Dominic J. Bagnoli, Jr., MD, FACEP, FAAEM, serves as chief executive officer of US Acute Care Solutions (USACS), overseeing the strategic direction the company.
EPM: A common thread from SEA executives is a mistrust of Summa leadership, specifically the problem of conflicts of interest, since Summa’s Chief Medical Officer, Dr. Vivian von Gruenigen, is your wife. How do you respond to those suggestions?
Bagnoli: “I am married to the CMO, who trained there, who worked there, who was the Chair of Women’s Health for eight years; who had the highest quality metrics in the State and was on the Board of Directors and then applied for the CMO job and started it six months ago. That’s fact. We never talked about business. She was not involved in any of the [USACS] negotiations. The only interaction I had with her around this contract was on the 24th, where she said: Tom’s going to call you. I hung up that phone call and started to say, “can you believe…” and then she goes, “I’m not talking to you about it.” And that’s the way our discussions went because she is the most principled, ethical person. I mean, she’s way better than anyone I know. And she’s getting dragged through the mud because why? Because she’s a female and she has a job and she happens to be married to a guy who runs a big business. Okay, but that’s all she’s done wrong. And it’s unfair to her. And these people, there’s been an outside counsel investigation of conflict of interest, that has been completely shown: no conflict, no impropriety. The Board is doing a second one. I mean, they are looking at all of this. There is nothing there. They’ve looked at all the emails. There’s nothing. There’s nothing to show that and there was nothing.”
EPM: Should you have done more to defend SEA as an independent group, perhaps turning down the contract in order to send a message to Summa leadership?
Bagnoli: Our mission is to care for patients. And if a health system tells us that the docs are going to walk out on patients, we’re not going to standby and allow that to happen – if we could help. This happened to be in our own backyard and locations where our employees seek care; where many of our employees have friends and families that work in the system and have patients that go to those facilities. And three of the facilities, Medina, Barberton and Wadsworth, we had docs who had worked there for five, ten years. So from our perspective, if they couldn’t work it out, we had to step up and help. I got the [final]call at 5:00pm on December 31st. Tom Malone said: Well, I need you. And I said: What happened? He said: We offered them a deal. They refused it. And we offered an extension and they also said no. And so they’ll be leaving. And we said: Okay. And we showed up.
EPM: As EMP you were a “big small group” and as USACS you’ve become “a small big group”. In the narrative of this story, you’ve been painted as the large corporation fighting against the local, independent group. How does that strike you, given your background at EMP?
Bagnoli: The groups that have joined us from around the country still have physician ownership. Because before we formed USACS, you had two choices: stay the course and take whatever risk comes your way – the SEA story is a good story about that; or sell to TeamHealth or EmCare and become an employee. That’s really what your choices were. USACS is a third alternative: Join us, become owners of USACS with other physicians across the country and continue to drive quality and physician ownership and create an environment where that can sustain itself long term in the market. That’s our entire strategy: finding the best physician-owned groups and saying, Join us and together we’ll own the company.
EPM: What have you done to insure that the residency program is taken care of, and that there’s a smooth transition for the residents?
Bagnoli: When we showed up on January 1, the only surprise we got was all the residents were gone. The previous group instructed the residents to go home for a month of home study . . . We met with the residents two days later, and on January 3rd, they started to cover their shifts as they normally would. And we started to work with them. We appointed a program director, who was approved by their appropriate committee on January 5th. He started on the 8th and spent his first week meeting with every resident, making sure everyone’s on board and doing all their work. So in a week the residency was back, alive and working. We’ve identified ten core faculty. We’ve offered jobs to every core faculty in SEA. But none of them have chosen to come back.