January 4, 2010

Wheaton-Franciscan cuts ties with Racine-based anesthesiology group

Wheaton-Franciscan All Saints has cut ties with its anesthesiologists and plans to replace most of the doctors with nurses, according to insiders at the hospital.

At least 11 of All Saints' 14 anesthesiologists are set to leave after contract negotiations broke down. They'll be replaced by certified registered nurse anesthetists (CRNAs), who are specifically trained to put people under in surgeries.

But surgeons who work with the anesthesiologists said they're concerned about switching to a system that replaces board-certified doctors with nurses.

"There's a risk of hearts attacks, blood clots ... of coding right on the table," one insider said. "You want a board-certified doc there."

Wheaton Franciscan-All Saints' response: Florida company will expand anesthesiology services in Racine

While the anesthesiologists and All Saints are not talking about the change, people close to the situation have confirmed the hospital is planning the switch. Our calls to anesthesiologists were not returned and All Saints twice promised us a comment, including a formal written response, but then never responded.

The story is particularly difficult to report because Wheaton-Franciscan has a policy that prohibits employees from talking to the media without permission. Anyone who talks to a reporter can be fired immediately, according to insiders.

While some are concerned about the switch to certified nurse anesthesiologists, it's a move that's becoming increasingly common.

Statewide, the majority of hospitals use CRNAs, according to Lawrence Beck, president of the Wisconsin Association of Nurse Anesthetists.

"You probably won't notice a change in the type of care," Beck said about the transition from anesthesiologists to CRNAs. "It's very safe."

Improvements in technology to put people under during surgeries, combined with significant amounts of training for CRNAs, has allowed hospitals to switch to a "team approach" with nurses, surgeons and anesthesiologists working together.

Cost is the big advantage of switching from anesthesiologists to CRNAs, Beck said.

"CRNAs are not paid as much," he said.

But local insiders said they're concerned Wheaton-Franciscan's decision to cut ties with its anesthesiology group is part of a growing trend. They noted several top-notch doctors, such OB/GYN Lenora Brockman and Pediatrician Jennifer Thomas, have left recently, that the Urology department is down to one doctor, that All Saints' dermatology department is gone and that the Medical College of Wisconsin ended its Family Medicine Residency in Racine last year.

Of course, insiders said, there are many good doctors and surgeons still in Racine. But there's a growing sense of frustration because Wheaton-Franciscan has taken away local control and lumped Racine in with Milwaukee, Franklin and other hospitals in the region.

"Why are all the good doctors leaving Racine?" one insider asked. "No decisions are being made here. It's time to bring back Racine health care to Racine."


Update: A Florida company brought in to manage All Saints' anesthesiology department will upgrade services, according to the hospital's chief of staff.

Dr. Nicholas Omdahl, vice president of medical affairs at All Saints, said Anesthetix Management LLC, of Palm Beach Gardens, Fla., will employ eight anesthesiologists and 14 certified registered nurse anesthetists. That's an increase over the previous provider, SEAC, which employed 12 anesthesiologists, Omdahl said.

Two doctors from SEAC will remain with All Saints and Anesthetix will recruit six more anesthesiologists to live and work locally, Omdahl said.

No scheduled surgeries will be interrupted by the transition, Omdahl said. Anesthetix is scheduled to start on Jan. 11.

While CRNAs earn less than anesthesiologists, the new system is not just a matter of cost savings, Omdahl said. Actually, the new group will cost more than the old, he said.

But the additional money will lead to a more efficient operation that saves surgeons' time and improves patient care.

"They (Anesthetix) are nationally known for efficiency," Omdahl said.

He added All Saints and its former anesthesiologists each agreed it was time to go in different directions. Omdahl said it wasn't contract related because SEAC's contract wasn't up for another 18 months.

Omdahl said SEAC had lost three of its members and had a difficult time recruiting replacements, which put a stress on their service.

"They couldn't meet the demands and they wanted to move on," Omdahl said.

He added All Saints did not ask the the anesthesiologists to leave.

"They made the decision to go elsewhere," Omdahl said.

47 comments:

  1. Wow, they are getting a head start on the way things will be after the Washington healthcare plans become law. Wake up folks this is the new future. Enjoy it.

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  2. Save us Obi Wan Obama you are our only hope.

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  3. My doctor was banned from practicing in Racine for a year because he refused to jump through All Saints' hoops. He continued his practice in Oak Creek, where his patients visited him. He has been back in Racine for years now (affiliated with Aurora) and is highly regarded by his peers and patients.

    I also knew a prominent physician at All Saints who left because of what he termed "dirty politics" at the hospital. He and his family moved out of state.

