Editor’s Opinion: A Case of Deja Vu

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It was the summer of 1985. Rebecca, my wife, was eight months pregnant with our third child. Dr. Tom Kinney and I, friends from our residency at Akron General Medical Center, had been the co-chairmen of the emergency department at Mansfield General Hospital in Mansfield, Ohio for the last two years. We had labored tirelessly for two years to build a staff of residency-trained ER docs. In addition to recruiting an entire staff, we had designed and oversaw the building of a brand new ED. Care had improved. Lives had been saved. All seemed bright…to us. True, there had been strong resistance from a segment of the medical staff that preferred the old ways. But with support from the hospital board, administration and a majority of the medical staff it seemed that we had weathered the storm.  But now it was time to negotiate a renewal of our contract.

The board offered a contract that had more risk on our part and a guarantee that was significantly less than we were currently making. I was insulted. I was hurt. I felt that the board and administration had not appreciated all the work we had done, the grief we had taken from the naysayers, or the improvements we had brought to the hospital. For them, it was just business. They had a bottom line to deal with and portion of the medical staff that they had to appease. For me it was personal.

We made a feeble attempt at brinkmanship. “If you don’t make a better offer, we’ll all just leave. And then where will you be?” we said. But as the last days of the contract approached we heard that another group had been approached. We felt betrayed by our brothers-in-arms. How could they do that to us? Our entire group left the ED at midnight on the last day of the contract, angry and resentful, with the nurses crying, fearful of the future, blaming everyone but ourselves. But the hard truth that took me years to reconcile, was that we left a contract on the table.


It wasn’t a great contract. But it was better than the one I finally accepted at another hospital, after dragging my pregnant wife all over the country. Everyone on the staff found jobs. We ended up selling our house at a huge loss. But life worked out for us. Maybe it was even better. But it didn’t have to happen the way it did.

Tom Kinney is still a great friend and we talk from time to time. Recently we discussed the debacle at Akron City. Certainly we don’t claim to know all the facts. But we both agreed that the feeling was eerily familiar.

Click here to read more from the Deal Breakers: The Summa Story series.



FOUNDER/EXECUTIVE EDITOR Dr. Plaster has been an emergency physician for more than 30 years, working exclusively night shifts for the past 20 years in emergency departments across the country. During that period, he joined the U.S. Navy and served two tours in Iraq. Dr. Plaster is the founder and executive editor of Emergency Physicians Monthly and the founder of Plaster Publishing.

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  1. Mark…

    I’ve seen the same thing happen here in Texas. It’s always best to remember that if you are an emergency physician, no one with administrative decision-making power is ever your friend when you are part of a contract group. No matter how well-oiled your emergency department machine is, no matter how good you think your rapport is with the administration, your employment is always constantly negotiable to someone. I practiced for over 35 years and experienced numerous changes in contracts and buy-outs. I would caution anyone going into emergency medicine from thinking that once settled in a great practice in an ideal location they are ever “set for life” with a great group and a great hospital. As the physicians in Akron discovered, great things can come to a very abrupt end and without any warning. Always keep your options open.

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