Pubdate: Thu, 25 Mar 1999
Source: Newsday (NY)
Copyright: 1999, Newsday Inc.
Contact:  (516)843-2986
Website: http://www.newsday.com/

A TOP DOC OUSTED AT NCMC / SUPERVISION OF CARE AT NASSAU JAIL CITED IN MOVE

A top doctor at Nassau County Medical Center who oversaw medical care of
inmates at the county jail among other duties was forced out Monday.

Dr. Faroque A. Khan, chairman of the department of medicine for 12 years,
"is no longer the chairman effective immediately," said Medical Director Dr.
Anthony Angelo.

The hospital's board of managers voted against renewing Khan's appointments
both as chairman of medicine and as an attending physician at a meeting Monday.

Angelo and other top officials said supervision of medical care at the
county jail was a key issue. Another was Khan's focus on research and
academic medicine at a time when the hospital's survival as a public benefit
corporation depends on a more consumer-friendly style that will attract
middle-class patients with private insurance.

"This is about a culture change," Angelo said. "We are moving from being a
county hospital that was not as responsive to patient care as it should have
been to a public benefit corporation that will live or die by our
responsiveness to our patients."

But Khan, 56, who learned of the decision while on vacation in Florida,
suggested yesterday he is being scapegoated for jail staffing decisions made
over his objections, as well as his resistance to demands that physicians be
present at the hospital 24 hours a day, seven days per week. After a meeting
with top hospital officials late yesterday, Khan said he was given the
option to resign or retire, but that could not be immediately confirmed.

"I find it ironic that I'm responsible for whatever inadequacies exist at
the jail when the staff that was supposed to provide the care was fired
against my wishes in unilateral moves by Dr. Angelo," Khan said. "Moreover,
after 12 years at the medical center, during which I worked with seven CEOs
and three or four medical directors, I find it curious that these issues are
surfacing now."

The quality and availability of medical care at the jail has come under
intense scrutiny since the Jan. 13 death of Thomas Pizzuto, a 38-year-old
recovering heroin addict who did not see a doctor until three days after he
was allegedly beaten by jail guards after complaining that he was not
receiving his methadone treatments. In recent years, the jail's health care
system had also been faulted by the state Commission of Correction, and
numerous inmates have filed lawsuits and complaints about being denied
medications and medical care.

Khan said that when he was asked to assume responsibility for jail medical
care in 1995, six doctors were assigned there full time. Two subsequently
retired, one died and two were fired by Angelo, both over Khan's objections,
Khan said.

"We dropped from six physicians to one full-time physician," he said. "To
fill that big hole we had been rotating in attending physicians who were not
anxious to work in the jail. I had been lobbying to fill those positions.
Nothing came of that until the crisis of Mr. Pizzuto. So now, to put the
blame on me, I find that rather ironic."

In addition, Khan suggested that he earned Angelo's enmity last summer after
fighting for and winning the reinstatement of Dr. Tajudeen Kashimawo, who
had been terminated over the care he gave a pregnant jail inmate who was
ordered back to her cell despite her claim she was in labor and who soon
after gave birth in the cell. Khan said the doctor's handling of the case
had been backed by the hospital's obstetrical staff, though a state review
later faulted him for not giving her a pelvic exam that would have shown she
was in labor.

"We second-guessed him a year after the event {based on that finding}," Khan
said. "I took exception to that, and the CEO agreed with me."

But while Khan and other hospital officials have blamed many problems with
jail medical care on guards who block access to doctors, jail officials have
ascribed the problems to the hospital's poor management as well as
overextended staff. Some jail officials described Khan as an absentee
overseer, overburdened by his duties at the hospital. "He spent very little
time here," said one jail source. "Was he there hands-on every day? No. And
that is something you need."

Angelo seemed to suggest similar sentiments in a letter distributed
yesterday to staff, saying that numerous areas need "innovative, hands-on
and immediate action . . .  rang{ing} from a thorough overhaul of how
medical care is supervised for inmates at the county jail to how our
attending physicians remain at the bedside of patients to better understand
their needs. Regretfully, Dr. Khan was at best indifferent to these issues." 

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