GUEST OPINION

It was surprising that a mere two weeks after listing Dr. Judith Hartner as one of the Top 25 Power People in Fort Myers (June 28 issue) she is the unwitting recipient of a tirade criticizing her.

In the "In other words" column of July 5 Roger Williams compares Dr. Bob Schwartz to a medic, heroically showing great compassion but poor table manners." This same article claims that "local government health officials hoodwinked the AIDS Treatment Center... Perhaps they were thinking of manners, when they should have been thinking of stricken men and women." It then criticizes Dr. Hartner for her callousness.

While Dr. Schwartz was never known for his good manners (bedside or otherwise), he was known for being a local pioneer in the treatment of HIV/AIDS. For that, our community will be forever grateful. However, now that HIV/AIDS is much more manageable due to advances in medications he has become increasingly insignificant.

This diminished role is not because of his manners (most have become accustomed to his unreserved behavior by now); it is due to his lack of professionalism and lack of quality primary medical care that has left the organization that he represents floundering and no longer supported by many of his peers. Additionally, many of his agency's patients/clients have left the AIDS Treatment Center to receive care at other area providers.

Let the facts speak for themselves regarding the organization that Dr. Schwartz represents. A Technical Assistant Report from February 2005, performed by the Health Resource Service Administration (The federal department. that provides much of the organization's funding) reported that, "There are deficiencies in the Board structure and function. Policies and procedures have not been developed and implemented to correct organizational weaknesses and existing policies and procedures do not provide needed structure and controls to promote effective operation."

Further, a site visit in 2005 reported that ARC (now the AIDS Treatment Center) does not have a mandatory, Continuous Quality Improvement plan in place, nor any clinical policies and procedures in place for HIV care, nor any system of providing or documenting routine health maintenance and required immunizations.

Meeting notes from the May 2005 Southwest Florida Regional HIV/ AIDS Council, the local planning body for HIV/AIDS care indicated that contracts for medical care and case management would not be renewed. This decision was not based on occasionally belching at the dinner table but on:

• An RHAC Physician Advisory Subcommittee meeting conclusion that "(he) does not perform basic medical examinations that are standards of care". Dr. Schwartz had clearly stated that he is not comfortable addressing patients' primary care needs.

• After a review of funding documents, it was reported that Dr. Schwartz was over-utilizing medical, laboratory and specialty services. His per-patient costs were approximately twice that of other comparable providers in the area.

• A Ryan White Title III Diagnostic Site Visit Report in January 2006 indicated that while some of the deficiencies previously noted have been corrected, many of the deficiencies continue.

Mr. Williams reported that, "For the last couple of years, dollars have been so scarce that Schwartz has turned down any personal salary whatsoever from his non-profit Center". What he does not say is that for at least several years prior to that, Schwartz's salary equaled fully 50 percent of the federal funds that were received by the clinic.

Dr. Hartner, director of the Lee County Health Department, is not the only person who has found Dr. Schwartz a difficult person to work with. Just ask the many board members, the previous executive directors, the former staff, or many of the patients that have fled from him over the past several years. Be assured that none of these individuals have left merely due to a belch by Dr. Schwartz.

Why shouldn't Dr. Schwartz shoulder the problems that he has created due to his documented waste of onceavailable funds, his refusal to provide primary medical care as is required by his Federal grants, and his inability to attract and utilize board members who have sufficient fiscal or, health care management skills. Had his organization been up to standards, they would have been aware of the resources they needed to request from the county at the time and not expected Dr. Hartner to come in and correct his mistake 18 months after the fact.

Dr. Hartner is to be commended for her sustained involvement in the community and for standing firm to avoid supporting over treatment or mismanagement.

- Sean McIntosh is a former

HR/Finance Manager for the AIDS

Treatment Center run by Dr. Robert

Schwartz. ¦

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