    There is only one hospital in town. Whenever there is a monopoly, there is corruption.

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  4. I live around the corner from the hospital, but had my baby in Waukesha County - on purpose.

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  5. You can bet now that W-F is paying less for nurses in this capacity instead of doctors that you won't see any lower charges on your bills. This hospital has been on a downhill slide ever since W-F took over. I had care through them with a broken bone and was not at all satisfied with the way I was treated. They wouldn't listen to a word I had to say and even went so far as to completely ignore a second injury that I had, even after telling two nurses and a doctor about it. Too bad they're the only show in town.

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  6. Let's all move to Denmark!

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  7. Nice! I have surgury scheduled for Jan. 11th and now I read this?! YIKES!!!!!!!!!!!!

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  8. 1:11
    Do you feel the same way about RUSD's monopoly?
    The City Health Dept?
    The FDIC or the Federal Reserve?

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  9. Who is covering the malpractice insurance on these nurses. Malpractice insurance premiums for anesthesiologists is one of the highest for all physicians. This is no job for a nurse. I would advise anyone who requires surgery that the go somewhere outside the city. I would suggest Froedtert Hospital.

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  10. I have always found the doctors, nurses and support staff associated with Wheaton-Franciscan All Saints to be extremely caring, competent and knowledgeable.

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  11. This article put me to sleep.

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  12. This is scary. There are at least a million ways Wheaton could cut costs to save money, yet they choose to cut corners on an aspect of patient care that is quite literally life and death.

    My primary care physicians are there, but if I'm in need of surgery, I'll be looking for other options.

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  13. Randy - your comments have nothing to do with this article and what will happen if this story is true.

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  14. Anon, 4:29

    Funny, thought folks were discussing quality of care at Wheaton-Franciscan All Saints.

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  15. Just another example of how bad All Saints has become. I've been trying to straighten out numerous billing problems with them for over a year and was finally told that they can't do anything more to resolve the issue. Time to contact my attorney.

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  16. Anon, 8:39,

    Sorry for your billing problems. I've always found them responsive if I had a question.

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  17. County of Racine vs. Peter W Selkowe


    Racine County Case Number 2008TR013460




    The defendant Peter W Selkowe was found guilty of the following charge(s) in this case.

    Fail/Stop at Stop Sign. This is not a criminal offense and results only in a money penalty for this offense.

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  18. Dammit, Pete! If there's one thing RacinePost stands for it's stop signs!

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  19. On the Vespa, yet, back in 2008. Is that all you got?

    But what's the relevance to an anesthesiology story?

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  20. A couple of comments...

    First, any place which promotes itself as one of the best places to work must be viewed as a place to be wary of. Self praise is no recommendation even if it originates in some magazine article.

    Second, Racine needs competition with another hospital. Try either Milwaukee or Kenosha and you will quickly see the difference in simple customer care. They listen, which translates into noticeable health care improvement. Doctors and nurses spend more time with you too.

    When talking to employees in Racine you get the real impression they are in the middle of a morale disaster. Talk to employees in either Kenosha or Milwaukee hospitals and you have good vibes from them. Which hospital do you want to go to? It's no wonder doctors are leaving.

    The politics at All Saints are deeply troublesome. But it appears to come from on high. The only way to fix this is to bring in competition. If Kenosha can support more than one hospital, why can't Racine? We really need this. Is anyone listening?

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  21. Try St. Luke,s in Milwaukee. Great doctors, great staff, very customer focused and no billing problems. I have had three surgeries in the last five years and decided to go a few miles north to avoid the mess in Racine. All Saints needs to do a lot of hard work to win back my confidence and business. I have had several friends die after being admitted to All Saints for no apparent reason other than infection and bad care.

    The service in the emergency room is even worse!

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  22. I am canceling my February surgery. If I am going to hold someone's hand to the tunnel with light at the end of it and expect that hand to lead me back, the hand that I am holding is going to be a doctor's hand not some nurse's. BTW does Dr. Omdahl think he is fooling the public when he says the nurses are going to cost more than doctor's? Go lie to someone else, I am going to Kenosha for my surgery.

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  23. You better check with Kenosha and see if they have nurses doing anesthesiology.

    I don't mind nurse practitioners but when I have sugery, I do want a physician, board certified to put me under. Most of my friends and relatives go up to Froedert and this would just add to the exodus away from Wheaton Franciscan. I agree, W-F has chisled away on staff and good practices since they took over All Saints.

    Anon -1/4/ 11:48. Listen pal, healthcare needs to be reformed, period. You don't know that nurses will steadily replace physicians with your so called Washington hc.

