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The Doctor Is Out 

Dr. Richard Carmona Resigns From The Top Post Of Pima County's Healthcare System.

NO ONE WILL dispute that Dr. Richard Carmona is a front-and- center guy.

Give him the scalpel.

Give him the organizational chart.

Give him a rescue chopper.

Give him a microphone.

But on the fifth day of Pima County's tortuous, tentative and tender parting of ways with its health czar, Carmona took a back seat. Way back.

Forced by the county's still-experimental Health Care Commission to resign the night before, Carmona sat quietly, partially obscured by a divider that provides a small room for cable television equipment. There he waited five hours for the Board of Supervisors to wade through testimony and its own halting deliberations on a record $808 million budget that will require record amounts of property taxes needed to begin to erase another record -- a $60 million deficit created mostly from losses in the health system Carmona ran for the last two years.

And shortly after 2 p.m., after a recess cleared most of the citizens who converged upon the Board to protest the county's new spending plan and higher taxes, Carmona stayed in the back as his nemesis, Health Commission Chairwoman Sylvia Campoy, stiffly read out provisions of the county-Carmona divorce.

The conditional resignation, worked out by Campoy and Carmona just before her Commission meeting began, is effective immediately and is without cause. Under Carmona's $188,000-a-year contract, he will get $75,000 in severance pay.

More important, the resignation agreement allows Carmona, the Health Care Commission and the Board of Supervisors to sweep away the controversies -- over money, management and personnel -- that have plagued the $288-million-a-year health system for months and led to Carmona's ouster.

His file will contain only the glowing performance evaluation he received when he was just the chief executive officer of Kino Community Hospital, the unstable 22-year cornerstone of the county health system. That evaluation, done for the Kino Community Hospital Advisory Board, was prepared by one of Carmona's lawyers, Michael Rollins.

Additionally, the resignation agreement states the "parting of the ways is appropriate and although the relationship has been mutually beneficial both parties desire not to continue it any longer or to discuss the matter of the reasons any further."

Another provision seeks to bar future legal action by Carmona, the Commission or the Board of Supervisors.

Before he headed the county committee that was the precursor to the one Campoy heads, Carmona was embroiled in a bitter legal dispute with doctors and officials at Tucson Medical Center. His settlement, which included a full-page newspaper ad extolling the virtues of combatants, resulted in a multi-million-dollar payoff to Carmona.

Supervisors voted 4-1 to accept the conditional resignation. Republican Ray Carroll hung with Carmona. But Carmona's two big boosters, Mike Boyd, the Republican who was Carmona's original sponsor, and Democrat Raul Grijalva, who became Carmona's patron, voted to dump him.

Grijalva recently implored Carmona to stay as the controversies and his battles intensified with Campoy, a close friend and political ally of Grijalva's.

The key fight occurred when Campoy sidestepped Carmona and forwarded to the County Attorney's Office allegations that a Kino internist, Dr. Charles Blanck, was writing bogus prescriptions. Blanck, who is Grijalva's physician, sat slumped in a seat alongside Kino Administrator Karen Shields for much of Tuesday's Board of Supervisors meeting.

Legal language must be pounded out by lawyers, including outside counsel that Grijalva said County Administrator Chuck Huckelberry could select, before the resignation will be final.

From the dais, Grijalva delivered an obligatory thanks to Carmona. With Kino consistently under political attack, Grijalva said he sought soldiers to protect it. Carmona, he said, served that role well.

"I extend my appreciation," Grijalva said.

It was Grijalva who won a power play to create the health care commission that he promised would protect Kino and the health system from political interference.

"The fact is it really changes nothing," Carmona said in an interview. "There is a lack of prudent public policy regarding health care. There is a mounting deficit that Mr. Huckelberry and I were attempting to deal with and that needs to be dealt with."

The replacement, Carmona said, is in a no-win situation, particularly if no one "takes the responsibility to sit down and say, 'This is how much we can spend for health care, this is all we spend, and we have to find out a way to prioritize these essential services.' "

Supervisors also raced to ratify the health commission's appointment of Karen Fields, a dietician and 20-year functionary of the county health system as the interim CEO. Fields has been the director of the Pima Health System, which includes the health maintenance organization that handles indigent patients.

Campoy said that Fields was selected because of her experience.

Fields said she does not want to be considered for the permanent position. Carmona is expected to work with her for about a week.

In the odd circumstance of being forced out twice -- once by the Health Care Commission and the next day by the Board of Supervisors -- Carmona said none of it would have occurred had the system's debt not blown up past $45 million.

Carmona says "scapegoat" fits him, depending upon who is talking.

"If they adhere to the agreement and say it's nobody's fault and that it worked well but that it was time to part ways, then that's OK," he said. "But if it's (Democratic Supervisor) Sharon Bronson talking and blaming me for the debt, then I'm a scapegoat."

Carmona says he has an offer to return to private surgical practice in Tucson as well as offers in Phoenix, New Jersey, New York and San Diego, where he has a second home. He says he wants to stay in Tucson.

On an elevator ride at Kino after Campoy's commission voted unanimously to get his resignation, Carmona was as upbeat as when meeting friends at the gym for a workout.

What about full-time work as a cop?

Possible. Deputies and jail guards, he said, have asked him to run for sheriff when longtime Democrat Clarence Dupnik hangs it up.

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