The emergency room doctors at Ascension St. John in Detroit were focused on just getting through a massive ransomware attack that hobbled one of the largest health systems in the U.S. for weeks, when their bosses told them to join an unexpected Zoom call in early June.
The message from TeamHealth, a national physician staffing company that says it employs some 15,000 doctors and is owned by private equity giant Blackstone, was short and to the point. “They got on a five minute Zoom call, said ‘We have lost the contract with Ascension. Good luck and Godspeed,’” recalled Dr. Michelle Wiener, one of the ER doctors at Ascension St. John. “So it took us a few days to even figure out who was taking the contract and what that meant.”
What it meant was that a new company, Independent Emergency Physicians (IEP), would be taking over for TeamHealth. And that the ER doctors, who unionized last year and held a one-day strike in April as they negotiated with TeamHealth for a new contract, suddenly learned they would need to reapply for their own jobs. “There's definitely a level of stress that goes with that,” Wiener said on Michigan Public's Stateside Wednesday.
But they were not, Wiener said, sorry to see TeamHealth go. With the rise in healthcare consolidation, many of the major staffing companies are now backed by private equity, and it’s led doctors to feel “like we're being bought and sold like cattle,” she said. Wiener and other Ascension St. John doctors say TeamHealth slashed staffing levels, with patients sometimes having to wait 15 hours or more to get care.
It’s why the ER doctors decided to unionize last year, Wiener said. “This is something that is really gaining momentum as we're trying to find our voice against these huge private equity firms that could crush us. I mean, we're 42 doctors, going up against Blackstone. And so this was the only way to really protect ourselves and be able to advocate for ourselves, as well as patients.”
(TeamHealth denied these claims, saying the median door-to-doctor wait time at the ER had dropped to just 15 minutes.)
Ascension told TeamHealth that “effective August 31, 2024, TeamHealth will no longer provide services at any of the six Ascension Detroit sites we currently staff,” according to an emailed statement attributed to TeamHealth VP of Communications Josh Hopson. “While disappointed … TeamHealth will do everything in our power to facilitate a smooth transition so that patients in the Detroit community can receive the urgent care they need without interruption.”
A spokesperson for Ascension did not respond to questions about why TeamHealth’s contract was ended, how many employees would be impacted by the change, and whether the new contract would be recognized by Henry Ford Health, which is expected to take over ownership of Ascension St. John as part of a $10.5 billion “joint venture.”
“Ascension St. John Hospital and TeamHealth have been in ongoing discussions regarding our professional services agreement for the provision of emergency medicine physician services that expires August 31, 2024,” the spokesperson said via email. “Unfortunately, an agreement has not been able to be reached, and we have made the decision not to renew our agreement once it expires.
“There are no immediate operational changes and there will be no gaps in service. Ascension St. John Hospital will be transitioning to another established physician services provider utilized elsewhere in Ascension Michigan on September 1, 2024.
“We are grateful to our TeamHealth emergency medicine physicians for the safe, quality care they have provided our patients, and will continue to provide over the next three months. We are committed to ensuring a smooth transition upon the expiration of the agreement.”
It’s not clear yet whether the Ascension Detroit ER doctors, some of whom have worked there for decades, will still have their jobs come September 1.
“We work at a Level I Trauma Center, and what that means is that that is the highest level of care that you can receive,” Wiener said. “We are the second-busiest ER in the state of Michigan. We serve a very diverse community, because we have Grosse Pointe on one side and Detroit on the other. … Everybody has a lot of grit. And we love our job. We love the community that we are in and nobody intends on leaving.”
Still, they’re cautiously optimistic. Unlike TeamHealth, which is based in Tennessee, IEP is at least based in Michigan. It has contracts with Ascension hospitals in Southfield, Novi, and Rochester, plus Henry Ford Allegiance Health in Jackson and Trinity Health St. Joseph Mercy Oakland in Pontiac, according to the company’s website. And it’s been getting into the growing urgent care business, buying up two Healthy Urgent Care centers in Novi and Southfield in 2019 and currently operating eight urgent cares in Southeast Michigan and Jackson.
A spokesperson for IEP didn’t answer questions about doctors’ concerns over whether they’d be able to keep their jobs, how the company would negotiate with the union, or what IEP would do to improve staffing levels and decrease ER waiting room times.
“We are excited to expand our 27-year partnership with Ascension Health,” an IEP spokesperson said via email Wednesday. “IEP’s priority is providing the best emergency care for our patients and the hospitals we serve. IEP is owned and led by local emergency medicine physicians right here in Southeast Michigan and our purpose is to take care of the patient by taking care of the provider.”