    We go to a nurse practitioner for minor ailments, bad colds, etc. It keeps our health insurance low and she does a great job and we have alot of confidence in her. I just think anesthesiology field goes to a physician.

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  24. Randy - your comment: I have always found the doctors, nurses and support staff associated with Wheaton-Franciscan All Saints to be extremely caring, competent and knowledgeable. This is about a whole new group of Dr.'s not current staff and if you need surgery, I hope you get a nurse to handle the anesthesia. Good luck!

    This has nothing to do with the current staff as you are referring to. therefore your comnets are worthless as usual

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  25. Check this, a small headline in today's JT (pg. 6-A):

    "All Saints says it will expand
    new anesthesiology services"

    "Wheaton Franciscan Healthcare-All Saints says it is expanding its
    anesthesia services with a switch to an exclusive service agreement
    with a national provider, Anesthetix Management."

    Not one mention of the breakdown in talks with anesthesiology doctors and about replacing them with nurses. This is a perfect example of Wheaton's, and the JT's, tactics in providing only half the story they want us to hear. What else do they leave out when they provide us with "information"?

    Randolph said, "I've always found them responsive if I had a question" concerning their billing practices. After I was treated there it was a constant headache dealing with their billing department. They constantly double bill people and also send bills to the insurance companies AND the patient; probably in hopes of getting paid twice. Talk about heads up butts, Wheaton almost has the market cornered on that one.

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  26. I agree with Randolph about the care and service i have received from WF. Always professional and weel done. Have there been issues? Yes, but they were always resolved to my satisfaction with just a bit of work and attention on my part.

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  27. Mom's hip surgery 3 years ago: 3 separate calls to the "Pride Line" for 3 separate problems (including the nurse who insisted that mom be given her insulin injection although she is not diabetic; or how about the head surgical nurse marking the WRONG hip for surgery just before the operation - thank God we were there), anyway, 2 of the complaints to the Pride Line were completely ignored and the third was a form letter response that did not address the issue we raised.

    Mom waited three hours in the ER with a broken hip before she was seen by an MD, therefore NO pain medication could be given to her during that time. When an MD finally did see her, they said it was too late in the day to schedule surgery - although three hours earlier would have been in time. So she had to lay in traction with a broken hip overnight, too. Thanks, W-F.

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  28. This comment has been removed by a blog administrator.

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  29. Sorry about your mom, Orbs, but don't jump to too many conclusions about what transpired. Traction before hip surgery can be both medically indicated and analgesic. Surgery in the morning's also often a better medical choice, too, when people are fresher.

    I remember when I was scheduled for my surgery, my doctor told me to keep repeating to everyone I met that “It’s the left one,” just to make sure I was marked properly. Indeed, the marking procedure’s in place to avoid just the kind of errors you cite. That’s why the person doing the marking looks for the sort of confirmation you or your family provided.

    Patients and their families have responsibilities, too, to be as informed as possible, and to act as their own advocates.

    Medical mistakes are difficult to avoid even in the best of places, especially medication mix-ups, such as that insulin incident you mention. (Though that might not have been such a mix-up either, since blood-sugar control before surgery can significantly reduce postoperative infection rates.)

    Still, there are some practical steps to be taken in improving the health care system throughout, and the health care reform bill’s provisions to exponentially improve medical record-keeping is just one of them.

    Last time I was in Wheaton -Franciscan All Saints, I noticed that they’re not waiting for the law, and they’ve already implemented the kind of computerized record keeping the bill calls for, so they’re out front in this area as well.

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  30. Randy - now you are a physician. Where did you get your M.D. You can't even respond to the article that was written - you want to keep talking about what "you" think is the current situation. Why don't you get on track or get the hell off this site.

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  31. Randy,
    You sound like a typical Wheaton apologist...former Racine physician.

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  32. Of all the fields of medicine this is last one I would want to see anyone other than a fully trained, experienced doctor.

    Well, this and the actual surgeon.

    So, when are they replacing them?

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  33. Why the blatant attacks on Randolph? He offered his opinion, which I last checked, is legal. He did not verbally abuse anyone. If you don't believe his thoughts then reply to the opinion.
    Be nice, people. We have enough hatred in this town already.
    SDJ

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  34. Randy needs to read the story and stay on subject. Plus I can't be civil to any Socialist living in this city or country.

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  35. Good Drs don’t want to deal with bad and unfair management so they pack and move on to the hospitals that appreciate their contribution and compensate them accordingly… it’s a matter of time before they either go broke or change their current management

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  36. Anesthesiology is not the only area of All Saints that is changing. There have been massive staffing cuts across the board over the past few years. If any opposition is voiced, staff are escorted to the door. Those remaining are worried about keeping their jobs. The company is currently undergoing a state inspection following the tragic death of patients. The antics the followed the arrival of the inspectors was a joke and involved some very questionable activities. Do you want to go to a place like this for surgery?

