Dive Brief:

• California physicians are fighting a plan by Tenet Healthcare Corp. to put an outside staffing firm in place to manage physician contracts, rather than having the contracts remain in place between the physicians and the hospital.
• The new plan would put a national staffing firm in place for managing inpatient care such as emergency medicine, anesthesiology and hospitalist services at up to 12 Tenet hospitals.
• Local professional societies, for their part, argue that this decision could result in some doctors losing their jobs if the new organization doesn't offer them a contract. They also suggest that the new staffing firm might offer doctors lower rates than they currently have in place with the hospitals.

Dive Insight:

In reality, the change doesn't affect a massive number of physicians. About 33 contracts stand to be affected by the current proposed change, according to the California chapter of the American College of Emergency Physicians. But it's easy to see how a national staffing organization might handle the contract between hospitals and physicians differently than before, and possibly to the detriment of a much larger panel of physicians if the change goes nationwide.

Doctors predict that the $15 million Tenet would save by moving in this direction would come not just from lowering rates with doctors, but by sharing profits between lucrative and less-lucrative specialties. For example, profits from higher-margin emergency department care could help pay for hospitalists rather than being returned to a local physician practices.

Perhaps in the face of widespread national publicity over the matter, Tenet seems to be backing off its original plan to put a single contract in place across the chain's Western region. Tenet recently said publicly that it was "never our expectation or intent that are hospitals would choose to move to a single source for these services." 

Tenet notified its Sierra Vista Regional Medical Center in San Luis Obispo, CA, that it was considering the change in May, but no moves have yet been made. 

"Both the [Sierra Vista] Governing Board and Medical Executive Committee are in the process of providing their confidential evaluation and recommendation to Tenet's Regional leadership," a spokesperson from Tenet's Sierra Vista Regional Medical Center told Healthcare Dive. "To date, no decision has been made, nor will one be made, until a full evaluation is made based on this recommendation."