Racine doctors preparing to split from Wheaton-Franciscan; Half of Racine's physicians prepared to leave

Local doctors are preparing a revolt against Wheaton-Franciscan Health Care that could dramatically reshape Racine's medical services.

At least 50 doctors are prepared to walk out on Wheaton-Franciscan over numerous concerns of mismanagement and poor billing practices, according to anonymous sources. Tension between doctors and the company have been building since the Milwaukee-based Wheaton-Franciscan (background info) completed its takeover of All Saints Healthcare three years ago and eliminated local control of Racine's hospitals, clinics and doctors.

Insiders close to the showdown say at least half of Wheaton-Franciscan's doctors in Racine will demand the non-profit corporation release them from their contracts and allow them to create their own medical group. Doctors want their own group so they can improve billing services, hire their own nurses and run their medical practices how they see fit.

The tipping point for many doctors was Wheaton-Franciscan's decision to replace its anesthesiology department with a Florida-based company that relies on highly trained nurses instead of doctors to provide anesthesiology to most patients. The decision came after negotiations broke down between Wheaton-Franciscan and Racine's anesthesiologists; , some had practiced locally for over 20 years.

But doctors were also upset by a series of business decisions that forced Wheaton-Franciscan to siphon money away from Racine to prop up its other buildings, a doctor said. The company is in the process of converting Racine into a "charity hospital" that primarily see patients without insurance. Other patients will be diverted to Wheaton-Franciscan's facilities in other cities.

"You cannot have a business survive like this," a doctor said.

More than 100 local doctors met Wednesday night to voice their concerns with Wheaton-Franciscan President and CEO John Oliverio. The 2-1/2 hour meeting did little to assuage the doctors, according to sources. At one point, someone asked the room how many wanted to leave Wheaton-Franciscan. More than 100 doctors raised their hands, according to a source.

"It was the first time I'd seen that many doctors in a room together in years," one source said.

The group of 50 doctors - which is roughly half of Wheaton-Franciscan's doctors in Racine - has been meeting privately with Wheaton-Franciscan's competitors to explore options. All local doctors employed by Wheaton-Franciscan have a restrictive covenant in their contracts that prevents them from practicing medicine in Racine County for 18 months after they leave.

If Wheaton-Franciscan refuses to let the group go on its own, the doctors are prepared to set up shop in a neighboring community, wait out the 18 months and return to establish the new physician-led medical group in Racine.

One doctor said there is little hope of repairing the relationship between Wheaton-Franciscan and a majority of its doctors. Thirty-eight doctors have left - many out of frustration - since Wheaton-Franciscan completed its merger with All Saints, a source said.

"They're incapable of fixing things," a source said of Wheaton-Franciscan. "They haven't done one thing in the last three years to make our jobs easier. They implement systems that add hours onto our long days, and they (the systems) don't even promote good health care."

The hope is Wheaton-Franciscan allows the doctors to split away, but still maintain a relationship with Racine's hospital. This will allow local doctors to keep their patients and improve service, a doctor said.

Doctors feel they can pull off the split now because a majority of Wheaton-Franciscan's doctors have agreed to leave.

"We wouldn't do this if we didn't think we had a solid group," a source said.

In order for the split to work, a doctor said, local patients and the community will need to support the doctors' efforts to improve Racine's health care.

One doctor wrote RacinePost with this account about their time in Racine, and the need for change:

I came during the last upheaval which saw many physicians leave. At that time morale was low-very low. Then Ken Buser and Thad Johnson took over and things literally turned around overnight. Until four years ago things were going great and physicians were happy as well as most of the staff.Patients were getting good care. Then came the formal merger with Wheaton. Most of the physicians new nothing about this, and, we certainly did not clamour for it as stated in the Journal Times. This was a move solely orchestrated by the Wheaton leadership (Mr. Olivario). We were only one of a few, maybe the only one, of their hospitals operating in the black. We paid for our women's center with cash. After the merger all of our money - the community's money - was basically siphoned off to Wheaton for many of their other failing hospitals. Our medical group has been literally dismembered piece by piece. Many good physicians have left,and, many of those physicians had been in town for a whole career. These physicians, who live in our community, were thrown away like yesterdays trash by administrators - many of whom do not even live in our community.

The fact that so many physicians are unhappy (not just physicians but nurses, clerks, operating room technicians - EVERYONE - including patients) means that the Wheaton organization has broken a fiduciary obligation to the Racine community it is supposed to serve. In the next few weeks there will be a large contingent of physicians who want to break aweay from Wheaton and still continue to care for their patients independently in the community. We will need the support of the community to do this because of restrictive covenants we were were forced to sign. You have some excellent physicians in this community who have been handcuffed. They want to provide excellent care. Please help us to be able to do this by calling the Wheaton organization and community representatives and tell them you suppport us. This is our community, you are our patients and we do not want to leave!

