Northern Inyo, Mammoth hospitals face off

By Deb Murphy

The 6,000-square foot orthopedic/physical therapy clinic slated to open in late spring on South Main Street in Bishop is a bone of contention between area hospitals.

CEO Victoria Alexander-Lane

CEO Victoria Alexander-Lane

The clinic is an expansion and relocation of Mammoth Hospital’s existing PT facility and, according to Northern Inyo Hospital Chief Administrative Officer Victoria Alexander-Lane, represents a duplication of services already available in Bishop and “an unnecessary tax burden on” the local hospital district. In late February, Lane sent a letter to the Inyo County Board of Supervisors requesting “support regarding NIH’s efforts to work towards better alignment of healthcare services.” The Board has yet to respond formally.

The next round went to Mammoth Hospital’s Chief Executive Officer Gary Myers responding to Lane’s allegations of lack of accountability on the part of Mammoth for follow-up care. Myers’ letter states Lane’s comments border on slander.

CEO Gary Myers

CEO Gary Myers

At its March 17 meeting, Inyo Supervisors suggested the Local Agency Formation Commission could deal with the issue. While Josh Hart, county planning director and Inyo’s LAFCO staffer, said the commission would “look into it,” the Mono County LAFCO seemed less inclined. LAFCOs generally deal with changes in boundaries and services of utility districts.

For NIH board member Pete Watercott, it’s an issue of trust. “Personally, I feel like we were led down a path. It sucks the trust out of the relationship,” he said in a recent interview.

The issue of the Mammoth-sponsored clinic creating an increase on area taxpayers was explained by Lane. “If people come here (for orthopedic care), we will be less dependent on taxpayers. Everything they need is here. Our surgical cases are covered; we (also) have digital x-ray equipment.”

As work proceeds on the Bishop clinic, the dispute appears to be at a standstill.

According to both Watercott and Myers, the orthopedic relationship between the two hospitals goes back to the early 2000s. NIH, between orthopedic physicians, initiated an agreement with Mammoth. According to Myers’ letter, the Southern Mono Hospital District leased office space and staffed ortho services in the Pioneer Medical Building in 2003. Dr. Mark Robinson, newly-named chief of staff at NIH, was the physician and credentialed at both Mammoth and Inyo hospitals. In 2011, Mammoth opened an outpatient physical therapy facility in Bishop to service Inyo County patients. According to Myers, NIH “chose not to address the shortage” following the closure of a private physical therapy practice in Bishop.

According to Lane, Robinson “felt he was being pressured to do surgeries in Mammoth. He felt that was undermining the agreement.” By January 2013, the orthopedic practice sponsorship shifted to and Robinson was hired by NIH.

By May 2014, Lane, Watercott and Myers were attending an Association of California Hospital Districts conference in Pasadena. According to Watercott, Myers told him Mammoth Hospital had made the decision to close their clinics in Bishop, but that the orthopedic group may want to continue on their own. Myers recollection of the exchange differs. In an e-mail, Myers states Watercott asked him if the hospital intended to open a surgery center in Bishop. The clinic on Main Street will not be doing out-patient surgeries.

“The two doctors involved in the Bishop clinic don’t want to be on staff (at NIH),” Alexander-Lane said. “They could be credentialed at both hospitals and do surgeries at both. If they did, there wouldn’t be an issue.

“We (NIH) have no clinics in Mammoth. They are the predators.”

In addition to where Bishop clinic patients undergo surgery, Alexander-Lane has issue with practices that could “result in our physicians having to provide emergent follow-up care for the infections and other negative outcomes which present in our emergency room.” The practices she described in a recent interview include knee replacements on an out-patient basis and the use of steroids to fight infection but “mask issues” that show up later.

Myers response by e-mail states that knee replacement patients at MH have “an average length of stay of one day.” He went on to add that he was unqualified to comment on the post-operative management “as it is outside my scope of practice (board certified physical therapist)…. Dr. (William) Karch stays fully up-to-date with the orthopedic literature and follows evidence-based protocols in the management of his patients.”

A review of studies of steroid use for knee replacement surgery published in SciMed Central, Annals of Orthopedics and Rheumatology shows four cases of infections in 791 patients. According to the article, steroids are used to reduce pain and inflammation, getting the patient into rehabilitation more quickly.

Despite the not-too-subtle war of words between the two CAOs, both maintain they are both open to future collaboration.


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19 Responses to Northern Inyo, Mammoth hospitals face off

  1. Jd April 3, 2015 at 5:49 am #

    Easy fix here and a win win. How about we join the two hospitals, one CEO, one staff. That way we can eliminate overhead, streamline staff, and it’s savings for the taxpayer. We need to be thinking regionally about services. We are already doing that in some cases such as the schools. Maybe the dumps could be this way too.

    • Vanessa April 3, 2015 at 3:15 pm #


      I am interested to know who you and other readers think should be the CEO of this combined hospital. And would there be two Boards of Directors?

