This was posted on a local news story by an ex-partner's wife. What a mess.
"It is preposterous that Methodist LeBonhuer Healthcare has allowed this to happen. Medical Anesthesia Group is one of the premier, top tier privately owned anesthesia groups in the country. Anyone who has ever worked for them, with them, or known them will attest to that fact. My spouse, Dr. Robert ‘Andy’ Crone, mentioned in this article, did leave MAG in October after 31 years, however, his reason for why he left was omitted. Here is his original quote that was cut:
“I lost confidence in the leadership of Methodist LeBonheur Healthcare after 31 years. I just didn't see a future where the hospital was going to work positively with MAG to continue to be partners. It didn’t seem like they had any interest in continuing the relationship with a group that had been there for 51 years.”
We are both native Memphians. Both of our families are in Memphis, Andy went to medical school in Memphis, he did his internship at Methodist Hospital and came back right after residency at Vanderbilt University Hospital because he knew he wanted to be a part of Medical Anesthesia Group after working with them during his internship. We raised 4 children in Memphis. We were active in the Memphis community, especially in the amazing special needs community this city has supported, we lived Downtown prior to moving (an area most of our friends will not even frequent anymore) and we were outspoken downtown advocates despite the crime and were active members of an inner-city downtown church. The very last thing we ever expected to happen, especially at our ages prior to retirement, was for Methodist to not come to an amicable agreement with MAG after having just gone through this with LeBonheur.
After negotiations with Methodist and LeBonheur failed in this same manner in 2021 and LeBonheur lost their top tier pediatric anesthesia provider group, Pediatric Anesthesia, PA, we had full confidence that Methodist would not repeat this same mistake and would not dare let negotiations fail with MAG. We were shocked and dismayed at the lack of leadership and loyalty the hospital displayed to a group of approximately 110 of the most dedicated, devoted, hardworking physicians and nurse anesthetists in the country when it became apparent that negotiations were stalled early last summer. (Discussions started after the closures of the hospitals and cutbacks of surgeries during COVID in addition to MLH losing the BCBS contract).
Medical Anesthesia Group had always ensured that all Methodist hospitals had anesthesia coverage for any surgical request, despite the cost to their group or to the individual physicians and nurse anesthetists (CRNAs). That might mean calling in extra physicians to work beyond their scheduled hours and paying physicians who were already inhouse to work overtime (that was not reimbursed by the hospital), having physicians work an unprecedented number of hours to cover all the surgical cases scheduled, and/or having nurse anesthetists work overtime. They did whatever it took in the best interest of patient care regardless of the cost to their personal lives or salaries and all without adequate additional compensation or recognition for these services from MLH.
This effort combined with the aftereffects of the hospitals being shut down during COVID, inefficiencies within the hospital, changes to payor mix and multiple other factors, made the financial loss impossible for MAG to continue to absorb. As salaries continued to drop and crime continued to rise in Memphis it became near to impossible to recruit new members to the group.
It became apparent to MAG that something had to be done in a partnership with the hospital to update their contractual agreements to better compensate the services they were providing. The existing contract Methodist and MAG had been trying to negotiate included portions that had not been updated since 2007 yet MAG continued to stretch horizontally to meet the demands of the hospitals, the surgeons, and the growing transplant program because that is who MAG was and what they did. They were consistently staffing many more OR rooms than were in their existing contract. Promises were made by Methodist LeBonheur Healthcare to new surgeons they were recruiting to MLH with total disregard to anesthesia staffing or even their own hospital OR staffing. (Surgeons MAY be employed by and paid by the hospital whereas anesthesiologists may not be employed by the hospital and do their own billing. Anesthesia is only paid for cases actually performed; therefore the decrease in their salaries during COVID when hospitals were shut down and very few surgeries were being performed).
As one MAG partner told Michael Ugwueke during one of the recent “town hall meetings” MLH administration was holding at each of the 5 hospitals with hospital employees, physicians, and staff “MAG has actually subsidized Methodist for years Michael, not the other way around. We have been increasingly stretched horizontally as far as we could to cover all anesthesia services at all 5 hospitals, all at a great cost to our partners and our group. It’s a shame that you have failed to realize that and recognize the level of care we have provided.”
