When you enroll in medical school, no one tells you that your practice will have two sides. One will be all the stuff you’re signing up for: healing patients, changing lives, making a difference, and working on the leading edge of science. You’re never explicitly warned about the other side, which involves working until midnight to finish your documentation, tracking and reporting quality data, recruiting new providers and staff, and endlessly renegotiating your rates with payers.
As a physician partner in a small independent anesthesia group, I’ve gradually watched the business side of medicine overtake the human side. My colleagues and I loved our patients and our independence. We really didn’t want to become corporate employees. But runaway complexity on the business side of medicine was taking its toll on our quality of life.
Fortunately, we found a solution. Joining Vituity, the nation’s largest multispecialty physician-owned partnership, solved our thorniest business challenges while allowing us to remain locally autonomous. In this article, I share how we made the decision to affiliate and what excites us most about this opportunity to deliver integrated, patient-centric care.
About Our Anesthesia Group
For over 30 years, Folsom Anesthesia Medical Group (FAMG) has provided exceptional perioperative care to Dignity Health Mercy Hospital of Folsom in Sacramento County, California. As a democratic physician-owned practice, FAMG is committed to clinical quality, innovation, and bringing the latest care advances to its community hospital patients.
In addition to providing anesthesia services for general and orthopedic surgery, obstetrics, and several specialist programs, FAMG also supports the region’s newest emergency department. In recent years, we have worked to bring advances such as regional anesthesia to Folsom.
“My colleagues and I loved our patients and our independence, but runaway complexity on the business side of medicine was taking its toll on our quality of life. Fortunately, we found a solution – joining Vituity.”
The Challenges of Anesthesiology Practice Independence
While my partners and I loved our independence and democratic culture, we definitely faced some challenges as shared owners. Running an anesthesia practice today is much more complex than it was 20 or even 10 years ago. Some of the emerging challenges we grappled with include:
- Recruiting. Even in our beautiful location at the foot of the Sierras, we had difficulty attracting top-notch talent to our community hospital practice. At just 11 full-time anesthesiologists, our group was stretched somewhat thin on the clinical side, which left even less time for the business of medicine.
- Contracting. Negotiating rates with payers involves time, legwork, and red tape. And with so many anesthesia groups consolidating into larger entities, our tiny partnership was at a disadvantage. What’s more, we knew that recently signed federal laws around surprise billing would make us even more dependent on effective contracting.
- Hospital relations. Our contract with Folsom requires us to meet ever-rising quality and patient experience expectations and collaborate with the hospital on initiatives. We knew that to be a good partner, we needed to create more bandwidth for hospital-focused activities.
- Physician quality of life. Due to increasing administrative burden and overhead costs, we found ourselves working harder while taking home less pay. And given industry trends, we worried that small independent groups like ours might eventually become unsustainable.
As much as we loved our independence, we decided to be proactive about our future. So we made a strategic decision to explore new options.
Affiliation with Vituity
At the decision stage, we considered many alternatives, from courting private equity to affiliating with a corporate anesthesia group. However, the choice kept coming back to culture. We all wanted to maintain our democratic values and autonomy over our local affairs. Fortunately, we found a solution in our own backyard.
Vituity, one of the nation’s largest democratic multispecialty groups, staffed the emergency and inpatient psychiatric departments at Folsom. I knew several Vituity anesthesiologists, including Vice President of Practice Development Michael Paige, MD, from my work at other Sacramento-area hospitals. Vituity quickly became the front-runner among our potential affiliation partners.
What eventually swayed our decision? First, we considered cultural fit. Like FAMG, Vituity is driven by clinical excellence but also genuinely cares about provider wellness and quality of life. Both also value democratic practice and ownership. Second, we knew that Vituity’s robust practice management arm would alleviate many of FAMG’s pain points, especially around recruiting and contracting. Finally, like all Vituity practice sites, we would remain locally autonomous and make most day-to-day decisions impacting our patients and partners.
We invited Vituity’s leadership to present to our group, and all our partners were impressed with their proposal. On August 1, 2021, after a surprisingly smooth onboarding process, we officially joined the Partnership.
Future Plans as an Anesthesiology Practice
One of our first goals with Vituity will be to right-size our practice. We’ve been impressed by Vituity’s national recruiting reach and relationships with anesthesiology residencies, and we are excited to be welcoming some new talent to Folsom this year.
As incoming medical director, I’m also looking forward to implementing some of Vituity’s proven care protocols. In a community hospital setting like ours, it’s common for anesthesiologists to have diverging methods and opinions about care. However, that's not always what’s best for patients. Vituity’s data focus and process expertise will help us improve care quality through self-monitoring and standardization.
We’re also excited to work more closely with our Vituity emergency medicine and psychiatry partners. Having multiple departments under the same umbrella will allow us to participate in Vituity’s proprietary programs, like the fragility fracture pathway. Relatively few community hospitals have access to this level of integrated care, and we’re honored to bring it to our patients.
Most of all, we look forward to having more time for what we do best: connecting with, caring for, and supporting our patients.
Originally Published May. 27, 2021