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Caleb Bryant Miller for The Texas TribuneDrs. Harish Chandna, from left, Ajay Gaalla, Dakshesh Kumar Parikh, cardiologists, in the waiting room of their office in Victoria.
VICTORIA — The e-mails and memos written by administrators and doctors at Citizens Medical Center here about three of their colleagues of Indian descent are, at best, derogatory. An operating room chief wrote of trying to force “the Indians off the reservation.” Others wrote about their “Indian troubles,” or labeled the hospital’s two rival cardiology practices as “the Cowboys” and “the Indians.”
Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.At worst, they could be considered racist: “I feel a sense of disgust but am more concerned with what this means to the future of the hospital as more of our Middle-Eastern-born physicians demand leadership roles and demand influence,” David P. Brown, chief executive of Citizens Medical, wrote in a 2007 memo to himself. He continued, “It will change the entire complexion of the hospital and create a level of fear among our employees.”
But whether racial animus led Citizens Medical, a 344-bed county-owned hospital, to close its cardiology unit to non-staff doctors — effectively revoking the privileges of Drs. Harish Chandna, Ajay Gaalla and Dakshesh Kumar Parikh to practice there — is the subject of fierce debate and a discrimination lawsuit filed by the three doctors in Federal District Court in the Southern District of Texas. The dispute has divided Victoria’s close-knit medical community, where many doctors and hospital officials say it is not about race — the city has long been home to doctors of all ethnicities and nationalities — but a struggle over egos and influence gone awry.
The Citizens Medical battle appears to have begun over operational disagreements between Drs. Chandna, Gaalla and Parikh and hospital administrators, and a lack of trust between the three Indian-American doctors and other cardiologists at C.M.C. Drs. Chandna, Gaalla and Parikh have their own cardiology practice and have practiced at C.M.C. and the neighboring DeTar Hospital for many years.
In e-mails, memos and court testimony, Citizens Medical administrators and doctors, who declined to be interviewed for this article, describe fractious relationships between themselves and the three cardiologists as they debated on-call schedules, compensation and leadership roles. The arguments sometimes devolved into shouting matches and name-calling — often, C.M.C. officials suggest in the documents, incited by the three cardiologists.
“From my review of the evidence, the common denominator in the rough aspects of the operation of the hospital were the three plaintiffs,” said Rex L. Easley Jr., one of the defense lawyers in the suit.
In e-mails referenced in a complaint the plaintiffs filed in August, Citizens Medical doctors also accuse the three cardiologists of starting a smear campaign against the hospital’s staff heart surgeon, Dr. Yusuke Yahagi, who is of Japanese descent and who complained of harassment and threatened to leave the hospital.
“This seditious speech and subversive actions toward [Dr. Yahagi] and C.M.C. is deliberate and calculated,” Dr. William T. Campbell Jr., a staff cardiologist and one of the defendants in the suit, wrote in a March 2010 e-mail included in the court file connected with the case. He continued, “These rabble-rousing behaviors are very disruptive to general medical care and are a poor reflection on Victoria medical community as a whole.”
But Drs. Chandna, Gaalla and Parikh, board-certified cardiologists who have been licensed in Texas for 13 to 18 years, say they were raising concerns about inappropriate procedures and poor patient outcomes, not being “disruptive.” In court filings, the doctors — one who was born in the United States and two who were born in India and are naturalized citizens — say they were consistently treated like second-class citizens, removed from committees and pushed out of laboratory posts arbitrarily, or overlooked in favor of “less-qualified” cardiologists C.M.C. hired.
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