplace, officials have expressed a new eagerness to approve independent facilities.
“We want to increase the opportunity for competition and lower-cost providers to enter the state,” Green Mountain Care Board chair Owen Foster told Vermont Public after regulators unanimously approved plans for the Upper Valley Surgery Center.
A spokesperson for Dartmouth Health, Audra Burns, did not answer questions about why Curtis had been let go. But she wrote that it was “important to note” that the health system had not opposed the free-standing surgery center when it came before the care board.
Curtis said that Dartmouth Health is well within their rights to fire him. But he said he’s been given no clarity about what to tell patients.
“I just have been struck by the fact that they have zero plan for what to do with patients who need to be seen — as in follow-up in seven weeks, that kind of thing,” he said.
Burns said that a new urologist would soon be brought on, but did not respond to follow-up questions.
Jeffrey Sass is one such patient who isn’t sure what Curtis’ coming departure means for him. The 75-year-old welder and sculptor was scheduled for surgery with Curtis in October, and now he’s wondering whether he should reschedule it before he leaves.
But he’s also dismayed that his surgeon was fired at all. Curtis, he said, is the kind of doctor who lets his patients contact him on his personal number.
“He really cares about his patients. That's very clear, and having him as a doctor has actually been kind of a pleasure,” he said.
Sass said he’s gotten “topnotch” care from Dartmouth Health doctors. But he also thinks a new surgery center, with its potential to reduce wait times in the area, is a great idea.
A few years ago, he’d been told by Dartmouth-Hitchcock it would be months before they could get him in for a spine surgery, despite crippling pain. There’s clearly plenty of work to go around, and Sass thinks the multi-billion dollar health system can afford a little competition.
“I don't understand it,” he said. “It's petty.”
