SSM facilities to outsource ER staff
Hospital group aims to increase efficiency, president says
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| Roy Sykes photo -- Dr. Kimberly Perry, medical director of emergency medicine at SSM St. Joseph Health Center in St. Charles, checks up on emergency room patient James Hutson. |
Steve Johnson, president of North Operating Group, SSM Health Care-St. Louis, said the hospital company hopes all current emergency room doctors stay on when a new management group takes control of the ER at the end of the year.
All physicians and management will be offered positions in the new management firm."Health care is getting increasingly complex on all fronts and one of the most complicated is the emergency department," Johnson said. "But we in the present administration don't have the depth and breadth of experience in the emergency department to manage the ER as efficiently."
Johnson said the move is designed to address holes in the hospital administration's expertise, not in the quality of physician care.
SSM sent a request for proposals to seven physician management groups last week. The selection will be made by a committee composed of physicians, administrators and the medical directors of St. Joseph Health Center, Dr. Alan Umbright, and St. Joseph Hospital West, Dr. Anthony Jennings. Hospital staff members were notified July 2 of the change.
Nationally, about two-thirds of emergency department doctors are employed by third-party management groups, a trend gaining steam in the last 10 years.
Johnson said he was concerned about employee reaction, but thought guaranteeing that leadership would remain the same in each hospital's emergency department after the management switch served as a palliative to employee fears about job security.
"Change brings about a certain level of anxiety, but the issue has never been the staff," Johnson said. "In the RFP (request for proposal), there's a requirement to retain current leadership, so physicians were assured of having continuity in leadership."
The seven physician management groups have until the end of August to submit their plans, from which Johnson expects two or three finalists will be selected by the end of September to be invited for on-campus interviews with the selection committee.
"We'd like to have a new partner in place by the end of the year or early next year," Johnson said.
With more ERs shifting to outside management, some questions about productivity and morale have been raised.
Robert McNamara, former president of the American Academy of Emergency Medicine, spoke out against the trend in 2004, alleging harmful effects on both doctors and patients. Among his criticisms was that imposition of the profit imperative of a business onto the patient-physician relationship in the ER would have averse effects. He also alleged that outsourced physician management groups do not always hire the most qualified staff when doing so could cut into profits.
Johnson said hiring an outside group that focuses only on emergency care would have beneficial effects on St. Joseph Health Center and St. Joseph Hospital West's emergency rooms.
Johnson estimated the hospitals would save at least $500,000 each annually by switching to outside management.
"These kinds of companies study this as a science and have developed throughput policies that reduce cost and create less wait time," Johnson said.
SSM already contracts out ER staffing at two other locations, at SSM DePaul Health Center in St. Louis and SSM St. Mary's Health Center in Richmond Heights.
