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Health agency settles with doctor's union

The Health Department will owe back pay and attorney's fees, and accept his resignation .

By ELENA LESLEY
Published December 25, 2006

The Citrus County Health Department wrongfully fired a doctor for raising concerns about his work environment, according to a decision from the state Public Employees Relations Commission.

Dr. John Castiello was terminated after he complained multiple times that he was forced to see more patients in a day than he could treat properly. The doctor of osteopathic medicine also asserted that his office space was inadequate.

"They said I was creating a 'hostile work environment,' " Castiello said. "But I stayed late; I never refused a patient."

The Health Department will not appeal the commission's final order and reached a settlement agreement with Castiello's union, the Federation of Physicians and Dentists/Alliance of Healthcare and Professional Employees.

According to the terms of the settlement, the department will pay Castiello four months of back pay and attorney's fees, as well as accept his resignation and record in its files that he resigned.

The department must send the following message to Castiello's patients: "It had come to our attention that some patients were erroneously informed that Dr. John Castiello left his position without notice. Dr. Castiello properly resigned from the Citrus County Health Department, and the lack of notice to his patients of his departure was an oversight by the administration."

Finally, the department must post a notice to employees for 60 days reading: "The Public Employees Relations Commission has determined that we have violated the law and has ordered us to post this notice." The document outlines the terms of the settlement.

Administrators from the department declined to comment on the matter.

The settlement "will enforce to employers that they can't dismiss someone for these types of activities," said Jennifer Blohm, a lawyer representing Castiello's union.

After four happy years working at the department, Castiello said problems started during a 2005 reorganization. The purpose of the restructuring was to increase efficiency and to comply with Federally Qualified Health Care Center standards.

"They were trying to become a federal clinic, so they had to audition," Castiello said.

Instead of only accepting patients who were at or below the poverty income level and who had no health insurance, after the reorganization, the department would not be able to turn patients away, according to court documents.

Patient loads would increase, but Castiello was told the number of complicated cases he saw would not go up.

In addition, administrators told him medical staff would take on other tasks, freeing up more of his time.

But according to Castiello, that is not what happened.

"You can see 30 throats a day, but not people with more complicated problems," he said. "You can't expect people to do a tuneup in the amount of time it takes to do an oil change."

Before the reorganization, doctors generally took the time to do thorough checkups on all patients who came in because they didn't know when they would be back, Castiello said.

After the reorganization, Health Department leaders "wanted us just to focus on their acute needs," he said. "We had incredibly sick patients coming in and we were supposed to see them faster."

Castiello, along with other doctors, began raising concerns with the administration.

In addition to patient load, he charged that his new office was below industry standards and that it was impossible to keep patient information confidential.

The office, which Castiello called the "nurses' locker room," was right next to a park, so the sounds of children squealing and even marching bands practicing interrupted his work.

"I would be trying to talk to someone about the nodule on their chest X-ray, and the band would start playing," he said.

One day, Castiello was looking at charts spread across his desk when he saw a man examining the documents through his office window. "I threw myself on the charts like a grenade," he said.

But even though other doctors were displeased with the reorganization, the administration was unresponsive, Castiello said.

Convinced that they could not satisfy Castiello, administrators made the decision to dismiss him. They informed him of his termination during a September 2005 meeting Castiello had called to discuss his concerns.

But the action was not a proper dismissal, Blohm said.

"When an employee is bringing forth concerns that others share, that is a protected activity," she said. "An employer can't just dismiss them."

Castiello's union challenged the termination, charging he had been dismissed improperly, and the commission took his side. Though the department was ordered to give him back his job, Castiello chose to settle on different terms instead.

"I would be going back to the same situation," he said. "It's too bad, because I thought I would stay the rest of my life there."

Elena Lesley can be reached at elesley@sptimes.com or 564-3627.

[Last modified December 24, 2006, 20:18:09]