MetroHealth System’s decision to terminate CEO Akram Boutros for taking what it says were unauthorized bonuses is drawing attention to the hospital’s pay structure beyond the executive suites. 

Just days after MetroHealth’s board of trustees fired Boutros, a former employee and others shared on social media the results of an internal hospital survey conducted in 2021 that measured the economic and social well-being of the organization’s more than 4,000 employees enrolled in its wellness program.  

The survey, based on responses from 1,900 employees (or about 46 percent of the staff of those in the wellness program), found: 

  •  11 percent of hospital employees had trouble accessing food
  •  12 percent had difficulty with transportation
  • 10 percent struggled with housing and utilities 
  • 58 percent said they endure daily stress and experience social isolation 

The study found that administrative and clinical support staff, which includes secretaries and patient-service representatives, reported having the most difficulty meeting their social and economic needs. 

Of this group, roughly 436 employees, or 20 percent, reported having difficulty accessing food and said they were experiencing financial strain. Seventeen percent of the 436 employees said they were unable to pay for housing or utilities.

The study was conducted during the COVID-19 pandemic, which exacerbated many of the social and economic factors stressing the healthcare industry. Healthcare workers around the country reported feeling burned out during the pandemic. 

MetroHealth’s analysis of the study was published in July online in the The Journal of Primary Care & Community Health. It examined nine factors contributing to a person’s well-being, including access to food, housing, transportation and utilities. 

MetroHealth’s Institute of H.O.P.E. (Health, Opportunity, Partnership, Empowerment) initiated the survey to understand if its employees’ needs were being met. 

“We are able to bring our experience in addressing the health-related social needs of our patients in a respectful, compassionate, effective way to our employees.”  

Dr. James Misak, Medical Director Institute of H.O.P.E

In 2019, MetroHealth created H.O.P.E to help connect the clinic’s main campus to patients, many of whom live in the Clark-Fulton neighborhood, to a wide variety of support services outside of traditional healthcare. That year, during a City Club of Cleveland speech, Boutros called on the region’s major hospital systems to address the root causes of poor health in Cleveland by supporting a holistic approach to improve wellness. 

Dr. James Misak, medical director for the Institute of H.O.P.E., said the study was conducted as part of MetroHealth’s commitment to provide for the wellbeing of the patients, workers and communities it serves. 

“We know that many of our employees are contending with the same social drivers of health as our patients,” Misak said in an email responding to Signal Cleveland questions about the survey. “We wish to extend the same concern to the wellbeing of our employees as we do to our patients.” 

In an effort to support staff, MetroHealth responded to the study by hiring a social worker to connect employees with the services and resources they said they need. The hospital also hosted a series of workplace events to hear more from employees and to provide financial coaching and to assist them with housing, utilities, and transportation.

“We are able to bring our experience in addressing the health-related social needs of our patients in a respectful, compassionate, effective way to our employees,” Misak said. 

A hospital spokeswoman added that MetroHealth’s employee survey was one of the first studies conducted anywhere that looked at the health and wellness factors of healthcare workers within a medical system. 

Boutros, who is accused of taking $1.9 million in unauthorized bonuses, has repaid the money with interest. But he denies that the board of trustees was unaware of the bonuses and he has sued the board for firing him.

Read the full MetroHealth study here. This story was updated to include additional information about MetroHealth’s efforts to assist employees and to clarify the number of MetroHealth employees. The hospital employs 8,000 people. About half of them are enrolled in the wellness program.

Health Reporter (she/her)
Candice, a Cleveland Documenter since 2020, has been a freelance writer whose reporting and digital media work have appeared in The Daily Beast, VICE, Cleveland Magazine and elsewhere. She has written about health, equity and social justice.