  2. Bishop resident April 3, 2015 at 3:40 pm #

    It is clear the NIH has a bit of an image problem and this certainly is not the way to fix it. It seems to me that Mammoth hospital has learned to market their doctors and has developed a strong program where NIH failed. Additionally I haven’t seen any true efforts on the part of administration to address some of these issues, it seems to be a continual blame game. Blame the rogue employee for privacy violations, blame the staff for feeling disrespected, blame the middle management for for management staff relations and now we blame Mammoth hospital for taking business from NIH. My question to the administration is this what actions are you taking to develop that customer base. What are you doing to assure that your employees feel safe because to me if the employees do not feel safe they will make mistakes and those mistakes can be more costly.

    The board and administration need to really do some soul searching and find ways to keep patients and deal effectively with the issues because the blame game and not taking some responsibility is getting really old. We as Bishop residents do have choices and I would hope rather than throwing a tantrum every time there is a problem you would take some responsibility and find ways to resolve these issues. We are paying customers and you have to earn our business we are not obligated to give it to you.

  3. Monoite April 3, 2015 at 3:49 pm #

    Maybe even a new CEO….. WIN WIN WIN!

  4. Cathy Powell April 3, 2015 at 5:27 pm #

    What is going on with Northern Inyo Hospital? It invites doctors from Mammoth to come down to Bishop in order to fill a void and now it complains and calls Mammoth Hospital “predators”. Then the NIH CEO questions the medical care provided by those same doctors, accusing them of malpractice. Does the NIH Board of Directors actually think these tactics will result in patients leaving Mammoth and happily seeking orthopedic care in Bishop. I highly doubt it.

    Let’s face it, Mammoth has developed a very skilled orthopedic practice, something NIH decided not to do. Residents of both Inyo and Mono Counties have benefitted tremendously from the quality of care offered by orthopedic doctors from Mammoth. Providing office visits and PT in Bishop only made sense given NIH’s inaction. That is a decision NIH must live with and complaining about it now benefits no one. I would think NIH is on the brink of being sued for the CEO’s comments, which will only cost the district more money. This is not how professionals should act – shame on you NIH Board for allowing your CEO to be so reckless!

    Instead of wasting time and energy trying to rewrite the past, shouldn’t NIH work with Mammoth to regionalize orthopedic services? Wouldn’t that benefit all taxpayers and patients? As the old saying goes, “play to your strengths” NIH – take hold of another area of health care and work with Mammoth for the benefit of all of us living and playing in this region. Now that would be professional.

  5. Really April 3, 2015 at 7:45 pm #

    How about NIH butts out of name calling and lets the free market and patients decide based where they wish to go for their medical care?

    Calling Mammoth Hospital a preditor because they offer a superior product speaks volumes about NIH management.

  6. chris April 3, 2015 at 7:51 pm #

    Come on, people. This is NOT a popularity contest! So MH filled a void, and more than adequately (personal experience). NIH should pick another medical field to highlight, focus on developing that, and using positive marketing (if necessary). Let it go, NIH. PT goes to MH. How about pulmonary medicine? Lots of folks here in the Eastern Sierra go to Reno or So. CA for help with breathing problems/illnesses; CPAP/APAP related issues, and so forth. Or, ENT/Otolaroncology! Again, something most East Siders would use – allergies, surgeries, etc. Maybe my suggested field of medicine aren’t the biggest money-makers, but if service is truly your goal, “build it; they will come”. Get over yourselves, NIH. Act professionally, and you’ll be surprised at how many locals will start to trust you again.

  7. Low-Inyo April 4, 2015 at 6:15 am #

    Don’t understand all the bad-mouthing NIH…..With my own experiences, they have been very good,from the desk-staff and onto the nurses and doctors….all very good.

    • Vanessa April 4, 2015 at 9:42 am #

      I wonder how many of those great doctors, nurses, and clerks have left NIH because of upper management?

    • Bishop Resident April 4, 2015 at 9:55 am #

      You’re right NIH has outstanding staff that provide excellent care. This is not a staff issue this is an administration and board issue. Once again instead of finding ways to address the issue they choose the blame game. If they are willing to publicly attack another hospital that provided a necessary service in a time of need what do think is happening to the staff behind closed doors. That staff that provided your outstanding care deserves to be treated with respect and dignity.

      • El Pulpo April 6, 2015 at 6:40 pm #

        Anyone want to give their opinion about Ms. Alexander-Lane’s performance? Go to the special board meeting tomorrow!

        It’s at 11AM you say? The agenda was only published today, you say? How in the world will you be able to get off work to attend?

        You won’t, just as the NIH Board of Directors planned it! Another secret meeting where executives get more raises while dedicated employees continue to harassed out of the Valley.
        The board is an abject failure. It is time for change.

