re: Alexander f. deluca, m.d., fasam

Dear Ms. Meyer:

This firm represents Dr. Alexander F. DeLuca with respect to matters relating to his recent termination as Chief and Medical Director of the Smithers Addiction Treatment and Research Center of St. Luke’s Roosevelt Hospital Center (the “Hospital Center”). I have replaced John Stanton as Dr. DeLuca’s representative in these matters.

On July 9, Mrs. Adele Smithers-Fornaci published a full-page ad in The New York Times, which asserted -- incorrectly -- that the Smithers Center had “adopted the alcoholism treatment strategy known as ‘Moderation Management,’” and called this “an abomination” to the memory of her late husband. Rather than take issue with Mrs. Smithers-Fornaci’s false statement, on July 10 the Hospital Center responded to it by firing Dr. DeLuca on grounds that did not exist – that he made “unauthorized statements to the press” and “changed the program” without telling the Hospital Center’s management. On the same day the Hospital Center issued a public statement that was untruthful in describing the grounds for Dr. DeLuca’s termination, and which defamed his reputation.

I do not know whether you have examined what occurred here, and would not be surprised if you have not. The facts are disturbing. In essence, the Hospital Center has wrongfully terminated and defamed an innocent member of its staff to avoid renewing its public conflict with Mrs. Smithers-Fornaci. Equally disturbing is the fact that in punishing Dr. DeLuca for discussing important medical issues with a member of the press, the Hospital Center has delivered a chilling message to its staff that will inhibit the free flow of information and opinions it should be promoting.

1. The Hospital Center’s July 10 Press Statement was False and Defamatory

The statement the Hospital Center issued to the press on July 10 observed that the Smithers Center had a “long and proud tradition of treating alcoholism by advocating total abstinence,” and made the following assertion:

”Since Dr. Alex DeLuca does not support the program philosophy [of total abstinence], we have accepted his resignation.”

That assertion is false and defamatory in two respects. First, Dr. DeLuca does support the program philosophy of total abstinence, which remained the program philosophy and principal treatment objective at Smithers throughout his tenure as its Chief. Nothing in the record – certainly no statement or writing by Dr. DeLuca – contradicts this. The false charge that Dr. DeLuca “does not support the program philosophy [of total abstinence]” is not a simple difference of philosophy. As Drs. Reibel and Ackerman and other members of your staff know, the charge is enough to render Dr. DeLuca unemployable in any leadership position at any of the major addiction treatment centers in the United States.

Second, Dr. DeLuca did not resign on July 10. He was terminated for cause by a letter of that date from the Hospital Center’s Chief Operating Officer, Wendy Goldstein, who wrongly accused him of making “unauthorized statements to the press about Smithers policies and practices.” By publicly asserting Dr. DeLuca resigned, the Hospital Center lent credibility to the false statement that he did not support the program philosophy of total abstinence, and thereby exacerbated the injury that statement caused his reputation.

While the Hospital Center is entitled to employ whom it wishes as Chief and Medical Director of the Smithers Center, it is not entitled to make public statements about Dr. DeLuca that are false and damaging to his career and his professional reputation.

2. Dr. DeLuca Was Wrongfully Terminated

Nor is the Hospital Center free to terminate Dr. DeLuca’s hospital employment and admission privileges in a manner that violates its own personnel policies and procedures, which it has also done. Although Dr. DeLuca’s termination for cause was based on charges that are demonstrably untrue, he was afforded no degree of due process, no hearing or other opportunity to rebut them. Nor was he afforded any severance benefits, despite the fact that the Hospital Center has routinely provided such benefits, including severance pay of more than twelve months salary, to other professional staff who have been terminated, such as Dr. DeLuca’s predecessor as chief of the addiction program at St. Luke’s, Dr. Gail Allen.

Had he been given the opportunity to respond to the charges against him, and a fair hearing, the facts would have acquitted him. The charge that he gave an “unauthorized” interview is incorrect. Several days before New York Magazine interviewed him on May 25, Dr. DeLuca notified Gerald Horowitz, the Senior Administrator of Smithers. Pursuant to the written policy established by Smithers on January 20, 2000, at the direction of Claudia Caine, it was the responsibility of Mr. Horowitz to notify Ms. Caine or a corporate Vice President of the interview, and Dr. DeLuca assumed that he did so.

