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What’s Happening

For 37 years, Southeast Anesthesiology Consultants (SAC) has collaborated with Atrium Health (formerly Carolinas Healthcare System) by delivering the depth and breadth of services necessary to meet the increasingly sophisticated demands at Carolinas Medical Center and its other hospitals. This partnership has delivered tremendous benefit to both organizations and the hundreds of thousands of patients and communities both organizations serve.

Despite this long history, Atrium recently notified us that it will not renew our contract to provide professional anesthesia services which expires on June 30, 2018. The decision is the culmination of protracted discussions characterized by the system’s aggressive business tactics and desire to drive down costs at the expense of our practice and, potentially, high quality patient care.

A major concern of ours is Atrium’s intention to adopt a radically different way of delivering anesthesia services, based on a greater reliance on Certified Registered Nurse Anesthetists (CRNAs). Anesthesiologists would supervise CRNAs at significantly higher ratios than under the existing medical direction model. Under this model, one of our physician anesthesiologists oversees no more than four CRNAs in providing services in Atrium Health operating rooms. It would also have CRNAs performing certain procedures at some sites without an anesthesiologist present. While we believe in allowing our CRNA colleagues to perform “at the top of their license,” the proposal sets a dangerous precedent by allowing non-physicians to set standards for medical care.

The new model:

  • Could seriously jeopardize patient safety and the ability to deliver optimal outcomes. Already functioning at appropriate capacity, SAC physicians would see their supervisory load increase by 50% or more. These and other changes will affect the ability to respond to patient emergencies effectively and otherwise provide proper oversight and care.
  • May lead to a reduction in the availability of certain anesthesiology sub-specialty services.
  • Make it more difficult to recruit and retain top-notch medical talent to North Carolina.
  • Increase legal liability for medical facilities, surgeons, the CRNAs and other providers.
  • Threaten the economic livelihoods of our physicians. Atrium’s proposal would result in a 25% reduction in our roster of full-time doctors.

Why You Should Care

Setting the standard of care
Atrium’s proposal sets a dangerous precedent where business managers rather than physicians set the standard for medical care. The system’s drive to have lower costs, higher profits and total control is having far-reaching and negative effects on doctors and their ability to make clinical care decisions for their patients.

Patient safety
SAC has a strong reputation among surgeons, radiologists and the broader medical community for excellent care, which has been delivered in a consistent and reliable manner. Atrium’s proposal could jeopardize patient care and safety during surgeries and other high-risk scenarios when the training, experience and expertise of highly trained, board-certified anesthesiologists are needed most.

Quality outcomes
SAC has a proven track record for enhanced efficiency and cost effectiveness in delivering care. Our quality improvement program has dramatically reduced the risk of errors, post-surgical infections and other complications compared to other anesthesiology practices nationally. This has resulted in improved patient outcomes AND major cost savings for hospitals.

Attracting and retaining talent
Atrium’s aggressive business behavior has led to excellent medical practitioners losing their livelihoods and leaving the state. This makes it more difficult to recruit and retain talented physicians to the region. If SAC and other practices are put at risk by the system, communities across North Carolina will have a more difficult time building their medical communities and advanced care offerings.

Community impact
Atrium is jeopardizing our doctors’ ability to live and work in Charlotte and the other markets that we serve. Aside from being highly credentialed and experienced practitioners, our 86 physician anesthesiologists are community members and leaders with families. Many have lived and worked together in the area for decades.

Additionally, SAC has been one of the area’s leading medical practices for nearly four decades. Our philanthropic support helped build Levine Children’s Hospital (LCH) and the Ronald McDonald House in Charlotte. Our physicians have also helped lead efforts to combat abuse of prescription pain medications, a growing public health problem in North Carolina and nationally that accounts for thousands of unintended deaths annually.

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