TALLAHASSEE — The doctor that the Florida Senate will soon likely confirm to be the state surgeon general came with strong recommendation letters, according to Gov. Ron DeSantis.

But several people who worked with him at the University of Florida and spoke with the Times/Herald said Scott Rivkees was a harsh manager fueled by vindictiveness.

Rivkees was the last of DeSantis’ major agency secretaries to be nominated, last April, following a protracted search for a doctor who would support the governor on issues like medical marijuana. At first glance, Rivkees appeared highly credentialed: the chair of the Department of Pediatrics at UF’s College of Medicine and physician-in-chief at UF Health Shands Children’s Hospital, an expert in his fields who had previously taught at Yale.

But an ongoing lawsuit filed in January 2018 sheds light on a different side of the surgeon general.

In 2018, Rivkees sued former UF Health employee Satyanarayan Hegde for libel and slander after Hegde had filed more than 100 record requests and posted online comments questioning Rivkees. Hegde earlier sued the UF Board of Trustees after he was let go, saying his termination was because of discrimination. The complaint filed by Rivkees called Hegde’s actions “frivolous” and “intrusive.”

Rivkees was chair of the department from 2012 to 2019.

Paul Carney, a former UF doctor who now teaches at the University of North Carolina School of Medicine, was later named as a co-defendant in the lawsuit. He has since been dismissed from the suit with prejudice.

In a 2016 deposition for Hegde’s earlier lawsuit, Carney mentions several doctors who met at each other’s homes years ago to discuss Rivkees and their dissatisfaction with his leadership of the Department of Pediatrics.

“What was discussed was a sense of fear in the department that anything that was contrary to what the leadership wished could be subject to reprisal,” he testified in 2016.

Carney said his status as a division chief was taken away because of how he approached Rivkees. He filed a grievance, which a committee denied. But Carney said multiple people who were interviewed said the committee was biased and asked pointed questions.

In the deposition, Carney also mentions that there was a new, non-quantitative section added to the employee performance review for “professionalism” that was based on the opinion of just one or two people. He said employees were upset about that.

Senate must confirm Rivkees

As an appointee of the governor, Rivkees has had to go through the Senate confirmation process that involves three committee votes and a full Senate vote. He received favorable votes for all three of his required confirmation hearings. His appointment has not yet gone before the full Senate.

Unlike a bill, a confirmation like Rivkees’ comes to the floor as a report of the Committee on Ethics and Elections. The committee chair writes a letter to the Senate President stating the findings of the committee and recommends confirmation. If there are any appointees that the Senate does not act on, the chair sends a letter to the Secretary for the Journal.

Senators can still ask questions of an appointee outside the hearing process by holding private meetings, and any confirmation can be sent back to a committee with a simple majority vote.

Rivkees’ Senate confirmation process was delayed for months after the News Service of Florida reported on a 2014 sexual harassment allegation against him at UF. The same article mentioned an improper financial disclosure from Rivkees.

According to the News Service report, Rivkees told a group of staff members who worked under him “if we can’t agree on this we’ll all have to get naked in a hot tub and work it out.” The report also says Rivkees, who worked with children, made a joke to veterinary students about neither being able to have sex with their patients.

One doctor interviewed by the Times/Herald, an assistant professor in the division of pediatric critical care, who was there when Rivkees made the hot tub comment, said he was approached by others who expressed their discomfort and sought advice on how to proceed.

The investigative report released by UF says Rivkees was counseled by a university dean. But at his first confirmation hearing in the Florida Senate in January, Rivkees said the investigation was the result of an angry employee, Satyanarayan Hegde.

The Senate panels vetting Rivkees asked him about the “hot tub” comment, along with his lack of history practicing public health medicine and how he’d split his time with a UF position he’s keeping. But little has been discussed about Rivkees’ management style and employee satisfaction.

If he’s confirmed to be surgeon general, Rivkees would still be a University of Florida employee. According to a five-page agreement between the Florida Department of Health and UF, Rivkees will continue as a full-time employee with salary and benefits set by UF. He now earns $546,810 from a variety of sources, including state funds, according to the News Service of Florida.

If senators confirm Rivkees, the state will pay UF $140,000 a year in quarterly installments of $35,000. The contract allows Rivkees to get reimbursed for travel.

