The private physicians group that staffs Wesley Medical Center’s emergency room says it has been given an ultimatum by the hospital: Become employees of Wesley’s staffing vendor, EMCare, or lose their jobs at the hospital.
The group, Emergency Services Professional Association, has worked with Wesley for nearly 50 years, according to company officials. It employs 18 physicians, 23 physician assistants and nurse practitioners and office staff members.
Physician Mark Mosley, Wesley emergency department medical director who has been with the ESPA for about 20 years, says the decision by Wesley will negatively affect patient care.
“We tried to explain to the administration the relationship we have with physicians in the community, the relationships with nurses and the kind of patient care we give is not something you can fly in from out of town and buy. It’s created from years of teamwork,” Mosley said. “When you take that away, you potentially put patient care at risk.”
Nick Adams, vice president of marketing and public relations at Wesley, said the hospital has contracted with EMCare for the past 16 months and EMCare has subcontracted with the ESPA for positions at the main campus and Wesley West Emergency Department.
“This structure has not proven very efficient or optimal for us or EMCare, so they are in the process of negotiating a direct employment relationship that is the same relationship in our Galichia emergency department and for our hospitalists,” Adams said.
Every ESPA physician has been offered a position with EMCare with a comparable compensation package, Adams said.
“We have plans in place that regardless of how negotiations go, we will always have expert, well-trained physicians in place so patients receive quality care,” Adams said. “Build one bridge while you work on another bridge.”
EMCare has multiple contracts with Hospital Corporation of America, Wesley’s parent company, Adams said. However, he thinks those contract decisions have been made by local markets and not on a national level.
ESPA physicians say they’ve been told they have until Sept. 3 to make a decision.
“Our only hope is public outcry, and the only problem is the clock is ticking,” Mosley said.
Letter to board
In a letter dated Monday and directed to the Wesley Board of Trustees, ESPA members outlined a history of issues between the group and Wesley.
The letter states that several years ago, the ESPA took a loss when it agreed to employ Ramona Warren, a pediatric emergency room physician, in order to accomplish Wesley’s goal of a pediatric emergency department.
“The pediatric ED was great marketing for Wesley,” the letter states. “However, it was a financial loss for ESPA. Patients who previously would have been seen by a MLP (midlevel practitioner) in fast-track were now being seen by ESPA physicians and a pediatric emergency physician.
“The loss of revenue from the pediatric ED was cutting into our physician and MLP salaries, which made ESPA less competitive to recruit and retain employees. ESPA, who had never had a problem with staffing, began to lose some of our newest hires to Via Christi and other markets.”
As a result, the letter says, the ESPA asked Wesley for a subsidy to cover some of the losses, which Wesley declined to do unless the group agreed to show its finances to a consultant chosen by Wesley.
“For a year ESPA refused the idea of a private company looking at ESPA’s financial records for fear that it put us in a position of being taken over,” the letter states. “ESPA was promised on multiple occasions that this did not represent a strategy to take us over. Ultimately, with the fear of losing physicians and MLP’s who could not be compensated at fair market value, ESPA opened her financial books to three different private consultant groups, one of which was EMCare.”
The letter goes on to say that the ESPA was forced to choose EMCare to help with financial efficiency. The Eagle reported in December 2012 that Wesley was expanding its recruitment of ER physicians through a new vendor.
Paul Petitte, executive vice president for marketing and public relations at Wesley at that time, said the move would not affect the positions of current physicians.
Adams, who took over Petitte’s position in September, said he did not know the reasons EMCare was brought on by Wesley or the history behind the changes.