NashvillePost.com has learned that the medical executive committee of Saint Thomas Hospital today cast a vote of no confidence in the leadership of Jim Houser, the president and chief executive officer of Saint Thomas Health Services, the Nashville-based parent of Saint Thomas and Baptist hospitals.

A source close to the proceedings cited "system changes" advocated by Houser as the cause of the medical staff's discontent, though the source would not elaborate on the nature of those changes.

The physicians' disapproval is believed to be focused specifically on Houser, who is the top representative of STHS owner Ascension Health in the local market area. St. Louis-based Ascension is the largest not-for-profit health system in the country.

Rebecca Climer, chief communications officer for STHS, issued a statement late this afternoon confirming that the committee "met this morning and expressed concern about Saint Thomas Health Services."

Climer said STHS "is moving through a very challenging time as we respond to a struggling economy and sharp reductions in capital – as is every other hospital in Middle Tennessee and the rest of the country."

Her statement continued:

"We know STHS must evolve to be competitive in today's environment and to ensure we fulfill our mission. We must continue to take advantage of our collective strengths as a system of hospitals and ancillary services. We must grow the services we can and otherwise smartly conserve our resources.

"In many cases, the changes within STHS may be significant. Many strategies for transforming STHS are being considered today. You can get a sense of the scope of our work through a new website created just for this change initiative at www.sthshealthcarethatworks.org.

"STHS is financially sound today. But if we wait until we are forced to respond to market pressures, we have been poor stewards of our ministries.

"Given all of this, it's not a surprise that some physicians are concerned about the changes underway at STHS. More than 2,000 physicians serve patients at STHS facilities and we are proud they share our desire to provide high quality and safe patient care."

STHS ran a deficit of some $5.1 million in the fiscal year ending June 30, 2007, the most recent period for which data is available from public disclosures made by all nonprofit organizations. Houser's pay package for the year amounted to $807,000.