Turmoil ensnares GIMC official
Medical director reassigned
during discrimination probe

The Gallup Indian Medical Center [photo by Jeff Jones / Independent]

By Natasha Kaye Johnson
For the Independent

GALLUP — For the second time in less than a year, Gallup Indian Medical Center’s Medical Director Gary Escudero MD, is under investigation for allegations made against him by employees.

The tension erupted at the hospital once again on April 9 after Dr. Ralph Warren sent an e-mail hospitalwide informing the GIMC staff of his resignation.

“It is with great regret that I herewith submit my resignation from the GIMC staff. I think the GIMC could be a great institution because it has a great clinical staff ... ,” the e-mail stated. “I cannot however, continue to work for Dr. Gary Escudero, whom I believe is the single worst administrator I have ever met,” the letter said. “He is unfair, unscrupulous, entirely disrespectful of all the physicians here at GIMC (most of whom are much more qualified and able than he), and totally lacking in any leadership skills.”

Warren, who is a non-Native surgeon, listed six other physicians who allegedly left GIMC because of poor management by Escudero. In a phone interview, Warren said it was a string of events in his seven years at GIMC which led him to the abrupt resignation.

“Dr. Escudero has always been unfair and has mistreated every good physician that has come through GIMC,” he said. “He is a terrible administrator and should not be allowed at GIMC anymore.”

The e-mail prompted GIMC’s CEO Bennie Yazzie to call an emergency meeting the next morning. He informed staff Escudero had been temporarily reassigned to Tohatchi Health Clinic for 120 days while an investigation took place. Staff was informed Dr. Paula Mora, chief of urgent care, would be temporarily filling his position.

“Some issues have been raised that have led to the temporary reassignment of Dr. Escudero,” said Jenny Notah, public information officer for the Navajo Area Indian Health Service. “There is an administrative process in place to review these allegations.”

This is not the first time Escudero has been under review.

A formal investigation of Escudero was conducted in June after 60 employees signed a class-action complaint against him for alleged discrimination against Native American patients and staff.

Interviews were conducted by Warren Treisman, a San Diego-based lawyer hired by officials at Indian Health Service headquarters in Rockville, Md. The interviews were to serve as a counseling session between the staff and Escudero; however, no issues were reconciled, according to Dr. Richard Laughter, a psychiatrist who is acting as the group’s spokesman.

“We’re supposed to be protected by EEO federal laws,” said Laughter. “There was no issues resolved and GIMC decided to stand behind Escudero.”

The 60 plantiffs who signed the complaint requested Escudero be removed from his position. The group said they felt strongly they are being ignored and are now taking steps to get the class action complaint certified by a judge.

Laughter said they are now waiting to be certified as a class-action complaint, which could take several months to several years.

“The GIMC administration has been able to keep their wrongs undiscovered by the general public,” he said.

Notah said the hospital is aware of the class-action complaint against Escudero, but declined further comment. Escudero could not be reached for comment.

Since the investigation, friction and hostility at the hospital has been building.

“What is happening is Native Americans are being retaliated against,” Laughter said. “Dr. Escudero does things by fear and intimidation. It’s like domestic violence going on and it’s hush-hush about it. This is the best way I can put it.”

While the class-action lawsuit alleges discrimination against Native Americans, there are also non-Native employees, including Warren, who also believe Escudero practices racial discrimination.

Employees claim Escudero has been practicing racial discrimination for years, but the final blow came when Escudero demoted Dr. Joseph Stone from the position of chief of Behavioral Health Department early last year.

Escudero’s reason for demoting Stone was allegedly because of poor productivity, but the removal was seen by many as a blatant act of discrimination.

Examples of discriminated cited

In the interviews conducted by Treisman, nearly two dozen employees from physicians and social workers to secretaries and technicians, cited specific examples of alleged discrimination, prejudice, and cultural insensitivity practiced by Escudero.

Escudero is accused of calling an employee a “drug addict” for using peyote in a Native American Church meeting, making the statement, “This health care is free, so they get what they get”, and referring to Native patients as “those people.”

In August 2006, Dr. Lyle Ignace, Chief of Internal Medicine, was asked to lead a Gourd Dance service in honor of a patient who died. When Escudero was on leave, an internal staff employee said Escudero stated, “I don’t pay him to dance, I pay him to see patients.”

In January 2007, Laughter describes an event where he showed Escudero markings on his chest from piercings which identify him as a Sun Dancer. Laughter said the Escudero referred to them as “self-torture.”

Escudero strongly denied making any of the statements

Institutionalized racism alleged

Several employees interviewed stated Escudero has deliberately prevented the hospital from implementing culturally sensitive programs.