Although MAG providers were stretched as thin as they could be stretched, they still were providing full anesthesia coverage. It was not until early summer when it became apparent that negotiations with MLH had stalled and were probably not going to progress that anything changed within the group and its coverage. Only then did MAG partners start making the impossible decision to stay or leave. At that point MAG had to make the difficult decision to cut their losses at money losing hospitals and cover what they were obligated to cover and not continue to extend themselves beyond the realms of what was physically or financially feasible to the group or in the best interest of patient care.
Prior to this, surgical cases did not go uncovered. MAG MDs had too much integrity to let decreases in their salaries, extensive working hours, or non-supportive hospital administration get in the way of optimal patient care beforehand. There was no “persistent challenge” to cover full anesthesia services prior to this. When MLH had to begin bringing in locums tenens and Somnia as MAG stopped offering free services, together, the hospital and Somnia were unable to fully staff the uncovered services that MAG had always been able to do.
In September, 2021, when Wayne Lipson, MD (a cardiovascular surgeon), was hired from Kentucky and named the new Senior Vice President and Chief Medical Officer for the hospital system, MAG initially felt they had a physician advocate who understood the importance of having a top tier anesthesia provider in the hospital and who understood the importance of continuing the relationships MAG had developed over the past 51 years, not only with the surgeons, but the OR staff, recovery room staff, and hospital staff in general. Unfortunately, this did not prove to be the case. Not only did he prove them wrong but he was a facilitator in recruiting Somnia to Memphis which has been mentioned in previous comments. Gone are the days of upper-level hospital administrators growing up within the system and understanding the importance of these years long relationships.
And these relationships do, absolutely, positively directly affect patient care outcomes and experiences. Pairing of anesthesiologists and nurse anesthetists with scheduled surgeries was a work of art for MAG and something they took great pride in doing correctly. They understood the nuances of the surgeons they had worked with for years; they understood their preferences and what surgeon preferred what type of anesthesia provider. Assignment for the day’s work and caseload was not taken lightly. It could take hours for the assigned partner to arrange the MAG case schedule and make assignments for MDs and nurse anestetists the night before to ensure that surgical cases were covered appropriately, and everyone was assigned correctly, prioritizing patient care; all of this before surgery even began. Then the ability to move providers around all over the city in the most efficient way possible from hospital to hospital, after the day's surgeries had begun to optimize OR time, was another feat in and of itself that they orchestrated with precision.
This was all done in the best interest of PATIENT CARE, regardless of the hours it took or the personnel that was required to do this to ensure that things ran as smoothly as possible for the patient. These preferences were paired for each surgical case in a way that takes years to understand. No outsider or corporate entity bringing providers in from out of town or even other providers coming in as locums from other local hospitals for a few days here, and a few days there for the exorbitant pay they are being offered, would have the insider knowledge that the MAG doctors have to orchestrate a system like this covering 5 hospitals a day, cath labs, GI lab, OP surgery centers, transplants, etc.
This was a system that MAG had perfected, and every surgical patient and surgeon benefited from it. These relationships have been being built and finessed over the past 51 year partnership between MAG and MLH. A corporate, non-locally owned entity cannot come in at midnight on a random February evening they selected and repeat this scenario in any shape or form for many years to come, if even then.
MLH has gone from a premier top tier anesthesia provider to a corporate, out town, some say third tier (at best) anesthesia provider. We have warned family and friends to run if scheduled for surgery at MLH, a hospital my husband devoted his entire career to, because there is no way to know if the new anesthesia provider will show up or who they will be, what the supervisory status will be (the ratio of pairing MDs with CRNAs) or much less what their credentials are.
The credentialing process required for all new anesthesia providers has been expedited to a point that it would be unacceptable elsewhere. What typically takes 2-3 months to gain credentialing at a facility is now being fast tracked as quickly as possible to onboard locums tenens providers and Somnia contract providers as quickly as possible. There are also non-pediatric trained anesthesiologists and CRNAs covering at LeBonheur CHILDREN'S Hospital, which has been disallowed in the past by their own administration. Memphis beware.
