All Saints surgeon: Anesthesiology services are safe, but corporate management created unnecessary strife

Dr. Dennis Anderson is a surgeon at Wheaton Franciscan All Saints. He wrote the following commentary in response to recent developments and comments regarding anesthesia services at Racine's hospital.

For background's purpose, Wheaton Franciscan All Saints ended its relationship with its long-standing anesthesiology provider in January and replaced the physicians with a hybrid of doctors and nurse anesthetists.

Here's Dr. Anderson's commentary on the change:

A lot has been said recently about the state of affairs surrounding anesthesia services at Wheaton Franciscan Healthcare. Some of the statements have been well thought out, some not so. Questions remain regarding patient safety, how the conflict came about, and who is to blame. I have been asked to weigh in from the perspective of an active Wheaton surgeon, so I offer the following as my own thoughts on the matter.

First of all, I must say that the anesthesiologists of SEAC (Southeast Wisconsin Anesthesiology Consultants) were among the best anesthesiologists I have ever worked with. Not a day goes by in which I do not regret the loss of their professional service and their personal companionship. I certainly look forward to the day when we can work together again.

Having said that, the current group of anesthesiologists and nurse anesthetists (CRNA’s) are licensed professionals, as well. They provide quality, safe service, and deserve respect. They had nothing to do with the current state of affairs. They are the innocent victims of all this. They really did not know what they were entering into when they signed up for this job. In speaking with them, none was informed of the local climate. Had I been involved in the interview process, I would have told them outright what was going on. They could have decided not to come, as it is not their fight. They could have chosen to come anyway, as it was a job, but at least they would have known what to expect. It may not have eliminated the emotional pain when harsh words are spoken, but knowing what to expect can lessen the shock.

In the past, whenever SEAC would consider hiring a new associate, they were always brought in to meet with the surgeons. Our input in the selection process was actively sought and respected. This is in stark contrast to the manner in which our new present CRNA’s were brought in. They were selected sight unseen by the administrators, with no surgeon input. The surgeons, for our part, were suddenly met with unfamiliar faces in our operating rooms, where our trusted colleagues once sat. The CRNA’s acknowledged that they did not have a chance to meet with any of the surgeons before arriving one day to start working in our OR. Thus, they were at great disadvantage, and a remarkably easy target for surgeon frustrations.

Unfortunately, as so often happens, the focus turned thereafter to personalities rather than remain properly focused on a failed process. I refer to the failed negotiations between Wheaton and the former SEAC group. Although many of the details of those negotiations are beyond even my scope, my analysis is as follows:

As this unfolded over the course of several months, there was little noise heard. When negotiations appeared to be making little ground, word started to get out. Those not directly involved in the talks, but who would be most affected by the outcome (i.e. the surgeons) began to ask questions. We got little to no information from the Wheaton negotiators. At the same time, we received constant updates from the SEAC members. Naturally, opinions began to form, but with only the information available. With no rebuttal, over time those opinions become cemented until they become virtual fact in our minds. By the time it became clear that negotiations were at an impasse, it was too late to call us in. We had already taken sides on the issue.
Had the surgeons been called in to mediate earlier in the negotiations, instead of excluded as we were, I believe that there could have been an entirely different result, and our SEAC colleagues could very well still be with us. While it was likely assumed by administration that we would naturally side with our physician friends, we may have in fact helped the hospital get some of the issues that it wanted, such as a nurse anesthetist model. In fact, as those negotiations were taking place, I was asked in a rather off-the-cuff way, if I have ever worked with nurse anesthetists. I said that I had, and that it had never been a problem. I assumed, however, that this referred to a new model to be hired by the SEAC group. Little did I know that they were destined to replace the SEAC group. It was exactly this type of slight-of-hand that so angered the surgeons. I, for one, could have easily embraced this new model had it not come about in such an unseemly way.

Now that our former anesthesiology group is gone, and permanently replaced, I can only consider them as casualties in a war that did not have to happen. Moving forward, I feel it is only fair to treat our new providers with the respect they deserve. Surgery, and anesthesia at St. Mary’s Hospital are safe and of high quality. Patients should feel comfortable coming to our institution for care. In speaking with most of the CRNA’s, now that they understand the circumstances, they are able to move beyond the hurtful words that had been tossed in their direction. We can all get back to the business of taking care of our patients, without having to worry about who should apologize to whom.

That is not to say that all issues are resolved. If it was the negotiation process that failed, then it is the process that needs serious re-examination. And Wheaton officials know that they were in charge of the negotiation process. Wheaton officials have to understand where they went wrong in this whole affair, and remain accountable so that it does not happen again. Up front, fair-minded negotiations will lead to more favorable results than the hard-lined, ultimatum-driven, corporate style they are used to. I think they know that now, but they may need reminding now and then.

Dennis Andersen, MD