For 38 years I was a pediatric surgeon caring for the surgical needs of infants and children in Charlotte. I operated at Carolinas Medical Center (Atrium) and Presbyterian Hospital (Novant). I retired in June 2014.
On May 25, Hugh McColl wrote a guest editorial in the Charlotte Observer. He defended Atrium’s decision not to renew Southeast Anesthesia’s service contract which ends on June 30. He has cast the resulting public conflict between Southeast and Atrium as an issue of resistance to growth and change. A growth and change issue similar to the one he experienced while pressing for interstate banking changes. He simplifies the conflict as purely anti-growth.
He like other decision makers ignore the difficulties associated with developing a reliable quality service line in a hospital setting. The issue is not resistance to growth and change. Regardless of the valid issues of future reimbursement for services rendered, the cost of free care, the differences of a profit and non-profit organization and contractual costs, the crux of this conflict is Atrium’s willingness to discard a superior service line while stating they can replace and duplicate, all in a matter of days, the superior care provided by Southeast.
During my years of surgical practice I operated on infants and children day and night. Many of these children were desperately ill and remarkably small (less than 2 pounds). The specialized expertise of the pediatric anesthesia team was crucial for survival during these operative procedures. In 1976 skilled pediatric anesthesia was lacking in Charlotte. Subsequently I have witnessed the progressive growth of anesthesia expertise and specialization for patients of all ages and for all health conditions. This improvement was orchestrated by the anesthesia leadership at both hospital systems. It took years for Southeast Anesthesia to recruit highly qualified anesthesiologists and then develop the high level of care patients now receive at Atrium.
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This is not the first time Carolinas Medical Center has discarded a service line and recruited its own physicians. After joining James P. Hamilton MD in 1976, we partnered with Carolinas Medical Center to establish a first-rate pediatric surgery service line. Along with our pediatric colleagues, we introduced techniques and procedures that improved the survival of the newborn child with surgical problems. We recruited bright young pediatric surgeons to expand our knowledge, technical skill and expertise. We became the pediatric surgeons at the then newly established Levine Children's Hospital. Yet when negotiations faltered with CMC several years ago, CMC decided to replace us with its own recruited pediatric surgeons. Levine Children's Hospital’s recruitment efforts were nationwide. The replacement plan has not been successful. The recruited surgeons never duplicated the team care or organizational excellence that took years for us to develop.
No matter the medical specialty, building a team of specialized excellent caregivers requires years of diligent effort. For present and former leaders of Atrium to seemingly ignore this business fact is unsettling at best.