The Issue The issue to be resolved in this proceeding is whether Petitioner was constructively terminated from her employment with Respondent because of her national origin.
Findings Of Fact Petitioner is a female of German and Turkish descent and has a somewhat heavy German accent. In 1995, Petitioner was employed with Bay Medical Center, a hospital in Panama City, Florida. Petitioner was employed as a unit secretary for one of the hospital units. She voluntarily resigned that position in 1997. In March of 1998, Petitioner was again employed by Bay Medical Center as a unit secretary. She was a member of a secretarial float pool and floated from one unit of the hospital to another as needed. Later, due to a hospital reorganization, the unit secretarial position was reclassified to a Clerical Support Associate (CSA) position. The CSA position included more duties than the unit secretary position and had a higher wage. As a CSA, Petitioner was responsible for providing essential clerical support as required by patient’s and clinical staff. Her duties included entering physician orders into the hospital’s computer system, scheduling tests and procedures for patients, charging and crediting patient bills, greeting patients and visitors, chart maintenance, and otherwise assisting as needed. Petitioner eventually, was assigned as a full-time CSA in the Critical Care Unit (CCU). The CCU was a very small unit with only eight open beds and was the least active unit in the hospital at that time relative to the duties of a CSA. The lower activity resulted in less work and less stress for the CSAs assigned to the CCU. Because of the light workload and low- stress environment for CSA’s, P.J. Dotson, Petitioner's supervisor in the CCU, used the CCU to train new CSAs. Because Petitioner had experience with the work, she occasionally helped train new CSAs. At some point, Ms. Dotson determined that the CSAs in the CCU were only performing two and a half to three hours of clerical work during an eight-hour period. The small amount of productivity by the CSAs was unacceptable. In order to increase the CSAs’ productivity, Respondent changed the job role of the CSAs in the CCU, including Petitioner's, and added basic patient care tasks. Some of the new tasks included feeding patients and helping patients on and off bedpans. Additionally, the CSAs' hours changed to require them to come in earlier. On December 12, 2000, Petitioner was disciplined by Ms. Dotson for complaining to a physician about Respondent's decision to change the job requirements of the CSAs in the CCU. The physician was Respondent's "customer," not Petitioner's supervisor and Ms. Dotson felt that it was inappropriate for Petitioner to discuss her employment situation with a "customer." Ms. Dotson’s position was a reasonable position by an employer. After the disciplinary action, Petitioner declined the upgraded CSA position because she did not want to change her working hours and did not want to do hands-on patient care. Rather than terminating Petitioner's employment, Respondent allowed Petitioner to transfer to the EKG department to work as an EKG technician which position also included some clerical tasks. Petitioner served as an EKG technician for two months. During those two months, Petitioner experienced numerous performance problems and was disciplined several times by Ms. Dotson. Petitioner admits she simply was not very good at direct patient care and performed poorly as an EKG technician. On February 20, 2001, Ms Dotson issued Petitioner a Notice of Corrective Action based on a number of issues that had arisen beginning around January 15, 2001. The Notice states, "During week two, we started experiencing several problems with the paper work [Petitioner] was doing. Files were not in correct order (alphabetical), Cardiology Associates were complaining about paperwork, [and] the unsigned copies of Echo reports were not getting to M.D.s for their signature.” These problems were detrimental to efficient and timely patient care in an area of health care, cardiology, where efficiency and timeliness of care are very important. Due to these concerns, Ms. Dotson changed Petitioner's orientation schedule and established specific times to achieve performance goals. However, the changed schedule did not help resolve Petitioner's performance problems. After Petitioner was fully trained to perform an EKG procedure, Petitioner "developed the inability to perform this task" within a few weeks. Petitioner also improperly double-billed a large number of Respondent's patients. The double billing was a major oversight on Petitioner's part that could have been seriously detrimental to Respondent's ability to serve Medicare and Medicaid patients if the problem had not been discovered and resolved by Ms. Dotson. On March 8, 2001, Petitioner received a final written warning because her work-related problems persisted. At that time, Ms. Dotson informed Petitioner that she needed to find a different position within Bay Medical Center, resign, or be terminated. Ms. Dotson also took this opportunity to coach Petitioner on how to sell herself to other managers, so Petitioner could acquire another position. One of the areas Ms. Dotson discussed with Petitioner was her communication skills. Ms. Dotson explained that she needed to communicate better because she has an accent, does not articulate well and often speaks with her hands in front of her mouth thereby making it difficult for others to understand