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Health district may split top job

Board would hire doctor, administrator to share duties

After two years of searching and struggling to hire a new health officer, the Spokane Regional Health District board voted Thursday to reopen the debate over whether a physician should lead the public agency.

The alternative would be to split the top job: a physician to oversee the medical decisions and an administrator to manage the budget and operations.

Spokane Mayor Mary Verner said it was time to reconsider how the health district is managed. She said the district has functioned admirably in the two years since she voted with the other board members to fire Dr. Kim Thorburn over management style and disagreements.

Other board members – with the exception of Spokane County Commissioner Bonnie Mager – followed her lead and voted to revisit the district’s management structure.

The Spokane County Medical Society was critical of the move.

“Public health challenges today, such as emerging infectious disease, emergency preparedness, disease prevention and public health nursing, demand medical management with absolute certainty that decisions are guided by a physician with public health experience and ethical principles,” the society, representing 1,100 physicians, wrote to the board.

Public health decisions, including such issues as which programs to cut or scale back during lean budget cycles, should be left to a physician leader committed to public health rather than an administrator looking at costs, said Janet Monaco, the society’s chief executive officer.

The board plans to solicit public comments before making any decision. The issue will be placed on the agenda and discussed in open board meetings at least twice before any vote. A decision to either retain sole physician leadership or split the executive duties could be made this spring.

Commissioner Mark Richard, who serves as health board chairman this year, said the issue is ripe for study. Thurston and Clark counties have health districts run by administrators with a physician offering public health guidance.

King, Pierce, Snohomish and Franklin-Benton counties have health districts headed by doctors with management experience.

While the board considers changes, it is renewing its search for a health officer.

David Crump, last year’s board chairman who has led the recruitment efforts, has refined the job posting and included more details. Among them: greater description of a negotiable severance package, moving expenses and other issues.

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