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  37. I'm getting out because of the poor performance of my physician. My 6 month check ups are a joke. He sits and looks over my blood work and talks, and talks, and talks not say anything. Then his exam consists of listening to my heart and lungs for about 5 seconds - no other hands on exam. I'm heading over to Auora.Just a warning - his office is at One Main.

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  38. I have worked with nurse practitioners and nurse anesthetists and LIKE HELL I would recomend them. They are all IDIOTS with crap training. Want to die Use a NP or CRNP, When you go to the ER you get a nurse, not a doctor. Watch name tags people

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  39. Recently I waited 3 hrs in the ER to be seen and then only saw a DOCTOR one time for 5 minutes! The rest of the time I had a physcian assistent. During the time I waited 4 families left in frustration. One of them with an elderly lady on oxygen in a wheelchair. They said they were going to Froedert. My own mother went there for chest pains a few years ago, right after their cardiac building opened & got a full work up. She said they had to stop her stress test because she felt like an elephant was sitting on her chest, yet they released her saying she had only acid reflux. At her follow up appointment with her regular physican that doctor immediately sent her to a cardiac surgeon who did a cardiac cath which showed 95% blockage to her heart artery. She immediately had a stent put in. Just how does a doctor misdiagnose heart blockage with acid reflux? And recently (Feb. 2010) they misfiled papers into my file and were trying to get me to take insulin shots when I dont need them! They also cant seem to find my MRI reports that have been in my file for years. This hospital sucks. The ONLY way they are getting away with this is that they are a monopoly. Beware of surgery there. My older cousin had double knee replacement and died the day after due to massive blood clotting. From the same doctor that wanted to do double knee replacement on me when I only went to see him for an evaluation and had no severe pain nor lack of mobility. I asked him why he was wanting to do replacements and he said because of my pain. Funny he never asked me my level of pain nor how this affected my mobility (which it did not affect me at all). Years later, here I am walking on my own without problems, some minor knee discomfort occasionally.

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  40. You people are all morons that say you want a doctor to put you asleep and are going to (blank) hospital--the majority of them use CRNAs and if you ask the hospital employees they usually choose the CRNA's to put them to sleep. Check facts before you spew out comments

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  41. Just because you stupid patients dont want to pay your bills doesnt mean that there are billing problems.... it is illegal for us to change anything pretaining to your billing because your insurance company wont pay it.... if your insurance doesnt pay, 95% of the time its for a good reason, get familliar with your insurance policy before you automatically assume that the billing is our fault

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  42. I'm saddened by this. My doctor was one of the ones that left in December and I desparetly wish I could find her! If anyone knows where Dr. Lenora Brockman is now practicing and could forward that information on, it would be greatly appreciated!

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  43. I am also looking for Lenora Brockman, she was the only Dr. that I remained seeing at All Saints, over the years. Your just a number there...not a patient.

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  44. Dr. Lenora Brockman will be soon at Aurora in Kenosha. :)

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  45. Its nice to see that a person working in billing is calling us "stupid patients"
    Perhaps the billing department needs to take a lesson in customer service, not double billing, how to file electronic claims and not having your patient explain the proper way to process a medical claim. And no worries, if they can't get it right, they just send you to collections. Billing is pathetic.
    My child recently had surgery at WF, and after surgery we found out the anesthesiology was out of network - which WF NEVER told us or even said COULD be an option for us to make an informed decision.
    Hmm, who's 'stupid' now?

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  46. WOW, lack of information regarding a profession is dangerous. CRNA's have been doing anesthesia longer than doctors. Please research the information before you bad mouth a group of professionals. For all the comments regarding Froedert, they use CRNA's! Or for all those that want a doctor,if you are lucky, you get a first year resident that has poor clinical skills (IV, intubations, central lines, ECG, etc) and very little anesthesia experience as your provider. Good Luck! I would rather have someone that knows how to take care of people!

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  47. Anonymous said...
    WOW, lack of information regarding a profession is dangerous. CRNA's have been doing anesthesia longer than doctors. Please research the information before you bad mouth a group of professionals. For all the comments regarding Froedert, they use CRNA's! Or for all those that want a doctor,if you are lucky, you get a first year resident that has poor clinical skills (IV, intubations, central lines, ECG, etc) and very little anesthesia experience as your provider. Good Luck! I would rather have someone that knows how to take care of people!
    12/18/2010 9:18 PM

    This is dead on. People need to do a little research regarding the topic. Froedtert employs many nurse anesthetists as do most hospitals.

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