her. In addition, Ms. Dotson explained to Petitioner that she demonstrated a somewhat negative attitude and failed to take responsibility for her mistakes. These traits were concerns for managers in the various departments throughout the hospital. These traits were also demonstrated at the hearing. There was no evidence that any action taken by Ms. Dotson was done for discriminatory purposes or that the reasons given for such action were pretextual. Indeed, Petitioner admitted that Ms. Dotson did not discriminate against her. However, because of these traits, Petitioner had a difficult time finding another position within Bay Medical Center, even though there was a high turnover rate among CSAs throughout the hospital. Eventually, Petitioner was accepted by Ms. Pat Owens to serve as a CSA on Three South, a medical/surgery unit at Bay Medical Center. Indeed, Petitioner’s transfer to Three South was against hospital policy since Petitioner was slated for termination from her earlier position and had received her final warning. However, in order to help Petitioner, the transfer was allowed. Although Petitioner had served as a CSA in CCU previously, the working atmosphere of Three South was very different. Three South was, as Petitioner described it, a "very, very busy floor." Three South had 39 beds and over 200 physicians on staff. However, during Ms. Owen’s time as manager of Three South, Ms. Owens did not formally discipline Petitioner regarding her job performance. Ms. Owens did not testify at the hearing. Petitioner admits that she made mistakes while Ms. Owens was her supervisor. She testified that there were "minor things" that Ms. Owens would make her redo. However, under these facts, the fact that Ms. Owens chose not to discipline Petitioner formally is not evidence of discrimination. The hospital was not satisfied with the way Three South was being managed by Ms. Owens. The unit staff were not following various hospital protocols impacting patient care. Numerous complaints were made by both patients and doctors regarding the quality of care being delivered by the unit staff. Therefore, in April, 2002, Ms. Andi Bush was hired as the manager of Three South. She was hired in order “to get Three South into shape.” Ms. Bush also became Petitioner's supervisor and demanded considerably more performance and compliance with protocols of all the employees on Three South. After Ms. Bush became manager, Petitioner claims that Ms. Bush commented on Petitioner's accent and that "[Ms. Bush's] hearing would be perfect if anybody else would talk to her. But whenever I said something to her or tried to quote her [sic] about something, all of a sudden she had this major problem." This alleged evidence is not convincing. Ms. Bush wears a hearing aid and relies on "lip-reading" because she has a significant amount of hearing loss due to nerve damage. She often has difficulty hearing others' words and asks others to repeat themselves. This difficulty was demonstrated at the hearing. In addition, Petitioner did not provide any details about the times Ms. Bush allegedly commented on her accent. There is no evidence in the record about how often or in what context any such comment allegedly happened. Given the facts that Ms. Bush is hearing impaired and reads lips and that Petitioner often speaks with her hands in front of her mouth, has an accent and does not enunciate her words, comments by Ms. Bush regarding Petitioner’s accent do not support a finding of discrimination. Ms. Bush, unlike her predecessor, enforced the hospital protocol’s and demanded that her staff comply with those protocols. It was clear that Ms. Bush's job, as the new manager of Three South, was to impose accountability and discipline on that unit. Indeed, Petitioner testified that, during Ms. Bush's initial meeting with the employees on Three South, Ms. Bush made it clear that she believed Three South was a "mess" and that "she was going to straighten it out." Petitioner failed to provide any evidence that Ms. Bush applied the rules or issued discipline inconsistently among the employees or that employees of other nationalities were treated better than her. There is no comparator evidence in the record to demonstrate that Ms. Bush's discipline of Petitioner was for discriminatory purposes. Under Ms. Bush's administration, Petitioner was disciplined on several occasions for various performance issues. On May 23, 2002, Petitioner was issued a written warning for failing to enter a physician's order. The order requested a consultation with a cardiologist to determine what treatment the patient needed. Because Petitioner did not enter the order, the consultation was delayed for over 24 hours. When the consultation was eventually performed, the cardiologist determined that the patient needed a pacemaker. Petitioner's mistake could have had dire consequences for the patient involved. Petitioner does not deny that she failed to enter the order but claims that she was told by her co-workers that she did not need to enter the order because the patient was going to be transferred to a different floor. However, Petitioner knew that other co-workers could not instruct her not to follow the hospital’s protocol for entering a physician’s order in a timely manner. The discipline she received was clearly not pretextual and was appropriate for her failure to enter the physician’s order. On June 5, 2002, Petitioner received a written warning for excessive absenteeism. Again, Petitioner