A recent interview with Cathy Jacobson, president and CEO of Froedtert Health, a large health system in Wisconsin, sent chills down the spines of physicians everywhere.
While she started the interview by stating that her organization’s goal (or in CEO terms, “culture”) is to put the patient first, she followed with a contradictory statement–explaining that patients don’t need primary care physicians: “Patients need primary care, but not necessarily a physician relationship.”
I suppose we should thank Ms. Jacobson for telling doctors what we’ve secretly suspected for quite some time: Corporate entities undervalue physicians and consider us replaceable.
This should come as no surprise to those who are following news reports and social media.
In April, 27 pediatricians were fired in Texas when Dallas area Children’s Health sold most of its clinics to MD Medical Group. According to CEO Alvaro Saenz, the ironically newly-named ”MD Kids Pediatrics:” “puts a greater emphasis on nurse practitioners and physician assistants, while staffing one to two pediatricians per location.”
Ah, the irony. While MD Medical Group enjoys the branding element of employing “MD” in its name (in addition to MD Kids Pediatrics, they also operate Clinicas Mi Doctor and MD Family), they have fired MDs (and DOs) and replaced them with NPs and PAs.
I spoke to three of the pediatricians who were fired as part of this acquisition, who were unwilling to be named due to concerns over losing their severance package. They told me that they and their physician colleagues were completely shocked by the sudden firing. ”We thought we were going to retire from this place,” one told me.
In retrospect, there were warning signs.
Several months before the firing, the pediatricians told me that administrators demanded that they increase their patient volume from seeing 18 to 20 patients per day to 24 patients per day. The system had also recently made cost-saving changes by firing each physician’s triage nurse several months prior and creating a centralized call center, despite concerns expressed by the group’s pediatricians.
The doctors I spoke with noted that the pediatricians who were retained tended to be the newer doctors just out of residency and those who saw a higher patient volume.
One of the fired pediatricians recently spoke to a colleague who was kept on staff. “This doctor was told that they could agree to the new policies or they could go, with no severance. They were also informed that NPs were already ‘lined up’ to take over for the terminated pediatricians.”
When doctors are let go, the community suffers
Administrators are slashing physician jobs in other parts of the country as well. In Baltimore, multiple pediatricians lost their jobs when Medstar Franklin Square closed its pediatric emergency room and inpatient pediatric services. Anna Reed, MD, one of the pediatricians whose position was terminated explained the trickle-down effect that the closure has had on the community.
“In addition to having no pediatric trained emergency physicians, the facility is no longer able to provide other services for children, like sedation for imaging tests and managing complications in newborn babies,” she told me “If a baby has a problem after delivery like jaundice, they now have to be transferred to another facility.”