In less than two weeks, a big change is coming to Atrium Health as a new group of anesthesiologists begins working at most of the system's Charlotte-area hospitals.
Atrium says it's confident the transition will go smoothly and that patient safety will not be compromised when the change begins July 1. Charlotte's dominant hospital system will replace a provider it has used for almost four decades with a new company formed in January.
For months, Charlotte residents have been watching the buildup to the move unfold in a rare public fight between Atrium and outgoing vendor Southeast Anesthesiology Consultants. The two companies have hurled insults at each other in newspaper ads. Southeast also has taken out billboards and radio ads.
Dr. Thomas Wherry, an anesthesiologist who founded the new company, Scope Anesthesia of North Carolina, says he's hired enough doctors to be fully staffed to serve the Atrium hospitals. Those are Cleveland, Kings Mountain, Lincoln, Mercy, Pineville, Union and the system's flagship location in Dilworth, as well as Levine Children's Hospital and Levine Cancer Institute.
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Wherry has spent recent months recruiting doctors to Charlotte. He said his new doctors began meeting this month with Atrium's nurse anesthetists and surgeons to prepare for the change. And he praised Atrium's process for integrating the new physicians into the system.
Southeast, an affiliate of Florida-based Mednax, claimed Atrium is jeopardizing patient safety by bringing in "an entirely new team of anesthesiologists who have never worked together." Southeast and Mednax have sued Atrium and Wherry over the lost contract and are seeking a temporary restraining order against Wherry's firm while the suit winds through court.
Atrium has said it dropped Southeast in part because Mednax rejected steps to lower anesthesiology costs while maintaining the same level of patient care. Atrium has also accused Southeast and Mednax of a fear-mongering campaign and is countersuing them for defamation.
In a court filing this month, David Lebec, a division medical officer for Mednax, insisted that Scope won't be able to operate at Atrium without using data and models developed by Southeast and Mednax.
"Even then, the only way a defectively designed and implemented anesthesia model could work as of July 1, 2018, would be for Atrium to voluntarily reduce the number of anesthetizing locations and limit the complexity of procedures," Lebec said.
Atrium refutes such claims and says it's not planning any reductions in how it offers care.
The ability to provide surgeries, including transplants, will also not be affected by the change, said Dr. Brent Matthews, chair of Atrium's surgery department.
"Our expectations on July 1 are that we can provide the same level of service that we're providing today," he said.
Mark Warner, president of the Anesthesia Patient Safety Foundation, said that in general, major transitions in health care teams increase the need for special attention to patient safety. He declined to comment on the Atrium development.
Transitions can be done successfully if they are carefully planned, and new teams can bring fresh perspectives and promote potential changes that can improve safety, said Warner. But it also takes time to develop highly functioning teams.
"So the real question is what efforts are planned to mitigate against any increased potential for patient harm during a transition," Warner said.
Atrium says steps it's taken to ensure a smooth transition include conducting drills with the new doctors and Atrium's nurse anesthetists — specialists trained to administer anesthesia under the supervision of a physician.
Such nurses have also been involved in interviewing Wherry's recruits, said Diane Blanchfield, who leads Atrium's team of 350 nurse anesthetists in the Charlotte region. Those nurses will still be with the system on July 1, she said.
Also, for three months each anesthesiologist will be partnered with a nurse anesthetist to help transition the new doctors to Atrium, Wherry said.
Scope will have close to 80 doctors, including full- and part-time positions, Wherry said. Southeast has said it has about 88 physicians.
Scope's hires are highly skilled anesthesiologists from across the country who are an average of about 51 years old and have 17 years of experience, Wherry said.
"Any hint or suggestion that anything's going to be less than 100 percent safe is patently false," Wherry said.
Years to build
Not everyone is convinced it's a good move for Atrium.
Duncan Morton is a retired pediatric surgeon who has been a big supporter of Southeast.
"I can't imagine a safer group than Southeast Anesthesia," said Morton, who estimated he's performed hundreds of operations at Atrium with Southeast's anesthesiologists.
Atrium is getting rid of a team of specialized doctors that took years to build, and replacing it with a large group of anesthesiologists formed in only a matter of months, said Morton, a former consultant for Atrium rival Novant Health.
"That's one of the real big issues: you don't know the skill set or weakness set of each individual person. They have no time for vetting. None," Morton said.
But Mark Swanson, another retired surgeon who worked at Atrium facilities, said patients should not be concerned.
"July 1 is not the great apocalypse," Swanson said, noting that he never experienced problems operating with anesthesiologists with whom he'd never worked before.
He said he expected the transition to go smoothly.
"Will it be absolutely without a blip? No. Will people die because of this transition in anesthesiologists? I do not believe so," he said.
Impact on bills
One thing that remains unclear is what will happen to anesthesiology costs for patients once Scope takes over.
Atrium says it expects care to be cheaper under Scope because, unlike Mednax, it is not a publicly traded company that faces shareholder pressure to increase profits.
Also, Atrium said it expects to have more transparency into, and control of, costs under Scope.
When asked how bills might change, Atrium Chief Operating Officer Ken Haynes did not provide specifics.
"It's affordability over time, and there'll be times when the patients will see their bills go down," he said.