In a statement to The News Service of Florida, a UF Health spokeswoman said Rivkees will focus 10% of his time on his federally funded research projects and 10% on teaching. The rest of his time would be spent as surgeon general, where he will oversee 15,000 Department of Health employees.

Retribution within pediatrics

Eight doctors and employees who worked under Rivkees were interviewed by the Times/Herald, and all spoke about fear of retaliation, physician decorum and not wanting to go up against the state. One specifically mentioned the ongoing lawsuit against Hegde. None would agree to let their names be published.

They said even years later they’re too afraid to speak out for fear of retaliation by Rivkees, who they described as hot-headed.

When Rivkees was upset or unhappy with the performance of doctors, he wasn’t afraid to tell them. Doctors interviewed by the Times/Herald, who asked to remain anonymous, said when they pushed back on things they felt were unjust, Rivkees would call them into his office and yell at them for extended periods of time.

One doctor interviewed said he stepped down from leadership roles just to distance himself from Rivkees.

When doctors came up against Rivkees, they said he would punish them by having them work extra long hours day after day.

Even doctors who hadn’t butted heads with Rivkees said the demands after he took over were too burdensome. Multiple doctors interviewed said the goals increased, meaning they had less time to spend with each individual patient despite the complexity of cases UF Shands sees.

It was like a business, the doctors said.

One doctor said while part of the shift of medicine to a business-like model is unavoidable, she found the demands exhausting and left.

Another said that while he was able to keep up with the growing workload and long days, it was the frustration with the pediatric critical care unit that eventually pushed him to leave after three years. He also left in bad health, facing high blood pressure and the symptoms that came with it.

Doctors interviewed by the Times/Herald pointed to a professional development program they say Rivkees used as a “retaliatory tool” for doctors who crossed him.

Professionals Resource Network, a program for impaired physicians, is meant for people who are unable to perform their duties and responsibilities because of substance abuse, mental illness, physical condition or disruptive social tendencies, according to its website.

Professionals Resource Network was created under the Florida Medical Practice Act of 1988, and is overseen by the state Department of Health and Division of Business and Professional Regulation.

In his deposition, Carney mentions that he was told Professionals Resource Network got a large number of referrals from the Department of Pediatrics and that it was being used as a “bludgeon to settle the score with faculty who disagreed with leadership.”

One doctor said they were sent to Professionals Resource Network after a meeting with Rivkees that ended in an argument over staffing numbers. Rivkees said the doctor had bipolar disorder and expressed manic behavior, neither of which were true, the doctor said.

Senate presses the surgeon general

In his first confirmation hearing, some senators pressed Rivkees on his background and on the sexual harassment claims.

Sen. Lauren Book, a Plantation Democrat and sexual assault survivor who has made issues of sexual harassment a centerpiece of her legislative career, asked Rivkees a series of questions about the allegations and what he’s done to ensure similar situations don’t happen in the Department of Health.

Rivkees admitted that he didn’t know whether there was sexual harassment training in place at the state’s health department, which convinced Book to vote no on the confirmation, she said. There is mandatory sexual harassment training for employees who work in the department.

At the second hearing, Rivkees addressed senators’ concerns in his opening statement but was not pressed further.

“A question was raised about human resources policies within the Department of Health,” Rivkees said. “The Department of Health has extensive HR policies … having reviewed these I find that they are outstanding and clear.”

Rivkees did not take questions from reporters after the first two hearings.

In an interview with the Times/Herald, Senate President Bill Galvano, R-Bradenton, said he would have liked to have seen “more specificity” in Rivkees’ answers before the Senate committees.

He said he hoped to see more questions of Rivkees as he moved through the confirmation process, and trusts senators to use their discretion when voting.

“I think senators should ask as many questions and be as comfortable as they need to be before they have a final confirmation,” Galvano said.

Rivkees responds

Rivkees did not respond to a list of specific questions about his tenure as the head of the Department of Pediatrics provided by the Times/Herald.

In a statement, Rivkees wrote that as chair of the department, he “worked to ensure that every staff member experienced an equitable workload and felt empowered to continue advancing the pediatric field.”

He made a note that he faced a “multi-million-dollar operational deficit” when he accepted the position.

He said each employee’s expectations were set by a committee and not just Rivkees, resulting in decisions that were “always evenly weighed and made as a group.”