Anesthetist job fight reflects health outsourcing trend

Karen Bouffard
The Detroit News

Almost 70 Metro Detroit nurse anesthetists are set to be out of work Friday due in part to a nationwide trend in which hospitals are increasingly contracting out to private firms entire departments to trim costs.

Sixty-eight certified registered nurse anesthetists at St. John Providence Health System hospitals in Southfield and Novi expect to be out of a job because they didn’t agree by a 11 p.m. Thursday deadline to work for a private vendor instead of the health system.

Southfield attorney David Shea, who represents the group calling itself the “Michigan 68,” said nurse anesthetists were privatized at McLaren Macomb Hospital and Detroit Medical Center hospitals without acrimony because employees were included in the process. He said his 68 clients among the affected 74 St. John Providence employees were blindsided and given few, if any, details about the new firm.

Health care providers around the country have been consolidating and contracting out services to improve efficiency in the wake of the 2010 federal Affordable Care Act, which has put pressure on systems to reduce costs because of reductions in reimbursement rates for Medicare services.

St. John Providence anesthetists soon could be jobless

Nurse anesthetists at the Providence-Providence Park hospitals in Southfield and Novi were told in mid-October they had until the end of 2015 to apply for jobs with PSJ Anesthesia PC. The company was formed in October by Southfield anesthesiologist Dr. Dominic Lago of Northland Anesthesia Associates PC, a practice affiliated with the St. John Providence system.

“They were outsourced to a single anesthesiologist at Providence who opened his company two weeks before,” Shea said. “The contract was given to Dr. Lago to take over the entire multimillion-dollar operation.”

According to a St. John Providence statement, “Currently employed CRNAs are still being offered the opportunity to request transition of employment from St. John Providence to PSJ, with comparable pay and benefits. Their employment with St. John Providence discontinues Dec. 31, 2015.”

Greg Bozimowski, a certified registered nurse anesthetist at Providence Park Hospital in Novi and a professor in the University of Detroit Mercy graduate program of nurse anesthesiology, is among the 68 holdouts.

Bozimowski, who has been with the health system since 1989, said the salaries offered by PSJ are equivalent to what the health system has offered. But important language about scheduling, disability and bereavement leave, job security and other issues is missing from the PSJ contract.

Had employees been involved in discussions about outsourcing, they would have explored other options, such as forming their own corporation — an arrangement that has worked at other hospitals across the country, Bozimowski added.

“People are (expected to sign) these contracts and they don’t know what policies and procedures they’re working under,” Shea said. They’re simply too uncomfortable to commit their careers to this person they don’t know, so they’ve simply said, ‘no.’”

Sixty-eight of 74 nurses affected are fighting the plan. Average pay for a certified registered nurse anesthetist is about $180,000 annually, Shea said. Nurse anesthetists possess a bachelor of science in nursing and a master’s degree.

Certified registered nurse anesthetists have a minimum of seven to eight years of education and specific training in both nursing and anesthetics, which usually are used to produce loss of consciousness for surgery or given in small amounts to relieve pain or anxiety without a patient losing consciousness, according to the Michigan Association of Nurse Anesthetists.

The health system said in a statement that services will continue in the new year regardless of what the nurse anesthetists decide.

“All anesthetizing locations are 100 percent operational and will continue to provide safe and efficient anesthesia services after December 31, 2015, without any interruption in care,” the health system said in a statement released Tuesday, adding that no more information would be provided.

Bozimowski questioned why the nurse anesthetists weren’t privatized with an established anesthesiology practice, as has been typical elsewhere.

“Across the country, about 44 percent of CRNAs are hospital employees. The rest are employed either by corporations or self-employed,” Bozimowski said.

“They didn’t come to the CRNAs for any input at all, and they didn’t do any bid process to look at other corporations. (There is) really a lack of trust.”