does not deny that she was excessively absent. Instead, Petitioner alleges that her absences "weren't really more extensive than anybody else's." Petitioner later admits, however, that these other employees were also punished for their tardiness and absenteeism. Petitioner provided no other evidence that Respondent applied its attendance policy inconsistently among the employees. Given these facts, the evidence is insufficient to demonstrate that Petitioner’s disciplinary action was discriminatory or pretextual. On July 3, 2002, Petitioner was suspended following two different incidents. First, Petitioner placed several documents in the wrong patient's chart. Second, Petitioner failed to properly consult a physician regarding a patient care issue. Both of these incidents could have had detrimental impact on the health and safety of Respondent's patients. Petitioner offered no evidence to dispute the accuracy of the report of these incidents. On August 7, 2002, Ms. Bush held a corrective action meeting with Petitioner to discuss the following incidents: (1) Petitioner's repeated failure to enter consultations into the computer; (2) Petitioner's repeated failure to consult physicians in a timely manner; (3) a patient complaint that her call light was not being answered during Petitioner's shift; and (4) Petitioner’s failure to file a stack of documents as she was assigned to do, but instead twice sent them to medical records to file. Petitioner denies making these mistakes, but her denial is based on her lack of memory for the events. Indeed, Ms. Bush based the disciplinary action on complaints and witness statements she received form a variety of sources. Again there was no evidence that the Ms. Bush’s actions were discriminatory or pretextual. Finally, on August 14, 2002, Petitioner was given her annual performance appraisal. Petitioner was rated as "unsatisfactory" based on her record of discipline and the real potential of her performance failures to adversely impact patient care. Based on her previous performance problems and the performance appraisal, Petitioner was told that she could no longer work as a CSA at Bay Medical Center. Indeed, Ms. Dotson who was consulted regarding Ms. Bush’s decision, concurred that Petitioner should not be transferred to any CSA position or position involving patient care due to past mistakes which were potentially detrimental to a patient’s health. Respondent gave her two weeks to find a different position within the hospital, resign, or be terminated. Respondent, through its personnel department, tried to assist Petitioner to find a position within the facility. After reviewing the printout of available positions with Petitioner the only positions that were open, and for which Petitioner was qualified, were in Dietary, Housekeeping, and Laundry. Petitioner did not offer any evidence of any other positions outside those areas that were available and for which she was qualified. Petitioner refused to apply to any of these positions and, instead, resigned on August 28, 2002. The evidence did not demonstrate that her resignation was forced or caused by any discriminatory actions by Respondent. Again, Petitioner failed to provide any evidence that Respondent discriminated against her and the Petition For Relief should be dismissed.
Recommendation Based upon the Findings of Fact and Conclusions of Law, it is RECOMMENDED: That the Florida Commission on Human Relations enter a final order dismissing the Petition for Relief. DONE AND ENTERED this 25th day of October, 2004, in Tallahassee, Leon County, Florida. S DIANE CLEAVINGER Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 25th day of October, 2004. COPIES FURNISHED: Denise Crawford, Agency Clerk Florida Commission on Human Relations 2009 Apalachee Parkway, Suite 100 Tallahassee, Florida 32301 Margie Beach-Gutierrez 5807 Butler Drive, Apartment 4 Callaway, Florida 32404 L. Taywick Duffie, Esquire Price H. Carroll, Esquire Hunton & Williams, LLP 600 Peachtree Street, Suite 4100 Atlanta, Georgia 30308 Cecil Howard, General Counsel Florida Commission on Human Relations 325 John Knox Road Building F, Suite 240 Tallahassee, Florida 32303-4149
Findings Of Fact Ruth Rogers is a licensed medical physician authorized to practice medicine in this state. The Complaint allegations centered around testimony of the Respondent, Ruth Rogers, during a custody proceeding in which the Child Protective Services (a State Agency) was attempting to gain custody of one Dena (Nikki) Decker based on facts which will be set forth in detail hereinafter. Jack McGowan, a medical doctor engaged primarily in pediatrics in Fort Pierce, Florida, testified that he first treated Dena Decker during August of 1973, at which time Decker was approximately seven weeks old. Dr. McGowan made subsequent treatments of Dena Deckur on a regular basis through December of 1976. During December, Dr. McGowan noted that Decker's lymph glands were enlarged and he ordered that certain lab work be performed, the results of which were returned to him sometime during early January of 1977. Based on the lab results, Dr. McGowan tentatively diagnosed Dena Decker as being a patient suffering from acute leukemia. To confirm this diagnosis, he referred her to the Shands Teaching Medical Center in Gainesville, wherein Dr. McGowan's diagnosis was confirmed. The treating physicians of Patient Decker at Shands Teaching Hospital were Drs. Jerry L. Arbosa and David Pockmore. It was their medical opinion that