While other Navajo Area Indian Health Services have begun to utilize traditional practices along with Western medicine, staff stated GIMC has not moved forward in fully implementing these programs.

Employees pointed out there are nine Indian health facilities in the Navajo Area, and GIMC is one of two which does not have a hogan. GIMC is also the only Navajo Area IHS which does not have a sweat lodge. While there have been committees formed to implement a hogan and sweat lodge into the hospital, employees stated within the interviews Escudero has made it difficult for these committees to be successful.

Escudero said in the interviews he was not aware the other facilities in the Navajo Area had hogans on site and he did not know GIMC is the only hospital with no sweat lodge. He said the committee had disagreements about what should be included as part of the hospital and because a consensus could not be met, the committee eventually disbanded.

In the interviews, Escudero said he doesn’t know of a written policy to promote traditional cultural values and culturally sensitive programs, but said he “certainly does not discourage it.” Escudero said there were no complaints regarding a lack of cultural insensitivity about employees until Stone was removed.

Ignoring Indian Preference Act

Several employees interviewed also stated Escudero does not follow the Indian Preference Act, a federal law which requires positions to first be filled by qualified Native American candidates before it is opened to non-Natives. Both Native and non-Native employees stated in the interviews they believe Escudero violated the preference act.
It was pointed out by employees there are 17 departments at GIMC; however, only three of them are run by Native Americans, including Dr. Lyle Ignace, chief of internal medicine, Dr. Charlene Avery, chief of the diabetes program, and Dr. Paula Mora, chief of urgent care.

Escudero is being accused of restricting qualified Native American people from chief positions and manipulating the selection process to help non-Natives secure leadership positions.

Dr. Gabriel Longhi, a non-Native, said in the interviews he believes Escudero tried to make him the director of behavioral health without competitive selection. He stated he had to remind Escudero to advertise the position to qualified Native American employees several times. Stone would eventually be hired to the position, but Escudero put Longhi back in as chief of the department after demoting Stone.

Longhi, acting chief of behavioral health, stated in the interview he has “personally been treated very well by Escudero, but believes Escudero is unconsciously discriminatory in his thinking and practices.” Longhi stated in the interviews he believes Stone’s removal was racially motivated.

Other employees gave testimonies stating Escudero deliberately avoided opening up positions for Indian Preference.

Abrasive at times, and less tactful

Bennie Yazzie and acting executive officer, Floyd Thompson, were also interviewed.

They stated Escudero “is tough on employees across the board, but does not treat anyone differently.” Both said Escudero is sensitive about religious tolerance, and did not believe he restricted culturally sensitive programs. They said he does not violate Indian Preference and sometimes there are no Native American candidates for chief openings. Both said they have never heard Escudero make derogatory remarks against Native Americans, and he has many Native patients who hold him in high regard.

They believe Escudero can be “abrasive at times and less tactful, but has high expectations of himself and the quality of work being performed at GIMC.”

Both stated Escudero removed Stone because he was not up to Escudero’s expectations and because he did not follow directives. They said Stone has good credentials, but he has not responded well to simple things asked by Escudero. They stated they were dissatisfied with Stone’s performance as a supervisor and clinician.

Financial pressure on Escudero

Mora, who has been temporarily been appointed medical director, stated she was not aware of any negative comments by Escudero in regards to Native Americans. She stated she believes his focus is to provide good care for patients.

Instead, Mora said there is a lot of financial pressure on management, and limited resources available, and believes some of those cuts be may misconstrued as discrimination.
Her interview was the only one conducted at the request of Escudero.

Mora recalled an incident last year where Laughter and Longhi were talking among five nurses in the urgent care department about newspaper articles concerning alleged racial discrimination. Mora said she heard Laughter say, “We all have to band together.” Mora said they were disrupting the clinic and asked them to leave. As Laughter left, Mora said she heard him state, “It is now time to put Indian back into Indian Health Service.”

When Stone was first demoted, Escudero alleged Laughter made a racial comment.

In the interviews, Escudero stated that Laughter said, “I’m not going to work for any white supervisor. If you get rid of Dr. Stone, I’m going to leave too.”

Petition circulated

On April 15, a petition stating “No Confidence” in Escudero began circulating. The petition asks to remove Escudero from the position of clinical director.

“The leadership doesn’t represent Indian interest,” Laughter said.

According to the union, in 2006, GIMC had the most union grievances for a month period of any IHS facility and they were predominantly Native American issues.

“Overall, this means the hospital is sick,” Laughter said. “When the hospital’s sick, how are we supposed to take care of the patients?”

“We have nothing to gain from this except for better patient care,” said Laughter. “We want the healing process to begin as soon as possible.”