Records detail problems in UT physician assistant department

11/13/2017

Patricia Hogue, center, listens to Michele Wheatly, former West Virginia University provost, as she answers her question about student body diversity Feb. 20, 2015 on the University of Toledo Health Science campus, the former Medical College of Ohio.

THE BLADE/DAVE ZAPOTOSKY
Buy This Image

An internal investigation into the conduct of the University of Toledo’s physician assistant department chairman raised concerns about the program’s stability before it lost its accreditation from a national agency in October.

UT’s Office of Academic Inclusion concluded July 5 that then-chairman Patricia Hogue did not violate any university policy but that her “behavior was unprofessional, and demonstrated poor management,” according to documents obtained by The Blade through a public records request.

The investigation and subsequent memo sent to Dr. Christopher Cooper, vice president for clinical affairs and dean of the College of Medicine and Life Sciences, the former Medical College of Ohio, includes concerns that Ms. Hogue failed to share accurate accreditation information with the PA program director and failed to take accreditation requirements into consideration when making hiring decisions.

RELATED: Accrediting agency: UT physician assistant program lacks oversight

Ms. Hogue, who helped start the PA program in 1996, contested those findings on Monday. She said the department was in compliance with the number of required licensed PAs on faculty before it lost accreditation, and that she was not directly involved in responding to concerns raised by the accrediting body after a June site visit.

The internal investigation was prompted by a March 29 complaint from Meenakshi Kaw, then the PA program’s clinical coordinator. Ms. Kaw alleged Ms. Hogue “had been insulting and verbally abusive, which negatively impacted [Ms. Kaw’s] ability to perform her job duties.” Ms. Kaw filed the complaint the same day she received notice her employment contract would not be renewed.

In addition to issues regarding accreditation, the investigation also found there was high employee turnover in the PA department, that Ms. Hogue demonstrated unprofessional behavior and poor management, and that she did not follow recommendations of the admissions committee when admitting students to the PA program.

“Based on the interviews, the high employee turnover rate, and the current probationary status, there is concern that if Hogue is permitted to continue to lead the department in the same manner, the program risks losing accreditation, harm to its reputation, and continued turnover of faculty and staff,” a July 20 memo to Dr. Cooper read.

At that point, the university’s PA program had already been placed on probation by the Accreditation Review Commission on Education for the Physician Assistant, but it was not until Oct. 6 that the agency determined UT’s program “is no longer capable of providing an acceptable educational experience for its students,” the commission wrote in a letter to UT.

University documents show Dr. Cooper met with Ms. Hogue in August to discuss the internal investigation’s findings and determined she would step down as chairman once UT found someone to fill the program director and department chair positions.

“We agreed that, once we successfully recruit a new Program Director/Department Chair, you will transition into the diversity role full-time, given the heavy responsibility that you have in this area,” Dr. Cooper wrote in a follow-up letter to Ms. Hogue.

He also emphasized that there must not be a fear of retaliation within the department, that Ms. Hogue renew her commitment to recruitment and retention efforts, that performance reviews should be conducted in private, and that she admit students to the program “in a manner that aligns with the mission and values” of the college.

“You are a highly-valued member of the faculty and an important leader within the University,” Dr. Cooper wrote.

But soon after the national accrediting agency notified UT it was withdrawing its accreditation, Ms. Hogue was asked to resign as chairman. She remains an associate professor in the PA program and will continue her role as associate dean of diversity and inclusion, which she has held since 2006.

The most recent document in her personnel file regarding salary shows Ms. Hogue was paid $151,804 annually. UT officials said Ms. Houge’s administrative stipend for serving as chairman will end, though they could not provide the stipend’s exact value Monday night.

It is not clear if her salary will remain the same now that she is no longer chairman.

Ms. Hogue said she originally intended to step down as chairman in December, 2016, in order to devote more time to her diversity role, but she stayed with the department because she knew a site visit was on the docket for 2017.

“I wanted to leave in December, but because we had a site visit that was coming up and had relatively new faculty, I just stayed on to help with the accreditation process,” she said.

Ms. Hogue said she believes the PA program lost its accreditation last month because staff did not perform well during a June site visit, and the team tasked with responding to citations from the site visit did not adequately communicate the program’s strengths in its response.

“I was not in charge of the response,” she said. “Normally, the PA program is responsible for doing it, but for this time the provost and the dean decided they were going to put together a dream team to write the responses, which took it out of the department.”

The accrediting body, in a 33-page letter to UT, concluded that existing students were unlikely to receive adequate instruction, the program did not have the resources to educate students, and there was “no reasonable expectation of rapid corrective action.”

The agency also noted the first-time pass rate for the physician assistant certifying exam was “very low” for 2016 and that even some “Straight A” students at UT did not pass the exam on the first try. The first-time pass rate dropped from 92 percent in 2015 to 74 percent in 2016, more than 20 percentage points below the national rate of 96 percent.

“We have exceeded our national average for the entire 20 years we’ve been here,” Ms. Hogue said. “We had one hiccup, and it just happened to be the year before we had our site visit.”

University documents show Ms. Kaw, the former clinical coordinator who filed the complaint against Ms. Hogue, was hired “despite the recommendations of the search committee to hire another applicant who was extremely qualified and had the credentials that would help with accreditation requirements.”

Ms. Kaw was not a licensed physician assistant, had no background as a site coordinator, and did not understand the role of a PA, a memo states. “Kaw’s husband is a doctor at the [University of Toledo Medical Center], and Hogue has a good working relationship with him, which influenced her decision to hire Kaw,” the memo continued.

University of Toledo Medical Center is the former Medical College of Ohio hospital.

Ms. Hogue said her working relationship with Ms. Kaw’s husband did not influence her decision to hire Ms. Kaw, and she maintained the clinical coordinator did not need to be a licensed PA in order to be effective. She said she needed someone to fill the position quickly, though in retrospect Ms. Kaw might not have been the right fit.

“She was about as equal as everyone else in the pool, and the fact that she was already here and we didn’t have to wait for someone else to come in,” Ms. Hogue said. “I have to admit that it was not a very good choice.”

UT is appealing the accreditation withdrawl, and Ms. Hogue said she is “looking forward to having a positive outcome.”

Dr. Cooper and UT President Sharon Gaber were out of town and unavailable for comment on Monday, but a university spokesman submitted a written response to The Blade.

“The University of Toledo conducted a thorough investigation through its Office of Academic Inclusion into a complaint raised by a faculty member who had been dismissed from the College of Medicine and Life Sciences. That review led to the college’s dean putting in place an active management plan with faculty affairs that included setting clear expectations and a plan to change the leadership of the Physician Assistant Department,” the statement read. “The University President is not involved in the management of faculty affairs, which is handled at the college level.”

The statement continued to say a new department chair, Linda Speer, and program director, April Gardner, “are committed to providing a high-quality education to our students. The new leadership is conducting a complete review of all standards and assessment methodology as the University appeals the decision of ARC-PA.”

Contact Sarah Elms at selms@theblade.com, 419-724-6103, or on Twitter @BySarahElms.