Beth Ann Rosica:  Another Chester County kerfuffle over a post-Covid review

“Those who cannot remember the past are condemned to repeat it.” 

Under the auspices of that sentiment, the Chester County Medical Society formed a Medical Emergency Response Workgroup to conduct a post-Covid evaluation to learn from mistakes and missteps; yet the new board president subsequently refused to allow it to be published under the society’s name, expressing concern about the impact of the report on county stakeholders.

The rift between the workgroup’s co-chairs and the board president demonstrates a continuing political divide and reluctance of critical examination and honest dialogue about failures in the overall handling of Covid.

The Chester County Medical Society was established in 1828 and is thought to be the oldest county medical society in the state. Their mission is to protect and expand healthcare resources in the community. The society’s board members are all volunteers and are not compensated for their time.

When the medical society’s board discussed the formation of the workgroup and the subsequent post-Covid analysis in 2022, the goal was to review and understand the pandemic and the county’s response since there had not been a meaningful analysis. The board agreed on a plan of action to conduct the assessment and then present findings to four groups, in this order: hospital CEOs, the Chester County Health Department, the county commissioners, and the public.  

Medical society president Dr. David Bobman expressed concerns that the report was too focused on blaming local stakeholders and asked for revisions after the initial report was completed. The co-chairs, Dr. Bruce Colley and Dr. Frank Speidel, revised the report eight different times before the meetings with stakeholders started. The presentation of the findings at the first meeting with Paoli Hospital was well-received, according to Dr. Speidel, as was the second meeting with the county health department that resulted in healthy dialogue. 

Something changed after that meeting because Bobman pushed back about the report being published under the society’s name. According to Speidel and emails obtained from him, Bobman believed the society had accomplished its mission to form relationships and alliances with local stakeholders, including the health department. Since that objective was complete, there was no reason to risk damaging the relationships by publishing the report under the society’s name. Subsequently, no other stakeholder meetings were held.

As Alexis de Tocqueville aptly noted in Democracy in America based on his travel to this country in 1831, a primary difference between America and other countries, like France and England, is that Americans readily form associations for some good, as opposed to relying completely on the government (although the same may not be quite as true today). Similar to churches, schools, and hospitals in the 1820’s, the Chester County Medical Society was formed by volunteers to work for the common benefit of all citizens, not for their own praise or glory. 

Members of the workgroup spent a great deal of their own time to conduct the evaluation and finalize the report. Yet, the president now seems more interested in having a seat at the table with county stakeholders than actually addressing issues to ensure the safety of the community. 

The report disputed by President Bobman includes this overview.

“Profound events such as the pandemic deserve a thoughtful, thorough examination.  Finding what was done well and what could have been done better is, we think, the way to improve and prepare for the next disaster. Using organizational and individual surveys, publications, both lay and scientific and input from physicians, the workgroup identified issues and their drivers, and offers recommendations for improved response to the next community adverse event.”

The report details the issues and provides four specific recommendations around the utilization of resources, communications, the recognition of shared concerns, and stakeholders’ meetings. While these recommendations were more pointed and detailed, they are not completely dissimilar from the findings of the county commissioned report

that was not publicly available until a Right To Know request. The medical society was not even aware of the outside commissioned report until earlier this year.

The medical society’s pro bono analysis and report was more thorough than the county’s contracted report that cost over $144,000. It was also conducted by physicians as opposed to a company staffed with employees without medical degrees who never saw patients.

The workgroup co-chairs, Drs. Colley and Speidel, were heavily involved in the design, data collection, and analysis for the report and spoke with me directly. Multiple requests for comment to Dr. David Bobman, President, and Lynn Stiley, Executive Director, were not returned.

Dr. Colley, a local practicing family physician, was previously the board president of the Chester County Medical Society at the time the project was approved and is a current board member. He also serves as the editor of the society’s journal, Chester County Medicine.

When asked about the dispute regarding publication of the review under the society’s name, Dr. Colley said, “it was the medical community that faced the Covid wave most directly. As such our patients brought to us a barrage of wide-ranging questions and concerns. We desperately needed expert guidance to supplement our best clinical judgment. Virtually every frontline physician I have spoken with found little guidance was forthcoming. Obviously and understandably, initially no one in the world had any concrete clinical advice. But with time, even two years into the epidemic when much was known, there were few precise recommendations for clinical interventions and epidemiological practices for the community.”

“To answer this ‘why’ we attempted to identify whatever miscalculations, oversights and errors that evolved out of our response to the Covid epidemic. Our summary report, I think, is a good start to address the ‘why’ for front line physicians and hopefully the wider community. Our survey and compilation of opinions and observations with respect to what was done well and what could have been done better for our Chester County citizens, I believe will lead to a better chance of protecting the health and wellbeing of Chester Countians in the next medical or public health crisis.”

Dr. Colley expressed disappointment that the review would not be published under the guise of the Chester County Medical Society, yet he remains on their board of directors.

Dr. Speidel, a retired emergency medicine physician, resigned from the board as a result of the president’s decision to not publish the report under the society’s name. 

When asked why he resigned as a director, Speidel said, “I resigned to object forcefully to Dr. Bobman’s authoritarian perception of the Medical Society as his possession for political influence, in contrast to the collegial, professional society I was a part of that saw a duty both to its members and the community. The project was undertaken not to find fault and blame, but to understand what was done well and where we could improve. The intent was for our community to be better prepared for the next disaster by learning from this one. Dr. Bobman, on his own as President, without Board input, terminated the project for political considerations.”

I reviewed numerous emails provided to me by Speidel illustrating the many conversations with Bobman and Stiley. Starting in early January and continuing through early April 2024, it appears that Bobman was concerned about releasing the report under the name of the medical society for fear of harming newly formed relationships with the Chester County Health Department and other local stakeholders. When Speidel then suggested canceling meetings with stakeholders, including the health department, Bobman and Stiley objected, concerned that the society would be left with “egg on its face.”

The completed report was intended to be published as a product of the medical society in the Spring edition of its publication. It will now be published in the summer edition only under the names of private physicians, Drs. Colley and Speidel.

While the good news is that the information will become publicly available, it is clear that the Chester County Medical Society is less focused on its mission today than it was almost one hundred years ago.

Beth Ann Rosica resides in West Chester, has a Ph.D. in Education, and has dedicated her career to advocating on behalf of at-risk children and families. She covers education issues for Broad + Liberty. Contact her at barosica@broadandliberty.com.