The writer, a Los Angeles freelancer, is a former Detroit News business reporter who blogs at Starkman Approved.
By Eric Starkman
The most dangerous hospital activity in the midst of the pandemic is intubating a Covid-19 patient. The highly specialized procedure requires anesthesiologists to stick their faces within inches of a patient’s mouth, touch the infected person’s gums and stick a tube down the airway. If the patient gags or coughs, virus particles fill the air.
One reason New York City hospitals experienced dire Covid mortality rates was because they heavily relied on doctors and residents trained in dentistry, podiatry, dermatology and other specialties to perform intubation procedures.
At Beaumont’s Royal Oak, Troy, and Grosse Pointe hospitals an elite team of more than 70 anesthesiologists trained and experienced with intubation performed all the procedures. 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.
Beaumont on Tuesday let these anesthesiologists who went way beyond their call of duty know how much the hospital company appreciated their dedication and service. Beaumont cancelled their contract, terminating a relationship with a practice that began more than a half-century ago.
Here’s the bottom line: More than 70 anesthesiologists who unquestionably are among the best in the country will no longer work at Beaumont’s three premier hospitals after December. The majority of these anesthesiologists have years of experience and are fellowship trained, meaning they had an additional year of residency training to hone their expertise. They are among the reasons that Beaumont Royal Oak, Troy, and Grosse Pointe hospitals are nationally ranked.
Beaumont “spokesman” Mark Geary doesn’t answer my questions, except to occasionally send a link to a news release or published article. Geary said John Fox, the accountant overseeing Beaumont, and COO Carolyn Wilson, weren’t available for interviews.
But here’s what Wilson told Crain’s Detroit Business in December when discussing Beaumont’s anesthesia outsourcing plans.
“Will there be savings? Absolutely. We’re counting on that,” Wilson said.
Focus on Profits
The more than two dozen Beaumont doctors, nurses, and other people familiar with Beaumont’s inner workings say privately that Fox and Wilson are focused only on boosting revenues and profits, at the expense of the hospital company’s reputation for top-ranked medical care. Morale is abysmally low at the supposedly “not-for-profit” company, they say.
Beaumont has already sustained some very damaging reputational defections. Marc Sakwa, who was chief of cardiac surgery at Royal Oak, and Jeffrey Altshuler, another renowned surgeon, bolted last fall to work at MemorialCare in Southern California. Sakwa, a Detroit native, was instrumental in raising funds for Beaumont’s various cardiovascular specialty centers.
Jay Greene of Crain’s last December reported an alarming story detailing extensive problems at Beaumont’s Trenton hospital impacting patient care.
"I would be derelict in my duties if I were not to advocate for the department of surgery, my surgical colleagues and all its employees," Zachary Lewis, chairman of Beaumont Trenton’s surgery department wrote to a hospital administrator. "I write with a final sincere request that you find a way to address the critical staffing issues at Beaumont Trenton affecting the ORs and department of surgery. Thus far, my pleas have fallen on deaf ears."
Said Lewis to Crain’s: “My only conclusion is they [Beaumont] are trying to cut costs any way they can — saving money by not hiring nurses — to increase their margins."
Beaumont’s announcement that it awarded Texas-based NorthStar Anesthesia to service its Royal Oak, Troy, and Grosse Pointe hospitals is indicative of the company issuing disingenuous misleading statements. The release states the “best practices” move was intended to rely on a single company to provide anesthesiologists and certified registered nurse anesthetists (CRNAs).
Beaumont Royal Oak, Troy, and Gross Pointe currently employ their own CRNAs, but its anesthesiologists work for North American Partners in Anesthesia (NAPA), a private equity controlled firm that acquired their practice in May. A well-placed source said NAPA was prepared to hire Beaumont’s CRNAs and offer a seamless solution. It’s likely NorthStar gave Beaumont a better pricing deal, but it will be a formidable challenge staffing Beaumont Royal Oak, Troy, and Grosse Pointe with 72 anesthesiologists comparable to the quality and experience the hospitals have long relied on.
As part of an earlier sellout of their practice to a publicly traded company called Mednax in 2011, Beaumont’s elite anesthetists signed non-compete clauses, which prevents them from joining NorthStar even if they wanted to. Despite years of dedication treating Beaumont patients, they will have to uproot their families and move.
Wall Street Pattern
NorthStar is part of a Wall Street trend to buy medical practices and squeeze more profits out of them by cutting costs and other measures. It was founded by a private equity firm in 2004 and flipped to another Wall Street company earlier last month. We’ll see who owns them next year.
In yet another smack in Michigan’s face, an industry trade publication reported this week that Advocate Aurora, the Illinois-based hospital company of no particular distinction that John Fox wants to merge Beaumont into, has sold two community hospitals for $190 million.
Two community hospitals fetch $190 million. Fox is giving away Beaumont, still ranked among the top one percent of hospitals in the country, to Advocate Aurora for free in its proposed merger.
It’s little wonder that spokesman Geary has nothing to say. The Advocate Aurora deal is of very questionable benefit for Michigan residents. But John Fox and Carolyn Wilson likely will profit handsomely.
Reach Eric Starkman at email@example.com Beaumont employees and vendors are encouraged to reach out, with confidentiality assured.
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