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Tahoe Medical Community Outraged

Physicians and staff at Barton Memorial Hospital are outraged over El Dorado County’s decision to exclude them from the selection process to determine a new ambulance provider for El Dorado County’s Eastern Slope.

The attorney for El Dorado County has deemed participation by Dr. Rick Tietz, who was the only Tahoe-based medical representative on the six-member selection committee, to be a conflict of interest. With less than a week until the selection committee makes a decision on who will be the new ambulance provider, Tietz has been replaced by an outside representative. The only Tahoe representation is Stan Hansen, senior vice president for the American Skiing Company.

Gail Herbe-Hamlin, El Dorado County public health director, said Tietz was removed because of his affiliation with Barton Hospital, which had included a letter with a proposal made by CalTahoe EMS, a joint powers authority between the city of South Lake Tahoe, Tahoe Truckee Fire Department and Lake Valley Fire Department. The letter stated Barton’s position on interfacility transport.



Tietz was not removed from the board because of any violations or misconduct, but because of his services to Barton Hospital as a base station medical director for which he earns a nominal fee. Tietz is one of several people who sets policy and oversees the work of paramedics at Barton. Tietz is also works out of Barton as an emergency physician. He officially works for Tahoe Emergency Physicians, which bills independently of Barton Hospital.

Tietz said he does not care if he is on the selection committee as long as there is representation from Barton. But El Dorado County said there will be none.



After Tietz’s removal from the selection committee, he asked to sit in as an adviser but the county denied his request.

“To not have a local physician on the selection committee is absurd,” he said.

El Dorado County has barred any contact between the selection committee, which has representation from as far as Texas and Florida, and representatives of Barton.

“I don’t know why we would be biased,” said Mary Flores, director of emergency nursing services for Barton. “These people, making the choice for our community, don’t even live here.”

Representatives of Barton are deeply concerned that a lack of local knowledge will lead to an uninformed decision by the selection committee.

“There are host of issues important to the health and safety of the citizens that may well not be addressed because they have not gotten our input,” said Dr. Steve Leman, an emergency physician at Barton since 1979.

“This is unacceptable,” Leman said. “We are the ones who have given our lives to take care of the emergency needs of the community. This is what I do. We are the ones who look into the eyes of the sick and dying patient. We are the ones who are there.”

While the Tahoe medical community complains about lack of input in the selection process and in drawing up guidelines under which ambulance providers would apply for, Herbe-Hamlin disagrees saying that a county consultant met with Barton representatives and there was time for public comment in which representatives from Barton commented.

‘When we crafted the RFP, we allowed for significant community input into the process,” Herbe-Hamlin said.

“I think the board would say, and I would say that there has been quite a bit of input put in by the community in this process, and it is not over yet. There will still be an opportunity for that,” she said.

The selection committee on May 23 will review written proposals from potential ambulance providers and hear verbal proposals; following the presentations, committee members will have the opportunity to ask questions. The selection committee will score potential ambulance providers and results will be tallied and made public after a closed session meeting following the presentations.

The El Dorado County Board of Supervisors will make the final decision during one of the regularly scheduled meetings. Herbe-Hamlin said this will most likely be at the June 12 or June 19 meeting. Public comment will be accepted at this meeting, but statements will be limited to three minutes.


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