Despite what is being said to local media by MLH leadership, full anesthesia coverage is not being provided at any Methodist Hospital to date and things are not running smoothly. MAG may longer be providing services to MLH hospitals, but because of the lasting relationships they have made with hospital and nursing staff, they know exactly what is happening in their absence and it is disheartening to all. This are not mischaracterization of the facts or misinformation.
To add insult to injury, the narrative being spun by Michael Ugwueke to at least one large surgery group in town during a recent meeting, is that MAG doctors were greedy and lazy; that coming from a leader who makes $2.7M dollar per year. As said in a previous comment, MLH can spin the narrative however they want to spin it, however, it would be difficult to find another individual in this city including MAG employees and CRNAs, OR staff, surgeons, transplant teams, recovery room staff, nurses, other physicians or friends and family who would call any member of the MAG anesthesia team lazy. It would be ludicrous to insinuate that working 21 days straight with no day off 3 times in a row in 3 months was lazy. And this same situation on repeat times all 40 MDs and 70 CRNAs. It would be interesting to see how these hours compare to the hours of MHL leadership whose outrageous salaries have been listed already in these comments.
And greedy does not apply to MAG but maybe it could apply to hospital leadership. Although MAG physician salaries were cut significantly after COVID and have continued to drop, the MDs refused to cut, or decrease, the salaries of their office staff or devoted nurse anestetists during or after COVID. They haven taken the cut themselves to continue to provide full pay for their employees. Unlike MLH who was asking for MLH nurses to return COVID bonuses.
This has been a tremendous loss both from a personal standpoint for the partners and nurse anesthetist of MAG and their families involved and for the city of Memphis. Memphis has now lost 18 upstanding, tax paying, community leading, loyal citizens who will never be back. And more will follow. Every member of the Methodist Board of Directors and Methodist Foundation Board, friends of the chief or not, should be ashamed that they have allowed this to happen.
It has been estimated that MLH will be paying between $12 and $20M dollars per quarter for contracted outside anesthesia coverage using locums tenens and contract workers through Somnia Anesthesia for all of their hospitals. And the leadership at MLH sees this as acceptable and a better option than continuing the services of Medical Anesthesia Group after 51 years or of Pediatric Anesthesiologist PA at LeBonheur. MAG had asked for a stipend that was less than half of that amount per year to help make up for the losses they have sustained and for the services they have continued to provide.
It is apparent to all involved that funding for a stipend or subsidy to pay existing, premier, top tier anesthesia groups versus funding for contract labor must come from two different sources on the Methodist balance sheet. A shell game has obviously been played with this entire funding process; a game in which there will be no winners except for power hungry hospital administrators seeking control. MAG was not asking for a stipend that would raise their salaries to even the 100th percentile of anesthesiologists’ salaries in the country; they were asking for a stipend amount that would raise them back to the 70th percentile of anesthesia salaries, which was still going to make it difficult for recruitment compared to other groups in the Southeast. As stated already, recruiting any young physician to Memphis is difficult at best even if salaries were in the top 100% percentile in the nation. Anything below that makes it near to impossible to recruit qualified talent.
MAG was our family for 31 years and will always be, but it is damn refreshing to have a spouse working a typical 40 hour week, as opposed to 80+ hours week after week, being on call 12 hours at a time, as opposed to 72 hours at a time multiple weekends in a row, and all because of his integrity and loyalty not only to MAG but to Methodist Hospitals. And all 40 partners and 70 nurse anesthetists did the same.
At University of Arkansas for Medical Sciences (UAMS) where is now on faculty, he is supported by an incredibly intelligent, informed, and engaged hospital administration that appreciates and listens to their physician faculty members. He is no longer considered a disposable commodity to the hospital. UAMS is doing it right. With 3 additional MAG partners already there, and more possibly coming, and at least one long time MAG CRNA coming soon, Little Rock is getting the best that healthcare can provide. Any other hospital that has been fortunate enough to gain MAG MDs or CRNAs are getting the best as well.
To quote a devoted, exceptional labor and delivery nurse with 35 years in the Methodist system, “Methodist Healthcare has hit the iceberg.” It is, indeed, a travesty to watch this sinking ship."
news.yahoo.com
