Vital Times 2019 - 88

We talked about what would happen if the contract
bottom fell out, if we became our own group, GAS, again.
What would we do? Would we sell out? Would we retire in
a coastal Italian village like so many other anesthesiologists
who had sold out their practice?
The Italian retirement joke was particularly funny to Henry
and myself. Our difficult personal family circumstances
made the likehood of such a cliched anesthesiologist
retirement pathway almost mythically comical.
"What would you do Henry?", I asked.
Henry thought about it, at that bar. "I'd have to fight,
Harrison, I don't know any other way. I want to be
remembered as a fighter and champion for this group, not
a quitter."
As Henry spoke, I realized what was at stake. What our
children would think of our lives, the character we displayed,
and they would hopefully inherit, mattered most.
"Ok I'll toast to that. Who needs Tuscan sun anyway?"
Brave words over beers at a neighborhood bar between a
would-be corporate warrior and a Vituity apologist.
******
"How many of us want to stay right here and practice
together as a group?", Henry repeated in the modular
meeting room. Slowly, some hands came up one at a time.
"Was this even possible? How would this work? We don't
even have a contract or the support of the hospital," rapidly
blurted out some. The hands all went back down.
"I'm not saying this is going to be easy, but there is a path, a
small one," said Henry, "and we will probably still fail".
As Henry went through the game plan of forming a new
group, I could see my friend was tired. He hadn't been
sleeping well. Warriors are like that. They don't sleep before
battle.

88 | CSA Vital Times

The unfairness of the situation dawned on me. Our
group, the highest rated department at Good Samaritan
Hospital, had joined a giant corporate entity, CEP/Vituity,
to provide better clinical integration and better contract
negotiations, and now our entire practice had been sold to
another corporate giant, Envision, by another corporate
giant, HCA. Our labor had been bought and sold without
our knowledge, input, or consent.
In the battle of corporate giants, we had lost our practice
through no fault of our own. Our practice lives, our
families' futures sold like a commodity. And now here was
my tired friend, away from his family, acting out of instinct
fighting the impossible fight. He deserves better. He should be
sitting in a renovated farmhouse in Tuscany, not here putting
up with this mess.
For the next hour, a sleep-deprived Henry answered
question after question as he put together a business plan
for a new group. As risk-averse anesthesiologists, we crave
certainty. All the certainty that previously was held by
Vituity now was owned by Envision, to be bought or sold
without consent. We'd have to fight our way to freedom
if we wanted it bad enough. The only certainty, if we did
nothing, was inevitable defeat.
The odds were daunting. HCA didn't want Vituity. Vituity
wouldn't release and support us. Envision owned the
contract, and their anesthesiologists were already on staff
at Good Samaritan Hospital. As the meeting was going on,
a few anesthesiologists were receiving texts from Envision
offering them their jobs back. We all nervously laughed
about that. How could we win this battle?
I worriedly looked at my friend as he patiently went
through business logistics. As a business case this was nuts;
it was a David vs Goliath. Giant corporations and MBAs
vs a small group of practicing MDs. No. Correction: it was
Henry vs the Three Giants. Could the odds be any longer?
At the end of the lengthy presentation on that July night,
Henry asked the question again. "Are you willing to fight
for it as a group?" This time most of the hands went up.
Vital Times 2019

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