Cook County Hospital Board Meeting Overflowing with Public Interest

Over four dozen citizens crowded the Board Room at North Shore Health (NSH) on Thursday morning, the 16th, to attend the regularly scheduled meeting of the hospital’s board of directors. 

The people attended to voice concerns over the November 1st termination of ER doctor Bruce Dahlman by Wapiti Medical Staffing as they chose not to renew his contract. This for-profit business provides ER doctors and other professionals to NSH.

A Cook County resident since 1984, Dr. Dahlman has practiced medicine here since 1986. He has been under a contract with Wapiti since they essentially took over the ER physician staffing for NSH. Despite the long-term relationship, limited due process, and a solid reputation in the community, Wapiti ended its agreement with Dahlman effective November 1. 

Judging by the people speaking during the “Public Comment” section of the meeting, Dr. Dahlman is a community pillar who has been treated poorly by hospital leadership and Wapiti. 

Just before the public comment section of the meeting, Board Chair Kay Olson read a statement and specifically said the ending of Dr. Dahlman’s contract was not “a Kimber decision,” referring to longtime hospital administrator and CEO Kimber Wraalstad.

One of the first speakers was Bob Evans, a five-year resident of Cook County, who was circulating a petition the morning of the meeting, asking the hospital board to intervene to reinstate Dr. Dahlman. The petition had 32 signatures in less than an hour. 

Michelle Miller of Hovland, who spoke after Mr. Evans, is a 25-year resident of the county, and her son lives with significant health issues. She’s delighted with her family's care at SMC and NSH. She was motivated to speak after people on social media started asking if others were outraged by Dr. Dahlman leaving the ER.

“I’ve heard from people who are fighting a battle there that none of us know about,” Miller said. “We owe a debt of gratitude to those staff members.” She has heard stories about the toxic work environment from several NSH employees. Some reached out anonymously, stating they fear losing their job if they speak publicly. Hearing that, she felt compelled to speak for them.

In a press release from the hospital board Thursday evening about the meeting, the NSH administration and the publicly elected Board of Directors wrote, “Dr. Dahlman contracted with Wapiti to work in Emergency Departments in various organizations, including North Shore Health. Wapiti exercised a contractual right to end their(sic) relationship with Dr. Dahlman.” The release said, “No corrective action has been proposed or taken by North Shore Health regarding Dr. Dahlman.” 

These statements in the press release, along with a tone thought condescending by some, lend credence to some of the comments made by the public that they believed there was more to Dr. Dahlman’s termination than they are being told.

First, the release states, “Much of the emotional response we have heard is based on the non-renewal of Dr. Dahlman’s contract with his employer (Wapiti).  All agreements are for a stated period and contain provisions for renewing or terminating them. Dr. Dahlman’s contract was due for renewal, and Wapiti chose to exercise its right not to continue. 

Asked for comment, Kim Harmann, Chief Executive Officer of Wapiti, wrote in an email, “The agreement and interactions Wapiti holds between a provider or a facility is(sic) confidential. We appreciate your understanding.”

Second, the release states, “No corrective action has been proposed or taken by North Shore Health regarding Dr. Dahlman.” According to a source who has seen it, the non-renewal letter clearly states that NSH and Wapiti, in consultation, decided to end its relationship with Dr. Dahlman.

The non-renewal letter from Wapiti cited a dozen clinical issues, all beginning in July of this year. During years as a contractor with Wapiti, Dr. Dahlman has had only a few clinical problems that would rise to Wapiti's attention. Twelve issues over four months, after years with hardly any, might fuel some skepticism in the public’s mind.

Due to the non-competition portion of Dr. Dahlman’s contract with Wapiti, he is now barred from working for any of the hospitals in the midwest where he served Wapiti clients, either directly or through another staffing firm, effectively ending his career.

Dr. Milan Schmidt, a retired physician who served the Cook Community for more than ten years at both Sawtooth Mountain Clinic and NSH, explained the process that existed when he was the ER Director of NSH for several years. He said that when issues arose, and he acknowledged that they always do in the medical field, he would speak with the physician involved to get that doctor’s side of the story. 

Dr. Schmidt would then evaluate the issue and speak with relevant NSH staff, and if the problem were serious, he would raise it with NSH’s Chief of Staff. Corrective action would be recommended, and the entire case would be documented and filed in the appropriate location. Only the most egregious issues were reported to Wapiti, and if the Wapiti physicians were not a good fit for the clinic, Dr. Schmidt would request they not be assigned to future shifts at NSH.

“In no case did Wapiti terminate a doctor and ban them without information coming from the hospital,” Dr. Schmidt said. “I never saw such actions as those taken against Dr. Dahlman.”

Eight people spoke during the ten-minute comment period, including former patients, colleagues, Dr. Dahlman and his wife, Kate Dahlman. 

The theme of all commenters was that Dr. Dahlman was a skilled doctor and colleague who, despite denials from the hospital administration, was being punished for being an outspoken advocate for nurses, fellow doctors, and patients. His colleagues pointed out that NSH's toxic work culture has led to significant staff turnover over the last several years.

In October 2022, local radio station WTIP presented an investigative look at staffing issues at North Shore Health. They interviewed Wraalstad and current and former staff members. WTIP wrote, “WTIP spoke with 18 current and former staff from North Shore Health who say an ongoing issue rests solely at the feet of the administration. A lack of appreciation for hospital staff, a workplace culture that is not supportive of staff, and a general disconnect between the hospital administration and the other employees at North Shore Health were among the reasons people told WTIP they either quit working at the local healthcare facility or were considering doing so.” 

More than a year later, little has changed.

After the public comment, the board proceeded with its routine agenda. Its next regular meeting is Thursday, December 21, at 9:30 am. Apparently, the board will take no further action regarding Dr. Dahlman's dismissal or possible rehiring.

Each board member and its PR person, Todd Ford, was asked by email to comment on Dr. Dahlman’s dismissal, press release, and whatever action was taken since the WTIP report from last year to improve the work environment. None chose to respond.

North Shore Health is a rural health facility, part of the Cook County Hospital District; it includes a 16-bed critical access hospital, a 37-bed skilled nursing facility, a home health agency, an ambulance service, and various diagnostic and therapeutic services.