Agency sides with doctor in age-discrimination case

University of Washington doctor Warren Guntheroth didn't mince words when the UW's medical centers paid a record $35 million penalty in 2004 for overbilling Medicare and Medicaid. He publicly blamed the dean of the medical school for the scandal.

Since then, Guntheroth claimed, medical-school officials have retaliated, trying to force him out. They questioned his competence as a cardiologist, hired outsiders to assess how he treated heart patients, and ordered other UW doctors to review his work, government records show.

"This was humiliation and harassment," Guntheroth said.

He complained to the federal Equal Employment Opportunity Commission (EEOC) in 2006, alleging age discrimination. Guntheroth, a faculty member for 50 years, turned 80 last July.

Most complaints filed with the EEOC are dismissed or settled before the agency has to rule. Over the past decade, only 4 percent to 10 percent of those who filed each year obtained a favorable ruling.

Late last year, the EEOC ruled in Guntheroth's favor, although a cloud remains over him because the UW has failed to recognize the finding.

Guntheroth, one of the first doctors in the country to urge parents to place babies on their backs to avoid sudden infant death syndrome, only recently revealed the dispute to The Seattle Times.

The EEOC ruling came as the UW was trying to get past the billing scandal, which medical school dean Paul Ramsey blamed on "innocent mistakes." A special review panel called it an "embarrassing" episode in which red flags were ignored.

The EEOC didn't examine whether the UW's scrutiny of Guntheroth stemmed from his public criticism of his employer. Nonetheless, he believes the ruling validated his complaint about being targeted.

The UW disputed his allegations.

Officials said the medical school was subjecting him to proper oversight aimed at protecting patients. State confidentiality laws protecting peer reviews barred them from giving complete information about Guntheroth to the EEOC, leading to a misguided finding, the officials said.

Guntheroth's public criticisms had no bearing on the scrutiny of him, said Edward Walker, medical director of UW Medical Center.

"I think that is groundless," Walker said.

Unpopular stands

Guntheroth, a professor of pediatrics, keeps regular hours at the UW Medical Center and still sees some patients he treated decades earlier as children. He was an avid rock and mountain climber until a few years ago when his wife developed lung cancer. She died late last year.

As a doctor, Guntheroth has taken unpopular stands, such as opposing insurance-industry efforts to curb medical-malpractice suits. During the UW billing scandal, he was one of just a few medical-faculty members to speak out.

He publicly chastised UW officials in 2002 when the university agreed to pay up to $3.7 million to prominent neurosurgeon H. Richard Winn to leave the UW after Winn, a tenured professor, pleaded guilty to obstructing a federal criminal investigation into the overbilling.

"The effect on the university is bad," Guntheroth said at the time. "How can we teach our students that crime doesn't pay?"

When the UW agreed to pay $35 million for the overbilling, Guntheroth again criticized the university, this time singling out Ramsey.

Ramsey "pretty much has a blank check as far as power is concerned ... ," Guntheroth said in 2004. "It's a little like the situation in Iraq. 'Hey, you were in charge; how could you let this happen?' "

In June 2005, Walker, the medical director, told Guntheroth that to keep his staff privileges he needed to submit two letters of recommendation from colleagues.

Walker told Guntheroth all UW doctors were being required to do so to meet new, tougher national standards for re-credentialing physicians.

Guntheroth said he refused because he had never been asked for such letters before, then reluctantly provided them.

Several months later, a fellow UW doctor accused him of not recommending preventive heart surgery on a patient, according to Guntheroth and a letter the UW gave the EEOC.

Guntheroth said he documented for his superiors that the surgery posed serious risks. The patient has remained symptom-free since, he said.

In early 2006, according to Guntheroth and the UW letter, he was hit with a broader charge: He had become too isolated from other medical staff.

Two committees looked at his performance, and the UW hired three outside doctors to review his work. Each was paid $10,000, Guntheroth said.

In a letter to the EEOC, the UW said its reviewers criticized Guntheroth for "uniformly poor documentation in clinical files which failed to meet the usual standards of care."

Guntheroth said two key criticisms were listed: that his letters to patients' primary-care doctors and surgeons were too brief, and that he had misread electrocardiograms (EKGs) and echocardiograms.

Guntheroth said he has long believed it is better to write concise letters to other doctors, because they won't carefully read long ones.

He said the complaints about reading EKGs and echocardiograms were subjective and lacked documentation. He pointed out that he has written one book on reading pediatric EKGs and co-written another.

The review led UW medical officials to put restrictions on Guntheroth, its letter to the EEOC said. They ordered monitoring of his patient records, limited where he could practice at UW facilities, and required him to attend monthly heart-disease conferences.

Guntheroth, who has no record of malpractice, complained to Ramsey, who referred the matter to the UW's dispute-resolution office in 2006, records show. The office found no discrimination.

Guntheroth then filed his EEOC complaint.

The UW told the agency it doesn't discriminate because of age, and pointed to its 14 faculty and treating physicians older than 70, including one who was 80 and another 85. None had been the subject of reviews in recent years, the UW said.

EEOC's opinion

Last summer, the EEOC told the UW it did not find evidence to show that Guntheroth had "engaged in misconduct which would warrant the adverse treatment and conditions of employment ... imposed on him."

In September, the agency officially said it found "reasonable cause" to conclude he had been the victim of harassment and discrimination.

The EEOC then urged the UW and Guntheroth to resolve the matter.

The agency proposed that medical officials provide better training about age discrimination; post a notice informing employees how to raise concerns about the subject; and not retaliate against Guntheroth. He asked for an apology from the dean, EEOC documents show.

UW officials declined to participate. And Guntheroth said the restrictions on him remain in place.

The EEOC cannot force an employer to resolve a case, although the agency can sue to enforce remedies. But the EEOC sues in only a fraction of cases, using its limited resources to bring suits with wide implications, such as class-action cases.

Otherwise, the EEOC advises people they can file suit on their own.

Guntheroth said this is what happened in his case. But at his age, he said, "I am not too interested in long, drawn-out battles."

Steve Miletich: 206-464-3302 or smiletich@seattletimes.com