Dena was in fact suffering from acute lymphoblastic leukemia and that this disease should be treated by chemotherapy at Shands Teaching Hospital in Gainesville. Drs. Barbosa and Rockmore explained to the parents of Dena Decker the benefits and side effects of chemotherapy treatment, and they suggested that this was the best method of treating a patient such as Dena Decker, who was suffering from acute lymphoblastic leukemia. They noted, however, that there were some side effects, such as loss of hair and the destruction of certain "good" cells as well as "bad" cells. Dema Decker's parents requested time to consider the chemotherapy treatment and Drs. Barbosa and Rockmore stressed to her parents that "time was of the essence". After a few days, the parents of Dena Decker declined the treatment and at that juncture, Drs. Barbosa and Rockmore called in the Child Protective Services of Gainesville wherein a custody proceeding was convened, with the State seeking a custody award of Dena Decker. During that proceeding, Dr. Ruth Rogers, Respondent, testified that she would treat such a patient suffering from acute lymphoblastic leukemia with natural foods, herbs and optimal psychological support. It was Drs. Barbosa and Rockmore's opinion that the method of treatment outlined by the Respondent would be futile and that the patient would die in a short period of time. There was no evidence that the Respondent, Ruth Rogers, counseled with Dena Decker's parents or that she at any time treated Dena Decker by the method to which she testified during the custody proceeding in Gainesville. Following the conclusion of the Petitioner's case, Respondent's counsel moved for a directed verdict, summary judgment, or a judgment based on a failure on the Petitioner's part to establish a prima facie case. After some consideration, the undersigned concluded that, based on the evidence adduced during the Petitioner's case in chief, insufficient evidence was offered to establish that the Respondent had violated Chapter 458.1201(m), Florida Statutes, as alleged. Section 458.1201 is the section of the Medical Practices Act which deals with the power of the Board in the denial, suspension, revocation of license, and other discipline of medical practitioners. It reads, in pertinent part: "458.1201l--Demial, suspension, revocation of license; disciplinary powers-- The board shall have authority to deny an application for a license or to discipline a physician licensed under this chapter or any antecedent law who, after hearing, has been adjudged unqualified or guilty of the follow- ing: (Here is set forth several categories of disqualification or misconduct included in which is subsection (m))." Subsection (m) sets forth as grounds for. . . discipline of a physician, the following facets of misconduct: "(m) Being guilty of immoral or unprofessional conduct, incompetence, negligence or will- ful misconduct. Unprofessional conduct shall be any departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice in his area of expertise as determined by the board, in which proceeding actual injury to a patient need not be established; when the same is committed in the course of his practice whether committed within or without this state." (Emphasis supplied) The administrative charge herein claimed to be proscribed by the above- quoted section of the statutes deals only with the testimony of the Respondent as to a method of treatment that she would use for treating acute lymphoblastic leukemia. Based on my examination of this record and an analysis of the reported case law, I conclude that the giving of such testimony is not proscribed unprofessional conduct as that term is included within this particular subsection of Chapter 485.1201(m). As the Court of Appeals stated in Lester v. Department of Professional and Occupational Regulation, Fla.App., 348 So.2d 923 (1977), the Court stated: "In construing the language and import of this statute we must bear in mind that it is, in effect, a penal statute since it imposes sanctions and penalties in the nature of denial of license, suspension from practice, revocation of license to practice, private or public reprimand, or probation, upon those found guilty of violating its prescriptions. This being true the statute must be strictly construed and no conduct is to be regarded as included within it that is not reasonably pro- scribed by it. Furthermore, if there are any ambiguities included such must be construed in favor of the applicant or licensee." This being so, I conclude that the above-cited conduct claimed to be violative of Chapter 458 is not proscribed by Chapter 458.1201(m) and I shall recommend that the Board enter a final administrative order dismissing the instant action against the Respondent.
Recommendation Based on the foregoing findings and conclusions, hereby RECOMMEND: That the Administrative Complaint filed herein against the Respondent be DISMISSED. RECOMMENDED this 28th day of August, 1978, in Tallahassee, Florida. JAMES E. BRADWELL Hearing Officer Division of Administrative Hearings 530 Carlton Building Tallahassee, Florida 32304 (904) 488-9675 COPIES FURNISHED: Michael I. Schwartz, Esquire Suite 201 Ellis Building 1311 Executive Center Drive Tallahassee, Florida 32301 David Rogers, Esquire 3101 Maguire Boulevard Post Office Box 20065 Orlando, Florida 32814 George S. Palmer, M.D. Execuivo Director State of Florida, Board of Medical Examiners 2009 Apalachee Parkway, Suite 220 Tallahassee, Florida 32301
