U.Va. president, board members stand up for UVA Health execs

The University of Virginia’s president and two UVA Health board members defended UVA Health CEO Dr. Craig Kent and U.Va. School of Medicine Dean Dr. Melina R. Kibbe on Monday, after 128 UVA Physicians Group-employed faculty signed a letter demanding their immediate removal late last week.

The letter, which expresses “no confidence” in Kent and Kibbe, was sent Friday to the rector and U.Va.’s board of visitors, which is set to meet for its quarterly meeting in Charlottesville later this week.

The signers, whose names were not made public but were offered for four board of visitors members to view privately, accuse the two U.Va. executives of “foster[ing] a negative environment that is contributing to an ongoing exodus of experience and expertise at all levels that contravenes our mission to provide excellent — and safe — patient care.”

Specifically, the letter outlines “egregious acts” such as hiring doctors “despite concerns regarding integrity and quality,” and “pressuring physicians, nurses and other staff to abstain from using the Be Safe process to report patient safety concerns.” The letter further says that the two executives have used “explicit and implicit threats and retaliation — often relayed to faculty via their chairs and chiefs” against employees who have “raised concerns about patient safety, capacity constraints and moral distress.” Other accusations include “excessive spending” on C-suite executives and “failure to be forthcoming” on audit performance and other financial matters, as well as “subjecting [medical] residents to bullying and harassment” and withholding recommendations for promotion and tenure in the case of faculty members who raise concerns.

In an email sent to approximately 1,400 U.Va. medical school faculty members this weekend, President Jim Ryan wrote, “The letter itself is daunting. There are many accusations. There are few details. Some of these accusations are fairly evident references to specific matters that we have already addressed or are actively working on. Others are new to us, but we will do our best to run them to the ground and get to the bottom of them. Even though it is difficult to investigate generalized and anonymous claims of wrongdoing, without specific details or names to follow up with, we will do our best to investigate.”

Ryan also notes that only four people are allowed to see the signatures — a group that did not include him. The faculty letter says that board of visitors members Rachel Sheridan and Porter Wilkinson, “in their capacity as chair and vice chair of the audit, compliance and risk committee,” and Drs. Stephen Long and David Okonkwo “because they have both worked at academic medical centers and can understand the rank and specialties of those signing,” would be allowed to “view and verify the signatures, should this be requested by the board of visitors.”

The president continues in his letter, which was provided to Virginia Business on Monday, that the university will conduct a “thorough review,” investigating the letter’s allegations, but says that he finds it “difficult to believe that the right answer here is to force yet another change in leadership … [that] will inevitably fail to satisfy 1,400 faculty members and thousands more health system team members.”

Ryan added that he views the faculty letter, which was published Friday by the Cavalier Daily, as an “unfortunate” decision by the signers. “They have besmirched the reputations of not just Melina and Craig. Instead, through some of their allegations, they have unfairly — and I trust unwittingly — cast a shadow over the great work of the entire health system and medical school.” Ryan wrote that his email inbox was “overflowing with testimonials” from other faculty members “who attest that the health system today is in the best shape it has ever been in.”

Kent and Kibbe released a response Monday, which includes: “Our leadership team respects and takes seriously this feedback and we are committed to learning more. We are also deeply grateful for the support and affirmation we have received from so many across UVA Health and the leadership of the University of Virginia.” Their statement also mentions “consistently high ratings” from third-party evaluators, as well as a 30% increase in total scheduled patient appointments and a 6% improvement in the number of new patients who are seen within 14 days.

Thomas A. Scully, a member of U.Va.’s Health System Board and a U.Va. alum, said in an interview Monday that he views the faculty no-confidence letter as a backlash fueled by a new merit pay system going into effect soon.

“I am 100% convinced that there’s a 99% correlation between 128 anonymous people and where they are in the pay scale, because [U.Va. is] just about to undertake this pay reform,” said Scully, a general partner in New York-based law firm Welsh, Carson, Anderson & Stowe’s health care group who served as administrator of the Centers for Medicare and Medicaid Services under President George W. Bush and is also a past president and CEO of the Federation of American Hospitals. “I think the reaction here is 100% people who are very likely to be on the lower performing end of the [pay] scale, who are going crazy before this happens.”

Kent has “done a lot of good stuff” since joining U.Va. in 2020, Scully says, including reaching agreements with other health systems so U.Va. can expand its medical care to other parts of the state. Kent also played a significant role in establishing the $350 million Paul and Diane Manning Institute of Biotechnology, which broke ground in late 2023.

Late last year, Kent’s contract was renewed through 2030.

Kibbe, meanwhile, was hired in 2021 as the medical school’s dean and chief health affairs officer for UVA Health.

According to Scully, Kibbe instituted a pay system revamp. “When she got the job a couple years ago, she said, ‘We have a pay problem here. We have people spread all over the place, and there’s no connection between what the physicians are getting paid and what their performance is and what the patient quality is and what the patient happiness is.'”

The payment reform process took a couple of years, said Scully, adding that he thinks it was bound to stir up controversy. “As soon as they did it, I thought, ‘Holy cow, you’re sticking your head in a bees’ nest.'”

Crutchfield Corp. founder and chairman Bill Crutchfield, another member of the Health System Board and also a U.Va. graduate, wrote a letter to the editor Monday defending Kibbe and Kent, writing that the 128 signers represent “less than 1/10 of 1%” of the health system’s 18,000 employees. Crutchfield cited high safety rankings by Vizient and other third-party auditors of UVA Health’s four hospitals. He concluded, “These anonymous writers are doing harm to UVA Health and, in turn, to our patients. If a small cabal of people hiding behind anonymity can force outstanding leaders out of U.Va., it will make it extremely difficult to recruit outstanding new physicians, nurses, technicians, and administrators.”

Scully said that he hopes the Health System Board will “come out with a strong statement supporting the current leadership and saying we have total confidence. … I’m sure we’ll talk about it. And I’ve talked to a number of people on the board so far, and I think my view is widely shared.”