Conflicts cause splits between hospitals and doctors in Maine, Minnesota

Infant
Neonatologists from one medical practice are leaving a children's hospital in Minneapolis in a disagreement over employment status. (Blake Farmer/WPLN)

Conflicts between doctors and hospitals are nothing new. But in some states, including Minnesota and Maine, they have escalated to the point where physicians are choosing to leave their respective institutions. 

At Children’s Minnesota’s Minneapolis children’s hospital, neonatal doctors who work at a medical practice are planning to leave at the end of the year to practice elsewhere, according to the Star Tribune.

The doctors from Minnesota Neonatal Physicians are planning to leave the Minneapolis hospital after it unsuccessfully tried to switch the physicians from private practitioners to hospital employees, the newspaper said. The doctors are instead moving to expanded neonatal intensive care units (NICUs) at two Minnesota hospitals: Maple Grove Hospital in Maple Grove and North Memorial Health in Robbinsdale.

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The hospital’s CEO, Marc Gorelick, M.D., told the newspaper the move was necessary to make the hospital more cost-efficient and improve the quality of care. The doctors said they were being asked to give up too much control over how they practice. Both disagreed about the consequences of the loss of the medical group, which helped build the hospital’s neonatal program.

RELATED: Doctor departures—The financial and emotional impact to a practice

Gorelick said the hospital will be able to attract new doctors willing to work as hospital employees based on the size and reputation of the hospital’s NICU. Jeanne Mrozek, M.D., medical director of the practice, said the hospital will have a tough time replacing the group’s expertise. The move to make physicians hospital employees is a growing trend, and the majority of primary care physicians are now employed.

Things are contentious between the two parties, as the group practice filed a lawsuit earlier this summer against Children’s Minnesota accusing a board member of telling people that the neonatologists accepted kickbacks in exchange for sending patients to specialists.

It may be part of a growing trend of physicians pushing back against efforts by larger systems to consolidate that includes an exodus of at least 100 doctors from Charlotte-based Atrium Health earlier this year. "I wouldn't be surprised if more large, multispecialty physician practices found ways to remain independent of, or break free from, hospitals," Barak Richman, J.D., Ph.D., a Duke Law School professor specializing in healthcare policy, told the Charlotte Observer.

In Maine, about 80 of 300 doctors at Central Maine Healthcare have left in the past fiscal year, according to the Sun Journal. The healthcare system is the corporate parent of Central Maine Medical Center, hospitals in Bridgton and Rumford and medical practices located in 15 communities.

Last month, medical staff at all three hospitals issued votes of no confidence in the health system’s CEO, Jeff Brickman, the newspaper reported. Last week, its board of directors affirmed support for Brickman, who was hired two years ago to turn around the financially troubled health system, but the board changed its bylaws to give doctors more of a say in how things are run. The day after that board vote, the president of the Bridgton and Rumford hospitals resigned, the newspaper said.

Unhappy doctors have been leaving the system, going to work elsewhere and some moving up their retirement date. At the heart of some of the morale problems is that at least some doctors have been required to see more patients, with one anonymous person saying that the patient load increased in one office by about 50%, the newspaper said. In addition, the system added a new electronic health records system.

Healthcare system officials blamed necessary cuts, new systems and a move to standardize physician pay and employment contracts for many departures, but say the high rate of turnover is starting to turn around, the newspaper said.

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