How an Anesthesiologist Practice Found a New Home at Vituity

Shale Imeson

Shale Imeson , MD

Anesthesia Medical Director, Lodi Memorial Hospital

Published August 22, 2019

Anesthesiologist in surgery

Today’s demand for high-performing physicians is strong. Whether you’re a clinician looking for the right place to start or grow your career, or a practice seeking an affiliation to strengthen your market position, you have no shortage of options.

Learning from experience, Shale Imeson, MD, a Vituity partner and former President of Morpheus Anesthesia, Inc. (MAI), believes that the most effective way to find the right partner is to start with a clear sense of your goals. It also helps to narrow down your market by location and size.

Dr. Imeson’s anesthesia group in Lodi, California found its way to Vituity in 2016. In this interview, he describes that journey, the key considerations that made Vituity the right choice for his practice, and the benefits they have enjoyed from their affiliation.

To start with, can you tell us a little about your old group?

Imeson: We were founded over 50 years ago by four anesthesiologists from Stockton, Calif., and provided anesthesia services for Adventist Health Lodi Memorial and outpatient surgery centers across the region. We were one of the larger anesthesia groups in the area, with 15 physicians, and were always looking for new clinicians to join our team.

What prompted you to consider affiliation?

Imeson: Today, more and more practices are part of larger healthcare systems. To remain competitive, affiliation was part of our long-term strategy. We’d always had a great, highly functional group and strong relationships with our hospital clients. But we did see a few things on the horizon that we wanted to prepare for.

A big one was the rise of corporate anesthesia groups. We didn’t want to become employees of a large hospital system and lose our autonomy and the ownership we have over the care we provide. We realized that to keep our independence and compete effectively with those large systems, we needed greater resources.

Affiliation with a larger independent provider group made sense because it would give us more negotiating power with hospital systems and payers, more sophisticated technology for dealing with constantly changing government regulations and payment models, and greater economies of scale.

What options did you consider?

Imeson: We got into serious talks with a couple of larger groups. One was a local group that met the majority of our goals. But we found out they were planning to merge with a larger national group that was financed by third-party investors.

That was a red flag for us. Venture capitalists are buying up physician practices to make money, not to make a positive impact on healthcare. They promise impressive financial benefits to the practice owners, who gain in the short-term. But all physicians then become employees, and the new corporate owners reduce their pay to "fair market value" and take the difference as revenue. They don’t invest in innovation or pay competitive salaries to attract the best clinicians. In five to seven years, once they’ve increased the practice’s profitability, they sell it.

That definitely wasn't the future we were looking for. As physicians, we wanted a long-term affiliation that would make us stronger and more competitive and increase value for our hospitals and patients.

And of course, we wanted to create a great future for ourselves, too. We wanted to maintain a practice environment where we could enjoy great careers and fulfill our noble cause, so to speak.

How did you first connect with Vituity?

Imeson: Our practice administrator, Ruth Stephens, met one of Vituity’s anesthesiology leaders at a practice management conference. He was part of Vituity’s first anesthesia practice. He talked to Ruth about Vituity’s desire to grow that practice line. And Ruth, being a sharp character, sensed this might be a great opportunity for us.

We ended up attending Vituity's annual partnership meeting, and what we saw really blew us away. Vituity stood head and shoulders above the other groups we'd considered. It was almost exactly what I’d imagined as the ideal situation for our practice.

Why was Vituity the ideal choice?

Imeson: From the start, we felt that we shared the same goals and are driven by the same principles. And these are things that go back to the founding of both groups. Fundamentally, we believe physicians should lead the care of patients.

The industry has been evolving in such a way that more and more things come between providers and patients. Insurance companies and government regulators are intervening in those relationships. As physicians, we may have dropped the ball. We’ve given in when we shouldn’t have. We’ve failed to exert our influence when it mattered.

So, for us, joining Vituity is our way of picking up the ball and saying, "Hey, things are going to change. We know good medicine. And no third party is going to hold us back from delivering the very best care. In the long run, that’s how we’re going to do our best for our patients, our hospitals, and ourselves."

Even payers benefit when physicians are in charge. Because when incentives are aligned toward quality and efficiency, costs tend to go down.

After three years with Vituity, what impresses you most about the partnership?

Imeson: The fact that Vituity is physician-centered is key. As doctors, we’re patient-centered, but as a group, Vituity is committed to helping clinicians have a great experience and a great career. They are more supportive of clinicians than any other group we looked at. They value every partner’s opinions and needs, treating everyone as a vital and important part of the organization. And they’re responsive to opinions and needs. Benefits like leadership training, innovation grants, and job security are unique in the industry, which helps us attract better clinicians, even in semi-rural Lodi.

One of the best examples of the power of our affiliation is the way Vituity went to bat for our practice when we were faced with a Request for Proposal (RFP) from our main hospital partner, just months after we signed a new multi-year contract. We thought our contract was secure, so this was a devastating blow. We were put up against several other anesthesia groups for the hospital’s business and given a very short timeframe to complete the paperwork.

Vituity responded immediately and comprehensively to the RFP. They provided all the required details, did the math, and helped us negotiate. Vituity’s Regional Director and Lodi Memorial Medical Director had good relationships with the CEO, who realized that the RFP not only created disruption but affected the morale of all physicians in the hospital at a time when recruiting and retaining clinicians was challenging enough. We secured a new contract, and the whole process made us stronger and solidified our position with the C-suite.

What other benefits of the Vituity affiliation do you value?

Imeson: The democratic structure works extremely well for us. Every physician is an owner in the company, and every partner, even those in the organization's top leadership positions, must actively practice medicine.

As owners, we’re given a number of opportunities to improve our business acumen and leadership capabilities. We have one general partnership meeting and three symposia annually, which all physicians and advanced providers are invited to attend. These are opportunities to meet fellow partners and learn new business concepts, including the latest ideas in marketing, recruiting, and quality initiatives. For physicians like me, who practice in small communities where business practices aren’t always as sophisticated, this is a time to ensure our relevance in a changing healthcare environment and add value for our hospital partners.

Without being part of Vituity, I know I wouldn’t have access to this level of inspiration or any of the other leadership training opportunities it provides.

Speaking of inspiration, have you taken advantage of Vituity innovation grants ?

Imeson: Absolutely. We try to tackle at least one innovation project a year.

Todd Primack, one of my partners at Lodi, led a multi-site effort to produce a professional six-minute video on the OB epidural experience for expectant parents. Funds from a Vituity innovation grant paid for professional videography, editing and production, which was completed with the help of Vitutiy partners from multiple anesthesia sites. It was a real team effort and produced a marvelous educational tool that is now used across the enterprise.

This is just one example of how medical practitioners, who know best practices and understand patient needs, are encouraged to innovate. Rather than asking us to adopt innovations developed by business experts, Vituity gives us a way to respond to our own patients’ needs in a meaningful way and spread our best practices throughout the organization.

Do you feel your practice is more profitable today because of your affiliation with Vituity?

Imeson: No question about it. Because of its size and reputation, Vituity has negotiated contracts with almost every major payer in our practice locations. This is huge for the hospitals we serve, who want to help patients avoid surprise bills. And it helps us get the reimbursements we deserve.

Between the size, momentum, and abundance of resources, Vituity is making quite an impact on the physician services marketplace. We’re happy to be a part of such a strong and caring organization.

To learn more about the benefits of partnering with Vituity, visit our Anesthesiology Solutions page.

Partnering to improve patient lives

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