California anesthesiologists should know by now that an
exclusive contract to provide anesthesia services doesn’t provide the same level of job security as a tenured professorship or a seat on the Supreme Court.
As CSA Legal Counsel Phillip Goldberg, Esq., has
reminded us more than once,
“hospital administrators have extremely broad discretion in selecting the group to staff the hospital’s anesthesia department.”
Yet many anesthesiologists were surprised to learn recently that Dallas-based Tenet Healthcare is considering a contract with a national management company that would replace current contracts with the anesthesiology, emergency, and hospitalist departments in its 11 California hospitals.
The
Tribune newspaper in San Luis Obispo
reported that Tenet is reviewing proposals from three national companies to provide anesthesiology and other services at the 11 hospitals, and may choose one of them by December. This news has sparked
pushback from the medical staff at Sierra Vista Regional Medical Center among other hospitals, and a letter of protest from the CMA that accused Tenet of acting “unilaterally and without regard to the varying needs and unique circumstances of each Tenet hospital.”
But Tenet’s action proves that having an “exclusive” contract means only one thing: You are the only one that can lose it.
From Tenet’s point of view, costs must be controlled. Apparently, Tenet has made it clear to the large contract management groups that it is looking for a no-subsidy arrangement for all its contracts. It’s nothing personal; it’s just business. But it
ispersonal for many patients and physicians.
To its credit, Tenet is discussing the situation with local hospital medical staffs. Score one for establishing relationships with your facility. As Mr. Goldberg advised us
last year, “Since anesthesiologists have limited legal bases for challenging decisions on anesthesia contracts, anesthesiologists should adopt a strategy of
reducing hospital administrations’ inclination to replace one anesthesia group with another.”
However, the risk to the Tenet anesthesiology groups is very much alive.