Board raises medical examiner’s salary, but adds conditions
Posted December 23, 2013
MACOMB COUNTY — Dr. Daniel Spitz, the Macomb County medical examiner, has a new contract in place heading into 2014, but his company must meet a handful of stipulations made by the Board of Commissioners if he wants to receive the incremental wage increases contained within.
Although Spitz’s contract was approved by the 13-member board on Dec. 19, the decision was not unanimous. The board voted 9-4 to reappoint Spitz as the county coroner from Jan. 1, 2014, through Dec. 31, 2017, with commissioners Michael Boyle, D-St. Clair Shores; Fred Miller, D-Mount Clemens; Toni Moceri, D-Warren; and Joe Sabatini, R-Macomb Township casting the dissenting votes. They also voted 10-3 to give Spitz’s company, Spitz Pathology Group, a four-year contract renewal over that same period, with Boyle, Miller and Sabatini voting against it.
According to Board Chair Dave Flynn, D-Sterling Heights, some board members had expressed concern over certain aspects of the contract, starting with the fact that Spitz is not a direct employee of Macomb County, despite being the head of a major department.
“I think there was consensus among the Board of Commissioners that the county’s medical examiner should be fully committed to Macomb County,” Flynn said. “The commission made it very clear that they would prefer to have a medical examiner who is a direct hire, rather than a contract employee.”
There was also the feeling among some board members that the bidding process may have been rushed or inadequate, as Spitz Pathology Group was the only candidate to apply for the position.
“Whenever there is only one bidder for a government contract, it can be a cause for concern,” Flynn said. “In a perfect world, I would hope for the board to be able to evaluate a number of qualified candidates. Some commissioners who voted against this contract were hoping to see a more robust nationwide search. However, we can appreciate that this position is a niche specialty that very few people are qualified for.”
The terms of Spitz’s new contract are essentially the same as those of his current one, but they include a few key changes: Spitz will now be required to achieve accreditation for the Medical Examiner’s Office through the National Association of Medical Examiners (NAME) and appear before the board every six months to report on his progress.
Spitz Pathology Group earned $377,000 this year for its work in Macomb County, and the company is poised to receive more than $400,000 annually in the near future. If the board feels that sufficient progress is being made toward NAME accreditation, Spitz Pathology Group — which consists only of Spitz and a second forensic pathologist, Dr. Mary Pietrangelo — would make $378,000 in 2014 and 2015, $389,340 in 2016, and $401,020 in 2017. Spitz is currently the highest-paid employee in Macomb County, earning about $200,000 per year.
When reached for comment, Spitz stated that he has no problem with the changes in his new contract.
“I’m happy to show the board the progress that we’re making,” he said. “We’re actively pursuing NAME accreditation as we speak, and we hope to be able to get there soon.”
Still, Spitz pointed out that this “voluntary” level of accreditation is not mandatory in order for morgue facilities to operate. And because it involves meeting a whopping total of 349 requirements, it is a feat that very few medical examiners’ offices in the U.S. achieve.
Spitz has faced heavy scrutiny from the Board of Commissioners this year. In July, the board issued a subpoena for Spitz to present himself at their next meeting after they said that he had been unresponsive to six requests to appear before them since January 2012, a claim that Spitz disputes. Spitz eventually met with the board in September to address concerns about the budget, operations, workload and accreditation of his office.
Many of the board’s questions focused on the possibility that Spitz may be overworked between his caseload in Macomb County and his other duties outside of his main job. In addition to working full-time in the Medical Examiner’s Office, where he oversees a staff of 10.5 full-time equivalents, Spitz also works part-time as the St. Clair County medical examiner, performs independent consulting work and lectures at Wayne State University.
NAME recommends that forensic pathologists perform between 250 and 325 autopsies per year. In 2012, Spitz and Pietrangelo performed 572 forensic exams in Macomb County, including 465 autopsies. This year, the two pathologists were on pace to perform between 470 and 490 autopsies.
Spitz stressed, however, that throughout this process, the board has never communicated any doubt about his capacity to perform the role of medical examiner.
“Dr. Pietrangelo and I are fully committed to our work in Macomb County,” he said. “Any outside work that we do only enhances our level of training, knowledge and experience. I think the board made it very clear that their concern with this contract was all about the process and not about my abilities or Dr. Pietrangelo’s abilities.”
Al Lorenzo, an assistant executive for Macomb County, seconded this notion. He pointed out that the reappointment of Spitz and his firm was supported by County Prosecutor Eric Smith, County Sheriff Anthony Wickersham and County Executive Mark Hackel.
“We are extremely confident in Dr. Spitz’s ability to do this job,” Lorenzo said. “Even though he was the only bidder for the contract, this is certainly not settling for us — this is an enthusiastic endorsement. Given the high standards that we were looking for, the number of people across the country with these credentials was very small.”
Lorenzo also pointed out that NAME accreditation might be very difficult for Macomb County to reach, as it is “an institutional responsibility — not an individual responsibility.” Most of its 349 requirements do not directly involve the medical examiner, but rather, the facilities and equipment of the medical examiner’s office. Therefore, achieving NAME accreditation would likely require additional funding from the county.
“What gets lost in all of this,” Lorenzo said, “is that Macomb County is currently being served by two outstanding pathologists. The only thing that really matters is the quality of the work that Dr. Spitz performs for us under this contract, and his performance has always been exemplary. In three years of working here, I have not received a single complaint about his work from the sheriff or the prosecutor, but I’ve received lots of compliments.”
Despite the board’s concerns about Spitz’s workload, Flynn offered no objections about the medical examiner’s performance. Still, he was glad that the new contract added a few more duties and responsibilities to Spitz’s job.
“The main thing here is that the board is making incremental progress toward NAME accreditation,” Flynn said. “Any future pay raises for Dr. Spitz will be contingent upon him showing that he is working toward accreditation and appearing before the board upon request. We wanted this salary increase to be an incentive, not a guarantee.”
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