Hospital board member’s online comments draw criticism

Published 1:30 am Tuesday, March 31, 2026

A WhidbeyHealth hospital district board member’s online comments on a medical journal article relating to the terminology for physicians drew criticism at a recent meeting.

Anna Sturm, PA-C, read Dr. Mark Borden’s comments regarding physicians assistants, nurse practitioners and other advanced practice providers during the board meeting. Borden wrote about WhidbeyHealth, saying that most of the providers are “mid-levels” who have little or no supervision and that the “quality of medical care ‘provided’ has indeed taken a huge plunge downward.”

Sturm addressed Borden.

“So on behalf of all APS in this organization, we don’t feel supported,” she said.

A doctor spoke up, saying the term “midlevels” should not be used for advanced practice providers — non-physician medical professionals who can diagnose, treat and prescribe. They include physician assistants, nurse practitioners and certified nurse anesthetists.

Also in response Borden’s comments, hospital CEO Nathan Staggs and board President Marion Joaus wrote a letter to the editor to correct and clarify his comments. The full letter is published in today’s Whidbey News-Times.

“We categorically reject the implication that care delivered by APPs represents a decline in quality,” the letter states. “Our responsibility is to ensure that every patient receives safe, evidence-based and compassionate care. We monitor quality metrics, patient outcomes and satisfaction closely, and we hold all clinicians — regardless of title — to the same high expectations.”

At the same meeting, Joaus also said that the medical staff recently passed a vote of no confidence in Borden. According to Borden, the vote was in response to his decision early this year to join two other board members in firing Staggs, a decision they immediately reversed after the medical staff spoke up. The other two board members resigned and have been replaced.

Borden admits that he would have taken the time to choose his words better if he knew how online comments were going to be “used against” him. Yet he stands by the point he was trying to make, which was that the hospital district and its clinics rely too heavily on advanced practice providers and don’t have enough physicians.

The policy paper from the American College of Physicians is titled “Physicians are not providers: The ethical significance of names in health care.” The paper argues that physicians should not be called “providers” because it de-emphasizes professionals identity and does not recognize the expertise of MDs among other clinicians.

In his comment, Borden agrees with the paper, writing that the term “provider” is “vague, misleading and essentially use to deceive patients.”

“Many of the patients I speak with do not know if they have been seen by a physician or a nurse practitioner,” he wrote.

Staggs and Joaus wrote that this is not true.

“Every employee of WhidbeyHealth,” they wrote, “is required to wear a name badge that identifies their credentials. Transparency is not optional; it is foundational to trust.”

Borden said he respects advanced practice providers and feels they are an essential part of the health care system. He emphasize that they are provide care under the supervision of a physician, and he feels the ratio between physicians and PAs should be more equal.

Yet hospital officials said the statistics that Borden presented in his written comments are just wrong. The walk-in and primary care locations on the island have a combined total of 29 medical professionals, with six medical doctors and 23 advanced practice providers.

Borden said the ratio should be closer to 1:1, which he said he sees at Island Hospital in Anacortes. Yet he concedes that hiring physicians is more expensive, and they are more difficult to find.

Borden’s comments delved what National Public Radio describes as a “turf war” between groups that represent advanced practice providers and doctors. While the advanced practice providers may seek greater autonomy from physicians and even a change in name from “physicians assistants” and to “physicians associates,” the American Medical Association has lobbied against such measures.

Borden stressed the difference in education between physicians and advanced practice providers.

A National Public Radio story on the issue, for example, states that a physician assistant master’s degree takes two academic years to earn and includes about 2,000 hours of clinical work. By comparison, a family physicians attends a four-year medical school and then completes a three-year medical residence, during which they clock about 10,000 hours of hands-on education.