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    Bayfront doctor plays diplomat as alliance ties end


    © St. Petersburg Times, published November 15, 2000

    ST. PETERSBURG -- Six years ago, representatives of a several private, non-profit hospitals in Hillsborough and Pinellas counties gathered at a Tampa hotel to discuss the radical notion that their fates should be intertwined.

    They included 28 administrators and doctors from Morton Plant in Clearwater, South Florida Baptist in Plant City, St. Joseph's in Tampa, and Bayfront and St. Anthony's in St. Petersburg. The gathering was the first of dozens as they crafted what would become Tampa Bay's largest health care conglomerate.

    "We sat down and said, "You know, everybody's making money right now. But times are probably going to change," recalled Dr. Larry Davis, who represented the medical staff at Bayfront.

    The non-profits were worried. Columbia/HCA, a for-profit chain, was buying hospitals and winning HMO contracts. President Clinton's plan for universal health care coverage tanked. Congress soon would cut the amount Medicare paid for treatment.

    "Our concerns about revenues came to fruition, and at the time it hit the hardest we had BayCare," Davis said. "It worked for us and the other hospitals."

    But now Davis, chairman of Bayfront's board of directors, finds himself orchestrating Bayfront's exit from the BayCare alliance. The hospital is counting on his good relations with doctors, City Hall and BayCare leaders to supply the political grease to make it a smooth one.

    The city's relationship with Bayfront and its president and CEO, Sue Brody, is strained following a protracted legal battle over the hospital's participation in BayCare. Bayfront says it will leave the alliance by Dec. 31, but both sides acknowledge the need to rebuild trust and cooperation.

    "There's been a certain breach of confidence here," said Mayor David Fischer. "It will take some work to get the council into a meaningful dialogue with the hospital, because there was quite a bit of ill feelings."

    To help, Davis has promised less of the secrecy that marked Bayfront's behavior while it was part of BayCare, as well as better communication with City Hall. He also has suggested that Bayfront may add members to its board of directors, to give the public more say in how the hospital is run. He and Brody also have promised to meet monthly with Fischer.

    "Now, if the mayor calls me, I can talk to him directly," Davis said. "I don't have to check with (BayCare president) Frank Murphy, to put it bluntly. If somebody on the City Council has a concern, they can call me, or call Sue, or come over and visit."

    Bayfront is finishing a 15-month fight that started when the city learned the hospital had ended abortions and made other changes to conform with Catholic ethical and religious and directives for health care. Two BayCare members, St. Anthony's Hospital in St. Petersburg and St. Joseph's in Tampa, are Catholic, and church rules require secular partners to follow certain Catholic provisions.

    Bayfront is private, but it sits largely on city property. The city sued Bayfront in April, alleging that its adherence to Catholic doctrine was unconstitutional. Attempts to settle the dispute died last month, and the other BayCare members voted Bayfront out.

    Because of the historic relationship between the city and the hospital, and because Bayfront may need more city support later, Davis' credibility with St. Petersburg officials is important, both sides say.

    "He has maintained good relations with all parties," Fischer said. "He is very easy to work with, he's always considerate, so no matter how the situation is, whether it's up or down, he's the type of person that you'd like to deal with.

    "I think he's certainly the right person to be there right now, because he's kept his doors always open."

    But not everyone at City Hall shares that view.

    "Unless Dr. Davis didn't know what was going on . . . how could I have any confidence that his credibility is going to be any better?" council member Kathleen Ford said. "If you recall, it all started because they didn't turn over requested information."

    Back in 1997, when Bayfront asked the City Council for permission to join BayCare, Brody said the hospital would not change its services. In fact, it quit providing elective abortions to conform with Catholic requirements. Although the hospital performed just a few abortions a year, when the fetus was severely deformed, Davis said he and others miscalculated the furor the change would cause.

    He also says BayCare and Bayfront erred by not being up front about how the Catholic connection applied to the hospital.

    "The way it was managed early on was poorly managed, and I've fussed about this," Davis said. "You have to communicate. If you're a public health provider for this many people, and you're huge, (keeping quiet) does not work," he said.

    At 59, Davis has spent nearly half his life at Bayfront Medical Center. He started as a pathologist there in 1972 and is now the director of the laboratory and department of pathology. He has served on the board of directors since 1987. Four times his peers elected him as chief of staff.

    He is an affable man, with a good sense of humor. The current chief of staff, Dr. David Parrish, said most physicians at Bayfront like and respect him.

    "I think he does know how to keep things in perspective, and I think he knows how to look at things from the perspective of both the institution and the practicing physician," Parrish said. "And that's hard to do, I might add."

    For the past two weeks, Davis has been assembling a team from Bayfront and St. Anthony's to find the best way to untangle the programs and services they have merged over the past three years. Bayfront will officially leave the alliance by Dec. 31, and the city isn't likely to drop its federal lawsuit against the hospital until then.

    Bayfront officials are examining contracts with insurance companies and other suppliers to determine how the split will affect the hospital's operating system. At the same time, it and BayCare are looking for ways they can still work together to save money. Davis, meanwhile, has resigned from BayCare's board of directors.

    "We are in a friendly divorce," he said. "But as you know, divorces oftentimes don't stay friendly. ... I just felt like I needed to go ahead and resign from BayCare so I could totally and fully represent Bayfront in these negotiations. And there will be negotiations."

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