Mercy Medical Center emergency department doctors and physician assistants were told: join an outsourced for-profit company or find a new job. Now, with pay cuts up to $60,000, multiple people have told MassLive they don’t have a choice but to leave.
In April, Trinity Health told staff it planned to outsource staff to Vituity — a for-profit, physician-owned group from California whose arrival previously caused staff departures at hospitals in Connecticut.
The collaboration, Mercy Medical Center and Vituity said in a joint statement to MassLive in April, “strengthens our commitment to improving access and delivering high-quality, patient-centered care while ensuring the long-term sustainability of these essential services.”
The statement highlighted Vituity’s “long history of success in improving patient care, emergency department efficiency, and provider support in many states across the country, including now at Trinity Health Of New England hospitals in Connecticut.”
Mercy Medical Center and Vituity did not respond to MassLive’s most recent request for comment.
The move came as there was already a potential mass exodus of doctors, physician assistants and nurses in the emergency department, as they claim the non-profit hospital focuses on “their bottom line.” And Vituity’s troubled track record, including departures when the company recently moved into Connecticut, added to medical staff’s fears.
MassLive spoke with multiple medical staff members close to the situation who all agreed to talk with anonymity due to fear of retaliation.
Some of them had hoped to stay at Mercy Medical Center, adding that Springfield is their home. But with Vituity’s pay cuts of $20,000-$60,000, it might not be possible.
Pay cuts
Medical staff in Mercy Medical Center’s emergency department had hoped to see the hospital hire techs or fix a delivery system to the lab that has been broken for more than a year. But staff who spoke to MassLive said those changes weren’t addressed.
Instead, a new system was created at the beginning of the year in hopes of seeing more people with less resources and staff, multiple staff members told MassLive. This included putting people in emergency room hallways and asking staff to sign on to patients they hadn’t yet had the chance to evaluate. If there is an empty space, a patient is being put there regardless of what else is going on, staff said.
Recently, patients have had to wait 18 hours in the emergency department before being brought back, although, it’s more common to wait about eight hours. And patients can wait five hours before being seen after being put in a bed. Just getting them to a bed is considered enough, staff said.
“We were already feeling that stress,” one staff member said.
More than a month ago, people started giving their resignation notices, including some staff members who never thought to leave before. The notices are often made 120 days in advance. The resignations made more and more of the physicians reexamine “what our future is.” As the number of physicians and physician assistants agreeing to stay dwindled, the staff left behind fear for their community.
“It’s really unsafe for patient care,” one person said.
Then in April, staff were told they could either sign on with Vituity or find a new job.
As staff began asking questions, there weren’t many answers, staff members said.
At one point, staff were told the partnership would begin in July, while they were later told it will start June 1. A press release provided to MassLive confirmed the partnership begins in June. It only affects emergency department staff.
“Our patients will benefit from Vituity’s experience in delivering high-performing emergency care across diverse communities nationwide,” said Robert Roose, president of community hospitals, Trinity Health Of New England. “This collaboration will also enable Mercy Medical Center to advance our Mission in the communities we serve and to uphold the highest standards of care.”
All emergency medicine providers were offered the opportunity to continue working through Vituity, Mercy Medical Center’s statement said. Mercy administrators will also work with Vituity to continue any visa and loan forgiveness programs that may already be in place for current emergency medicine providers.
In May, doctors and physician assistants began getting verbal offers. None of the people MassLive spoke with have been allowed to see a physical contract.
The offers were significant pay cuts, sometimes ranging between $20,000-$60,000 less than they are currently making. Additionally, they could not be guaranteed pay would not continue to be cut in the future.
For some, that means $22 per hour less than before. For other’s, it’s even more.
Mercy had told MassLive in April they were hopeful that people may reconsider their earlier decision to leave the hospital.
Since then, however, medical staff that had once planned to stay at Mercy Medical Center, are now having to look at jobs elsewhere.
“It’s not good for Springfield,” one staff member previously told MassLive.
New doctors
Nurses are also bracing for the change.
Although their jobs are not directly being affected by the new company, their day-to-day will drastically change.
Ann Marie Paquette has been a nurse for 45 years, including 16 years in the emergency department at Mercy. She knows the doctors she works with and they know her. It helps them both work faster and better as a team.
She said the current doctors also help out newer nursing staff, which is incredibly important. It leaves her wondering, will the new people brought in by the for-profit company be willing to take the time to help others?
Vituity has already begun posting job listings for emergency medicine physician assistants and nurse practitioners. It did not list salary.
It advertises that the company has opportunities at 475 sites across the country.
“With Vituity, if you ever need to move, you can take your job with you,” the job posting states.
A warning from Connecticut
Lawmakers and healthcare workers tried to put a stop to Trinity Health of New England partnering with Vituity for four of its Connecticut hospitals, saying it would adversely affect hospital employees and patients, Connecticut Public Radio reported in January.
“On Jan. 6, we all received emails that we have 90 days to either leave the communities that we have served for decades or sign up for a for profit company without any details,” Dr. Gagan Singh, regional director for hospital medicine at Saint Francis Hospital in Hartford, Connecticut, told the news outlet.
Connecticut state Sen. Dr. Saud Anwar, Democratic co-chair of Connecticut’s public health committee, said lawmakers tried to tell Trinity to “stop this right now. Reverse your decision right now.”
But the not-for-profit health system continued with the decision to outsource some of its employees.
About 120 physicians, some of whom had been working in the area for more than 15 years, had until April 7 to agree to work for Vituity or lose their jobs.
“They did not have enough time to seek a job,” Anwar told MassLive. “It was done in a very poor taste and very poor communication and unprofessional manner.”
Additionally, Anwar said the physicians “were not given the details of the contract” and not given the chance to make informed decisions before signing or losing their jobs.
About 30 physicians did not return to Trinity Health of New England, leaving Connecticut for work elsewhere, Anwar said.
For those who stayed, quality of life has diminished, as they are expected to see more patients than they should, Anwar said.
“The quality of life for the physician is not as good,” he said, adding the quality of patient care, therefore, also goes down.
Now, he’s working to try to pass several bills in Connecticut to stop this sort of thing in the future.
“We’re trying to work on some bills here to have a large change like this go through the Attorney General’s Office and the Office of Health Strategies,” he said.
These changes would include if a private equity company is going to be involved in healthcare, if the value of the buying entity is more than $10 million or it includes more than five physicians. It also encourages transparency and a due process to allow physicians to look over their contracts.
“We’d never thought people would be that unprofessional and also so profit driven that they would use these kind of mechanisms, but they did,” he said.
The senator encourages Massachusetts to do the same.
“There’s a shortage of physicians in the country, and there’s a shortage of physicians in New England. If we do not treat our physicians in a fair manner, we will lose them to other parts of the country. And most of the parts of the country are very welcoming to physicians from our parts of New England,” he said.