        • Fairness April 7, 2015 at 6:26 am #

          I checked it out, it is only closed session. It is not like the Board has not heard what the complaints are. Do you have to have your evaluation in public? I think not. Have you ever asked to talk with the CEO? I think not.
          Why don’t you ask to sit down and ask her what her strategy is? Your not interested?
          Start with listing the unfair thing this CEO has done? You cannot. I have not heard any facts, just moaning about unfairness, employees leaving and poor morale, none of which are facts.
          Try framing the facts, oh, that takes work and logic.

          The Animal might consider thinking like a human.
          If you are really interested check out the Brown Act, can the Board give a raise in a special meeting? You should know if you are looking for FACTS.

  8. Trouble April 4, 2015 at 7:17 am #

    I just want to say that there is a new orthopedic surgeon in Bishop that I had a very successful surgery at NIH last month. His name is DR. Meredick.

  9. Sad April 4, 2015 at 12:53 pm #

    Sounds like some NIH employees have commented negatively about their employer, can’t blame the NIH CEO for supporting NIH. Sad the employees don’t. I talked to a nurse who told me she does not support NIH. It makes me sad that we spent all that money to have a top notch hospital in Bishop and the people still think Mammoth is superior. Mammoth is fine, but so is NIH, lets support our hometown NIH people! Don’t forget we live in Bishop.

  10. concerned April 5, 2015 at 12:35 am #

    Another attack from this CEO. So far I have read nothing positive out of her mouth. Your employees are at an all time morale low, the media coverage is terrible. Look the history of orthopedics in Bishop from Mammoth is clear. When there was no longer an orthopedist here, Dr. Perry and Karch filled a void. They have been here ever since.NIH declined to move when a private practice PT clinic closed and that left a huge void. So Mammoth offered services to help people out who were traveling to Mammoth already for PT. My advice look within. You have a broken hospital. You want to do well in a competitive market, offer better care. Dr. Meredick is excellent and a step in the right direction.Mammoth has success in PT by keeping quality people in the area and recruiting more quality people to the clinic. To the Board of NIH, you need to look at this lady you have in charge, she is reckless and makes me want to avoid NIH at all costs. 45 minutes is nothing to drive for quality care. That CEO needs to GO!!!! Instead of attacking why doesnt she try to/ work with Myers and MH. This behavior of blaming “rogue” employees, putting down your staff and acting surprised the nurses unionized, and calling MH predators is infantile and grossly unprofessional. The term no such thing as bad press does not apply to healthcare.

    • Philip Anaya April 7, 2015 at 7:17 pm #

      The CEO of NIH has to understand that I as a patient trust my Doctor and NIH staff with my health care and the possible lifesaving skills and care . Yes I want NIH to be there with it’s facility open, available and safe and a workplace that offers it’s care givers the best support possible ,the best environment for their efforts . When Staff has a concern over any issue those concerns need to be addressed . That’s what we expect from the CEO and the Leadership of NIH.

      • Philip Anaya April 8, 2015 at 8:49 am #

        Just to add for clarity. In the Navy the XO takes direction for both possible and impossible tasks from the Captain . The XO runs the ship at the Captain’s direction and do not forget about the Chief Petty Officers who put the pedal to the metal . A happy ship has everyone motivated and involved in the task at hand and so it should be at NIH. When the CEO is capable and intimately knowledgeable of performing medical procedures that Staff provides then that person is capable of making decisions based on the medical welfare of patients . Untill then the Chief of Staff has to have the latitude that addresses all the issues that affect medical decisions at the Hospital and the CEO has to be the one to hold that idea and make it happen . If there are to be resignations then it should have been the CEO, not the Chief of Staff.

  11. practical April 7, 2015 at 11:43 am #

    Personally I think the comments here are a little bit dramatic and resemble a lynch mob based on old beliefs. Unfortunately the reason we all love this area tends to be the reason we live in a bubble. To me this is simple economics and is the norm in the rest of the world. To think we are sovereign from regional economics simply because we live here is ridiculous. I think I would be right to assume you would be starting the same lunch mob to pay higher prices or not have local healthcare at all. I see a CEO thinking outside the box to save a sinking ship in an already struggling local economy, and doing so using methods that are the kinder side of normal in the rest of the world. Do I agree the method is right? Perhaps not but sometimes you have to choose the greater right of the wrong to survive. I certainly don’t envy the position she is in or the chooses she has to make and am doubtful any of could do better in the circumstances. As for the secret raises under the table, I am also superman as long as we are making things up we have no ode about.

  12. Mildred April 8, 2015 at 5:24 am #

    We are lucky to have two really great hospitals to chose from. Competition is what makes things better and keeps prices down. Good luck Mammoth on your new place in Bishop. You accept my insurance where as NIH does not. More of the Mammoth doctors accept my insurance where as NIH doctors do not. That helps me tremendously. See you there!


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