WhidbeyHealth Board Member's Comments on APP Staff Spark Backlash, Leadership Response

Anna Sturm, PA-C, stood before the WhidbeyHealth Board on Monday and read aloud online comments posted by board member Dr. Mark Borden describing many of the hospital's advanced practice providers as "mid-levels" operating with "little or no supervision," and suggesting the quality of care at the district had declined.

"So on behalf of all APPs in this organization, we don't feel supported," Sturm told the board.

The remarks drew immediate pushback from medical staff, who objected to the blanket use of "mid-levels" for clinicians who diagnose, treat and prescribe. Advanced practice providers, a category that includes physician assistants and nurse practitioners, are licensed professionals whose scope of practice is governed by state law and clinical credentialing, not the informal hierarchy implied by the term.

The fallout reached beyond the boardroom. CEO Nathan Staggs and Board President Marion Jouas co-authored a letter to the editor published in local media, stating that WhidbeyHealth categorically rejects "the implication that care delivered by APPs represents a decline in quality." The letter emphasized that the organization tracks quality metrics, patient outcomes and satisfaction across all clinicians regardless of credential type.

The meeting also brought to light a formal rebuke: the hospital's medical staff had recently passed a vote of no confidence in Borden, a serious professional action that signals a fracture between the elected board member and the clinicians he is charged with overseeing.

The episode is the latest in a prolonged governance struggle at WhidbeyHealth, the primary health system for Island County. In recent months the district has weathered board resignations, disputes over CEO leadership and a dramatic staff-driven reversal of a vote to terminate a previous CEO. The management company HealthTech has also been a recurring source of tension over strategic direction and governance roles.

Staggs and Jouas used the letter to try to stabilize public confidence, but the vote of no confidence against a sitting board member, combined with Sturm's unambiguous statement before the full board, signals that repairing staff trust will take considerably more than a public clarification.