'Borderline Riot': Racine's doctors held a tense meeting Wednesday night to complain about All Saints

Nearly all of the doctors who work out of Wheaton-Franciscan All Saints, the former St. Mary's, held a meeting Wednesday night to express their frustration with how Racine's hospital is being run, according to reliable sources.

At least 100 doctors attended the meeting and called for changes in how the hospital, and their jobs, are managed. The meeting was called because the overall morale among local doctors is low, according to the source. At one point during the meeting, someone asked the crowd how many doctors want to leave All Saints. Nearly everyone in the room raised their hand, according to the source.

"It was a borderline riot," according to the source.

If you or anyone you know was at last night's meeting, please send us an email at: racinepost@gmail.com. Anonymity guaranteed to all who write.

Update: Thanks to everyone who's written in. We'll have some follow up stories later today and next week. A few more details on Wednesday's meeting:

* The meeting was held in the Racine Room at the hospital

* All Saints' doctors called the meeting to express their frustration to hospital executives.

* This is in the comments, but it's worth mentioning here. All Saints doctors can't leave and practice at, say, Aurora in Racine because of a non-compete clause in their contracts. Doctors can't practice in Racine for up to a year after they leave All Saints. Doctors say this is frustrating because it basically locks down the Racine market for anyone who wants to compete. For example, if a Racine doctor wants to start their own practice they can't do it locally because of the noncompete clause. Some leave for a neighboring city - like Franklin or Oak Creek - or leave all together.

* We're getting quite a few complaints in the comments and by email about All Saints' billing. We'd like to a pursue a story on this, so if you have any problems with your medical bills, please let us know.

New anesthesiology provider at All Saints starting Jan. 11

A Florida-based company will take over All Saints' anesthesiology department next week, according to a corporate press release.

Anesthetix Management LLC, of Palm Beach Gardens, Fla., signed an exclusive service agreement with All Saints to replace SEAC, the current anesthesia group at All Saints. Anesthetix will start Jan. 11, the release said.

All Saints described the change as an "expansion" that will improve local service and create a "state of the art" unit in Racine. Among the benefits: Anesthetix will provide 'walking epidurals' to women in labor.

The press release said Anesthetix will use new anesthesiologists and certified registered nurse anesthetists and current employees to create the new department.

Here is the full press release from All Saints:

All Saints Selects New Anesthesiology Services Partner

Wheaton Franciscan Healthcare–All Saints announced today it is expanding its anesthesia services. The transition is to an exclusive service agreement with a leading national provider, Anesthetix Management LLC (Anesthetix), effective January 11, 2010. This expansion of anesthesia services builds upon the good work of SEAC, the current anesthesia group at All Saints. All Saints, SEAC, and Anesthetix are working collaboratively over the next several weeks to ensure that the high quality surgical service that our patients have come to expect continues and the transition for our patients, surgeons, and staff is seamless.

Beginning January 11, 2010, Anesthetix will coordinate and provide all anesthesiology services at All Saints. The new practice group, to be known as Racine Anesthesiology Services, PLLC, will be comprised of new anesthesiologists, certified registered nurse anesthetists (CRNAs), and members of the current anesthesiology group, SEAC. They will work together to give the Racine community increased access to sophisticated medical care and improved service for All Saints patients and medical staff.

“In addition to implementing a variety of efficiencies, Anesthetix will be adding a new level of care and anesthesia options for our patients undergoing certain types of diagnostic testing,” said Dr. Nicholas Omdahl, Vice President of Medical Affairs, Wheaton Franciscan Healthcare – All Saints. “We are very pleased with the initiative they have already taken in working with us to better approach the needs of our patients and medical staff.”

Beyond forming a new state-of-the-art anesthesia department, Anesthetix is also expanding coverage for obstetric patients, ensuring that any laboring mother will have immediate access to the latest standards of labor pain management, including ‘walking epidurals’.

"We have found All Saints’ administration, hospital staff and physicians to be wonderful people who are highly committed to providing the best medical care possible for their patients and we are honored by their confidence and trust in Anesthetix to deliver on this commitment,” said Steven M. Gottlieb, MD, Chief Executive Officer, Anesthetix. "We look forward to working with them and establishing a new, higher standard of anesthesia care for the patients in the greater Racine area."

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.