Three months after Samaritan Health Services removed Dr. Dana Kosmala from its Lebanon operations, the pediatrician is now established at a private practice in Albany.
On Dec. 7 last year, an estimated 200 parents, children and supporters rallied in front of her former office to show support for their favorite doctor, who at the time had been serving about 2,500 patients.
At the time, neither Samaritan nor Kosmala expressly said why the health provider let her go, but more details have emerged since they parted ways near the close of the year. Kosmala had worked for Samaritan for more than 22 years when she was let go. She said she had one of the largest patient panels (largest number of patients she was responsible for) of all the 20-plus pediatricians within Samaritan.
Kosmala earned her medical degree at Western University of Health Sciences in Pomona, Calif., and completed her residency in 1998. She got board-certified in internal medicine and pediatrics. After serving a stint as chief resident at Loma Linda University Medical Center, followed by two years working with San Bernardino County outpatient pediatrics, Kosmala accepted a job at Samaritan Health Services and moved to Lebanon in 2001.
Kosmala said it never crossed her mind to become a doctor until her high school boyfriend made the suggestion, and she credits her faith in Christ for essentially putting her on that path.
“It wasn’t like my childhood dream or anything,” she said. “It’s just what God wanted me to do and it worked out well.”
Kosmala now works Mondays and Tuesdays at Willamette Valley Pediatrics, 1123 Hill St. SE, Suite B, in Albany, alongside her long-time medical assistant (MA) Rhonda Marshall.
As a matter of policy, Samaritan will not share details about what leads to an employee’s parting of ways. According to Kosmala, Samaritan Health Services President and CEO Doug Boysen told her she was let go for accessing patient charts inappropriately, but Kosmala responded to him she believes she was fired for her stance on transgenderism.
“He said, ‘We would never fire you for that,’ and I said, ‘Well, that is not what the lawyer wrote in her email.’”
Kosmala noted that she was put on administrative leave after a meeting regarding transgenderism but before a meeting about alleged policy violations.
In a statement to Lebanon Local, Samaritan said, “Samaritan employees and providers are held to a code of conduct that is centered in respect and integrity for all. Furthermore, Samaritan providers are allowed to determine their personal scope of practice. This means they are not required to provide services such as gender affirming care. If a provider does not include this service in their scope of practice, Samaritan’s commitment is to refer the patient to a provider who is better suited to meet their needs.”
According to Kosmala, the chart access charges were all defensible and nothing different than what all other doctors in Samaritan do, and though Samaritan allegedly told a group of physicians Kosmala had “hundreds” of violations, only 10 were brought to the table. She said Boysen agreed they should have shown her the “hundreds.” Of the 10, they included her accessing the Samaritan charts of adult patients, all of whom had requested and given her permission to do so. Boysen could not be reached for comment.
Samaritan stated the company uses a monitoring system to identify questionable access into patient records and “proactively investigates accesses flagged by the system.” However, Kosmala had noted the alleged offenses took place long ago and Samaritan never raised an issue until now.
“Employee access to patient health information must be limited to the minimum necessary to perform a job duty,” Samaritan stated. “The appropriateness of access is determined by the duty being fulfilled.”
Kosmala said in one case, a 91-year-old acquaintance had a health concern but didn’t know who her current primary care physician was, so she gave Kosmala permission to check her chart to find out. In another case, a colleague asked her to order a test, and a third case involved an acquaintance who needed help finding a primary care physician that was closer to home.
She reported that Samaritan didn’t agree with this because, despite being trained in internal medicine, she is working for Samaritan as a pediatrician. Her rebuttal to this idea was that doctors “practice outside the scope of their practice” all the time when they, for example, call in antibiotics for their medical assistants or offer medical services to an injured child during a sports game.
“It’s called being a good Samaritan,” she said, referring to the sports example.
Samaritan stated, “When an internal investigation determines that a violation of the law or a Samaritan policy or code of conduct has occurred, corrective action will be initiated, which can include employment separation.”
According to Kosmala, what essentially led to her disconnection from the valley behemoth had started because of her frustration with a lack of professionalism from staff who played on their phones, were disrespectful and talked openly about patients.
“We brought those things to our manager, who did absolutely nothing about it. Nothing,” she said. “This is not okay. We are here to work, to be kind, respectful, all the Samaritan PRIDE.”
PRIDE is what Samaritan refers to as their values: passion, respect, integrity, dedication and excellence.
After again pressing the manager to change what Kosmala said was becoming a toxic work environment, she was told the staff reported she was difficult to work with. Then the human resources department was brought in. As meetings progressed for the next several weeks, one of the staff members involved – a social worker – brought up an instance from three years ago, claiming Kosmala refused to use pronouns.
Kosmala responded that she doesn’t use pronouns, but she does call patients by their preferred name. The social worker, according to Kosmala, also reported that Kosmala thinks transgenderism is “trendy.”
“In my practice with junior high and high school girls, I think it is trendy,” she agreed. “I am totally okay with diversity and I do love my diverse patients, but love and approval aren’t always synonymous.”
Kosmala explained that love does not always mean affirming what someone believes. She would not, she said, throw her daughter in the ocean if she believed she was a mermaid or recommend liposuction because an anorexic patient thought they were fat. Additionally, she argued, some staff at Samaritan may not agree with her religious faith; they take a diverse view on that, but they can still get along.
Still, her transgender and homosexual patients would hug her when they left because “they know I love them and I’m there to care for them,” she said. “I don’t have to affirm or agree with their ideology, and that’s okay.”
Kosmala said she believes the social worker – whom Kosmala noted “prides herself on writing transgender-affirming letters” for pediatric clients – used these claims as her own defense for being called out for talking about patients.
“I think she used it against me when I complained about her breaking HIPAA,” Kosmala said. “When she would go see a patient and then she would lead that patient out and come back and talk to those two MAs about the patient she just saw, that is a HIPAA violation. She did this every day, all the time. So that is why she is attacking me.”
Samaritan emphasized that the company protects patient information as required by HIPAA through a variety of methods, including auditing and monitoring access to the electronic health record.
As Kosmala forges a new path at Willamette Valley Pediatrics, she welcomes her patients to reach out. Currently she can accept First Health, PacificSource and UnitedHealthcare insurance. While Samaritan Health Services “took months” to release her so the insurance agencies could credential her personally, she said, they have not yet released her from their company to allow her to accept IHN, Moda and Samaritan insurance.
Kosmala can also be found at area farmer’s markets, where she and her husband sell fresh fruit from their local farm.
“Kids have been my life for almost 30 years,” Kosmala said. “They’re just my joy. It feels natural; I love them and taking care of them gives me purpose.”