By Brendon Nafziger and Heather Mayer

A group representing physicians contracted by the City of Hope Medical Center in California expressed an "overwhelming loss of confidence" in the hospital's CEO, Michael Friedman, in the latest round of bare-knuckled sparring between the cancer hospital and the group of physicians suing each other over a controversial contracting scheme.

For several weeks, the two organizations have traded accusations regarding the creation of a proposed medical foundation, and planned recruiting for it.

In the vote announced Monday, the doctors group, called City of Hope Medical Group, slammed the hospital for not renewing a contract with its physicians engaged in research, teaching and some specialist work. In its announcement, it also accused the hospital of illegally soliciting doctors away from the group.

The cancer hospital, located in Duarte, a suburb of Los Angeles, seeks to replace the physicians group when the contract expires Feb. 1, 2011 with a new medical foundation the doctors group says will be largely run by the hospital.

Though announced this week, the vote was taken before the physicians group filed a lawsuit earlier this month against the hospital, accusing the hospital of trying to illegally control doctors through the medical foundation.

The hospital promptly counter-sued the doctors group, arguing that it is trying to recruit the doctors legally. The hospital is requesting judicial intervention to block the doctors group from interfering with its plans, and it blames the group for "besmirching" its reputation since talks between the two organizations broke down.

"To carry out threats the medical group has written to us, they said they were prepared to use publicity, legislation, the patients, the media, in any way to obtain their contract ends," City of Hope CEO Friedman told DOTmed News. "The management of this medical group is prepared to proceed with a scorched earth policy."

The foundation, headed by hospital corporate chief medical officer Alexandra Levine, would be run by 22 board members, who do not hold medical degrees, and one doctor "as a peace offering," the doctors group said.

The group believes the new foundation is illegal because it claims it violates California law, which forbids the corporate practice of medicine. The group also fears that the structure of the medical foundation will interfere with patient care because it will not be headed by doctors.

"Our view is how does one physician out of 23 [board members] make this work?" said Vincent Jensen, the doctors group's COO. "As a patient comes in for treatment, they want their doctor in control of how they're treated. They don't want 22 board members who know nothing about medicine to be able to make medical decisions."

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