David Bussone's resignation Monday as president of Tampa General Hospital came at the request of one of his staunchest supporters, hospital board chairman Frank Fleischer.
The surprise announcement at the regular board meeting was followed by a second bombshell. Retiring Hillsborough County Administrator Fred Karl, 70, has agreed to try and lead the stricken public hospital out of its crisis as its interim president.
"There's a great ray of hope shining through because of what happened today," said Jan Platt, the county commissioner who first called for Bussone's resignation last year. Ironically, Monday was her last regular hospital board meeting before her commission term expires.
Reached later at his county office, Karl vowed to keep the hospital public, make substantive changes, and rebuild the hospital's credibility.
"I tend toward the hospital remaining public because I am a public person and that is the arena where I work best," Karl said. He said the hospital is not about giving jobs to nurses and doctors or raising parking revenue. "It's about serving patients. And if we do that, everything else will fall in line."
Karl, who leaves his $137,500-a-year county job Nov. 18, must meet with hospital lawyer Ralph Dell to reach a contract agreement. The hospital board will meet at 8:30 a.m. Nov. 7 to review that contract. Fleischer said he anticipates Karl could stay a year or longer.
Bussone's resignation ended a stormy three-year tenure that mirrored the uncertain state of health care and public hospitals in the 1990s.
He was credited with engineering a strategic business plan, moving toward outpatient services and changing outdated methods of dealing with patients. But his leadership crisis became public in March 1993 with a public relations fiasco surrounding the layoff of 213 workers.
That's when Platt went on the attack, calling for his dismissal.
In fact, Fleischer said Monday, Bussone offered his resignation during that time. Fleischer refused to accept it.
The problems escalated with a near-breakdown in relations with the University of South Florida, the loss of an orthopedics program and financial woes that last month resulted in additional layoffs.
Just 10 days ago, at a chaotic annual evaluation, Bussone narrowly retained his $210,000-a-year job after County Commissioner Phyllis Busansky called for his resignation.
That session provided a snapshot of the bickering and divisive antics that have damaged the hospital's reputation in the community and among health care professionals.
Some board members slammed Bussone for being secretive, for failing to abide by Florida's Sunshine laws and for their fear that he had a secret agenda to take the hospital private. Doctors jeered the board. Board members taunted each other.
The system had collapsed, Fleischer said.
Fleischer, also criticized for letting the situation fester, vowed after the meeting to take command. He met secretly Thursday with Bussone at his Harbour Island home and asked Bussone to resign.
"This is difficult for me to do," he recalled saying. "We're stagnating. We're at an impasse. ... We're not going anywhere."
Bussone responded: "I understand. I'll do what's best for the organization."
Under terms of the severance agreement written into his five-year contract, Bussone will be paid one year's salary. His resignation was effective Monday. Bussone did not attend Monday's session and was unavailable for comment.
Two board members appeared shaken by the announcement. Burt Lowe questioned Fleischer's authority to push Bussone out. He stalked out of the meeting after a vote to accept Bussone's resignation.
"The messenger has been shot," Lowe said.
Just as the hospital community was divided in their opinions of Bussone, they were united Monday in their approval of Fred Karl, a senior statesman known for fixing administrative disasters.
Spokespeople for doctors, employees, and the University of South Florida vowed to work with Karl through the transition. He has long-standing working relationships with major players, including University of South Florida President Betty Castor, assistant county administrator Pat Bean and Hillsborough County's legislative delegation.
Such support could be crucial at a time when the hospital, reeling under the burden of a $22-million annual charity debt and the $10-million cost to participate in the Florida retirement system, could look to Tallahassee for financial relief.
Fleischer said Bussone's resignation does not affect the status of chief operating officer Jeanette Taft, who will be let go Dec. 31. Karl, however, said he will review the situation before making any decisions. Fleischer also publicly supported Bussone's chief financial officer, Claudia Griffiths.
Rumors surrounding Karl escalated last week, even before Bussone had resigned. As a joke, county staffers brought Karl a paper gown and shoe coverings. Fleischer, stymied by the chaos, said he learned of the rumors in the newspaper and decided to approach Karl.
"I didn't think he would even talk with me," Fleischer said. "What does he need this for?"
BUSSONE'S CAREER AT TGH
July 1991: David Bussone, former head of the largest hospital in Mississippi, is chosen president of Tampa General Hospital.
January 1992: Tampa General is listed among the top 20 financially successful hospitals by a national health care magazine.
June 1992: The hospital is criticized for paying the expenses of advertisers, accountants and lawyers without requiring receipts.
September 1992: Tampa General's governing board refuses Bussone's request to raise another top executive's pay by $40,000.
February 1993: The board learns that Bussone has authorized $120,000 worth of advertising during professional hockey games.
March 1993: 213 Tampa General employees are given pink slips. Hospital board member Jan Platt calls for Bussone's dismissal.
November 1993: A vote to unionize Tampa General employees fails after a divisive and bitter campaign.
May 1994: The board gives Bussone a 10-2 vote of confidence.
October 14, 1994: At a raucous board meeting, Bussone narrowly survives a motion to fire him. He is criticized for being arrogant, secretive, and communicating poorly with certain board members and much of the community.
October 24, 1994: Bussone resigns. Retiring Hillsborough County Administrator Fred Karl agrees to take the job on an interim basis.