Nor did Dr. DeLuca make “statements [that] were harmful to the [Smithers] program, its patients, its employees and the community,” as Ms. Goldstein charged in her letter terminating him. On the contrary, he discussed the research and use of evidence-based psychological treatment approaches, such as Group Motivational Interviewing, as a pre-treatment to improve engagement and retention into abstinence-based treatment at Smithers.

These treatment strategies for engaging and retaining patients are well known and the standard of care in the field. (See, e.g., in Principles of Addiction Medicine, 2d edition, section 8, chapter 1, ”Enhancing Motivation to Change” by Prochaska, and chapter 3, “Brief Interventions” by Graham.) The concept, design and implementation of these ideas were thoroughly discussed in the October 1999 issue of the peer-reviewed Journal of Substance Abuse Treatment (volume 17, at pages 181-92), in an article entitled ”A Group Motivational Treatment for Chemical Dependency,” by Foote and DeLuca, et al.

These treatment approaches are also the subject of federally funded grants that were approved by the Acting Chair of the Department of Psychiatry and the senior administrator of that Department, and from which the Hospital Center derives hundreds of thousands of dollars each year. E.g., a NIDA-sponsored 3-year RO-1 Award of approximately $1 million to study “Group Motivational Intervention in Drug Abuse Treatment” (1 RO1-DA12209); and a SAMHSA-sponsored 3-year RO-1 Award of $1.4 million to study “Facilitating Substance Abuse Treatment for HIV+ Patients” (1 KD1- TI12018-01).

Finally, as the foregoing makes clear, Dr. DeLuca did not change the treatment program without telling anyone, as has also been charged. A treatment strategy that is designed to better engage and retain patients in Smithers’ abstinence-oriented treatment groups, and for which the Hospital Center receives substantial Federal funding, does not amount to an unauthorized change in the program any more than publicly discussing it could possibly be “harmful.”

Although the New York Magazine article contains the incorrect statement that Smithers “has decided to. . . abandon the lifetime-abstinence approach,“ this was not based on anything Dr. DeLuca told the reporter. In fact, the statement does not appear in the unedited story the reporter submitted to her editor; it was altered to read as it did by the editor.

Had the Hospital Center given Dr. DeLuca an opportunity to respond to the charges against him, it would have learned this and other exculpatory facts.

3. The Hospital Center’s Treatment of Dr. DeLuca has Chilled the Free and Open Discussion of Important Medical Issues

I believe the real reason the Hospital Center acted to terminate Dr. DeLuca on July 10 was not because he gave an “unauthorized” interview to New York Magazine, but because of its fear of re-igniting its battle with Mrs. Smithers-Fornaci over issues such as the funding of the Smithers Center and the sale of its former home on East 93d Street. I submit that it was grossly unfair to destroy Dr. DeLuca’s career and reputation simply to avoid another fight with Mrs. Smithers-Fornaci.

It was also a serious betrayal of the Hospital Center’s duty to the public and its professional staff to capitulate to Mrs. Smithers-Fornaci’s campaign to punish and silence a respected addiction professional who dared publicly to discuss widely accepted treatment strategies she disagrees with. The failure to stand up to Mrs. Smithers-Fornaci’s tactics of censorship – even to take issue with her untruthful assertion that Smithers had adopted “Moderation Management“ as a treatment program – is particularly shocking for an institution that is affiliated with a great learning center such as Columbia University.

There are several courses Dr. DeLuca can take to restore his professional reputation, and to redress the damage that has been done to it. These include commencing an action against the Hospital Center for defamation and wrongful termination. Given the need to undo the damage to his reputation and employability resulting from the Hospital Center’s false and defamatory assertions, Dr. DeLuca would have little to lose and much to gain from a highly visible public confrontation with his former employer and a full airing of the medical and legal aspects of his case.

But truth and fairness are too often the chief casualties in battles such as these. I believe it is in the interest of the Hospital Center, as well as Dr. DeLuca, if these issues can be resolved amicably and fairly. Although we do not know one another, I do know several people who have worked with you, and am encouraged by your reputation for fairness to believe that these matters might be resolved.

To that end, I will call you to request an appointment to meet with you. I hope you will do me the courtesy of making time for that.

Sincerely yours,

R. Scott Greathead