Denver’s historic safety-net hospital is scrambling to recover from a slew of doctor resignations.

Physicians heading the departments of medicine and surgery at Denver Health Medical Center left last year and have not yet been replaced. This month, three of its five neurosurgeons, including the chair, gave notice of their intent to leave April 1.

In addition, the chiefs of ophthalmology and oral surgery have left, along with six hospitalists — doctors who specialize in the medical care of hospital patients. The hospital also confirmed that Dr. Christopher Colwell, who heads emergency medicine, and Dr. Jeff Johnson, a top trauma surgeon, are leaving for other jobs.

The departures raised questions about Denver Health’s ability to continue operating as a Level I trauma center, one of only a few in Colorado. Current and former Denver Health doctors who spoke to The Denver Post also voiced concerns ranging from reduced operating room staffs to the hospital’s commitment to serving the needy and the state of its partnership with University of Colorado Hospital.

Some described the situation as a crisis, with a medical staff disconnected from the administration, a de-emphasis of academics and research and a growing emphasis on making money.

Responding to doctor concerns, the hospital administration recently implemented a series of changes, which included dismissing its chief clinical officer and agreeing not to change its physician compensation system.

Hospital chief Arthur Gonzalez offered assurances in a memo that the University of Colorado would provide neurosurgeons to Denver Health. Neurosurgery is vital to Denver Health’s ability to retain its Level I status.

“Denver Health is absolutely and unequivocally committed to its mission,” Gonzalez told The Post, adding that caring for the needy, education and research all belong to that mission.

He acknowledged, though, that the hospital “is going through immense change” because of the federal Affordable Care Act, which provided a Medicaid boost but may take money back from other sources, and potential losses in state payments to hospitals.

“For example, we are more focused on strategic direction, metrics and accountability than ever before in our 155-year history,” he said.

Denver Health is trying to make 4 percent more than it spends yearly to finance a $485 million capital plan, a challenge that Gonzalez said keeps him awake at night. “You’ve got to make some tough choices sometimes,” he said.

The doctors who resigned in the last eight months departed for varying reasons, and “it would be inaccurate to paint all of these people with the same broad brush,” he said.

One veteran physician said he believes Denver Health’s partnership with University Hospital is under strain — though officials at both hospitals say it remains strong.

Denver Health, which treated 222,687 patients last year, depends heavily on the help of medical residents from the University of Colorado School of Medicine. Those residents rely on Denver Health’s deep bench of experienced physicians, which has been thinned by departures.

Dr. Ernest Moore, a 40-year physician at Denver Health and its interim trauma medical director, said a loss of medical residents would have “devastating consequences.”

“You could not provide the level of patient care we have without the residents from the University of Colorado,” he said.

The risk for Denver Health, Moore said, is that the University system, which operates the Anschutz Medical Center in Aurora and has acquired other Front Range hospitals, no longer needs it as it once did.

That risk rises, he said, if Denver Health is seen as providing “a sub-optimal environment” for medical resident training.

Mark Couch, chief of staff for the University medical school, responded that the university remains committed to Denver Health, which has about 200 of its medical residents in various training programs there.

“We value that relationship and support their mission,” he said. “It’s a very important location for us.”

Gonzalez said maintaining a strong partnership with University is a top priority for Denver Health. “We have enjoyed a long history of collaboration, and that will not change,” he said.

Dr. Gregory Jurkovich, Denver Health’s former surgery chief, said neurosurgeons grew concerned about the safety of severely injured patients while he worked there — and they recently took those concerns to the university.

“I was told by them, by the neurosurgeons themselves,” he said.

Jurkovich was recruited by Moore and lasted 3 ½ years before leaving in what was called a voluntary separation.

He said Denver Health changed rapidly after Gonzalez replaced Dr. Patricia Gabow at the helm in 2012.

Dr. Ken Bellian, the hospital’s new chief clinical officer under Gonzalez, “told me I was not a team player in the direction Denver Health wanted to go. It was never explained to me what that meant,” Jurkovich said.

“I in the large part agreed with the efforts Denver Health was trying to make. I just didn’t like the way they were going about it,” he said. He found the administration “largely disrespectful of the clinicians, particularly those who were hospital-based.”

Many of the doctors who left or gave notice after Jurkovich departed had worked under his supervision.

“It’s challenging work,” Jurkovich said. “A largely indigent patient population, multiple languages, resource constraints.” For some, he said, “the ability to function in that environment just became too difficult with all those other constraints.”

Hospital administrators are taking steps to stop the bleeding.

The memo circulated about 10 days ago by Gonzalez and Dr. Bill Burman, president of the medical staff, announced “a decisive plan” to deal with recent events. It ended a controversial new payment plan for doctors.

Its elements also included neurosurgery coverage from the university, a promise to work with doctors “to reformulate the physician leadership structure at Denver Health” and to eliminate the job of Bellian, who had been given wide latitude to manage the hospital.

The memo blamed “problems inherent in the way that role was structured.”

Bellian declined to comment.

Colwell, who is leaving Denver Health for San Francisco General Hospital, said the medical staff went to Gonzalez to discuss “finding ways to work together and focusing on our mission and values,” including Bellian’s elevated authority. “Certainly a fair part of the staff wondered if that should be part of the structure,” he said.

He predicts Denver’s venerable hospital will emerge from its current challenges as a healthy institution.

“I think the future of Denver Health is very bright,” he said.

Moore said he is not worried that the hospital will change its fundamental mission of top-quality care for all.

But he said that scheduling surgeries has become an issue, particularly for patients who need more than one.

“That’s where the frustration arises,” he said. “One of the problem areas is access to the operating rooms for secondary operations.”

Gonzalez responded that “there has been no reduction in operating room space or capacity,” but “if we are inundated with trauma or urgent surgeries, elective surgeries sometimes have to be delayed or rescheduled.”

Hospital officials say they are close to hiring a new chief of surgery.

David Olinger: 303-954-1498, dolinger@denverpost.com or @dolingerdp