Moving the Heroes

Is the Age of the Specialist coming to an end?  Likely it ended some time ago, and we are just now coming to a fuller realization of the aftermath.

Up in the very <ahem> special state of Michigan, the Beaumont health system fired their contracted anesthesiology group  in what this article deems a true slap in the face to dedicated, and very essential professionals. 

“These contracted doctors also were responsible for setting up a Covid-19 ICU unit at Beaumont Troy. The anesthesiologists did this while earning a fraction of their regular pay and being on call around the clock.”

The author states that this group – North American Partners in Anesthesia (NAPA) – is being replaced by Texas-based NorthStar Anesthesia, who likely offered a more competitive bid to oversee Beaumont’s CRNA’s.  The replaced NAPA anesthesiologists signed non-competes in 2011, which now prevents them from working for the new group.  So in the middle of a big virusy party, the old bunch has to go home and call Mayflower.

The author ascertains that the fired anesthesiology group imparted a level of expertise that made Beaumont hospitals “nationally ranked,” whatever that means.  If he is correct, it is shakily like a world-class athlete that hones himself to a peak for years, and then in the middle of the Olympics sells a kidney for beer money.  The Beaumont spokesman was necessarily vague, but proud of the expected savings.  The CEO is merging Beaumont (for free) into another system that has just sold a couple of community hospitals.

Which makes me think of specialists.  It’s expensive enough to set up a primary care office (I did it, once, and won’t again).  How expensive is it to set up a specialist’s office?  It probably can’t even be done without hospital support, which means, they have to be on corporate team.  If your surgical group has to do surgeries in the local hospital, bringing them revenue and supporting the community, then it will support you – until it doesn’t.  Even specialists who only do their procedures through out-patient surgical centers will increasingly have to utilize those built and owned by the local hospital, likely already a part of, or soon to be consumed by a health care system. 

Which means that the trend of hospital systems calling the tune and increasingly determining what the specialists will be paid can continue without restraint.  This has happened with very bad effect to nurses, and will more and more with the specialist physicians that the primary care and ER types rely on.  Certain local markets, and more isolated hospitals can hang on for a while, but by definition with increasingly thin margins. 

So tell me more about how hospital health care workers are all “heroes” and how their corporate masters are behind them all the way.  Until they aren’t.

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Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption.

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6 Responses

  1. arf says:

    Noncompetes need to be outlawed, in all lines of work, not just medicine. At the very least, condemned by every medical organization you have joined.

  2. arthur gindin says:

    The only thing worse than the cartoon was the EXPLANATION! What garbage! Send no more

    • Kurt says:

      Man, Lighten up. Cartoon of forgetting one’s pants but remembering the mask was funny. Nocturnal dreams about going out naked or partially nude are rife in the general population. I for one had a chuckle at the implied humor.

  3. Benjamin Van Raalte says:

    The anesthesia group sold itself to a private equity group first. That meant the current partners cashed out and screwed the younger partners. The younger partners are better off financially going elsewhere.

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