Anesthesia docs: We’re new and improved

If a commercial jet crashes, how likely is it that you will book your next flight on that airline? Not too likely, unless you’re one of the intrepid travelers who believe those planes will be even safer with the extra scrutiny that comes after an accident.

Anesthesiologists working at Enloe Medical Center don’t use that analogy to describe the situation they’ve been facing, but the parallel is clear.

Following three patient deaths in surgery, an outside inspection team scrutinized Enloe’s anesthesia and surgical procedures. This reignited debate about Enloe’s wisdom in severing ties with its long-time anesthesiologist group and forming one of its own, which struggled to enlist physicians and was forced to rely on locums tenens (traveling doctors).

Several of the anesthesiologists who’d made Chico home decided they’d had enough. They convinced the hospital administration to award them the service contract, which took effect March 1, then undertook the task of recruitment.

Their incorporated group, Northstate Anesthsiology Partners, started off with five doctors. Now it has 10 under contract, two more with contracts pending and two others who have agreed to join them—along with a stack of resumes from intriguing candidates. Since 14 is the number of anesthesiologists Enloe needs, NAP has met its goal in under two months.

“It’s gone much faster than we thought it would,” said Dr. Michael Hieb, NAP’s president and a member of its three-officer board.

Two of the new doctors are particularly notable, since they actually are highly respected former staffers. Barry Johnson and Diane Gill were members of Anesthesiology Associates of Chico, whose failed negotiations led to their ouster last May by then-CEO Dan Neumeister, who then resigned when the medical staff rebelled. Johnson will join NAP in early May; Gill, an outspoken opponent of Enloe who reluctantly left Chico for a job on the East Coast, has an ETA of Aug. 15.

A third AAC alum, Roger Phillips, is due back June 1. NAP also lured Harvard-trained anesthesiologist Juan de la Riva from Roseville and former Naval Medical Center practitioner Orlando Ricci from Southern California. Ricci has worked weekends at Enloe; he’ll move here in July.

NAP also has contracts out to an anesthesiology resident who hails from Oroville and a critical-care anesthesiology fellow at Stanford.

Already in place are Hieb, Jenifer Henrie, David Bernard, Victor Werlhof and A. Duane Menefee. The inclusion of Menefee may raise some eyebrows, since he led the failed Medcorp group that NAP usurped, but he does not hold a leadership position. Henrie, as secretary, and Bernard, as treasurer, complete the inaugural board.

What distinguishes NAP from Medcorp is structure. Medcorp received a contract from Enloe and brought in independent contractors. “That’s not a really good model for physicians,” said Hieb, who came to Chico six months ago when Medcorp was in place. NAP, by contrast, is a corporation in which each of the 14 members has a stake.

“We’re offering competitive financial and benefits packages with the rest of California,” Henrie said, “and we’re offering equality—equal choice of cases, equal monetary incentives and an equal voice.” (After a short evaluation process, new doctors get an equal vote as well.)

The “P” in NAP is particularly significant: “Partners defines who we are,” Henrie said. That appeals to doctors.

So to people who may think NAP “probably is just taking anyone” to fill vacancies, Hieb says, “that’s not true. We’ve turned away handfuls of people who just didn’t meet the standards we set.”

Those standards apply to the locums still at Enloe. Hieb and Henrie say they have tightened oversight and expanded review of cases, to the extent that some of the doctors feel like they’ve returned to residency.

NAP is keenly aware of apprehension in the community. Akin to Enloe CEO Debi Yancer’s pledge for openness, the group is readying a Web site with information about its members and is working to create a system in which patients will know which doctor will provide their anesthesia four or five days before surgery (as opposed to the current 24-hour notice).

“People will take their business to another hospital,” Henrie said, “but if you look at the credentials of the anesthesiologists at Enloe [now], they’re equal to the credentials of any group in California—Stanford, Loma Linda, Johns Hopkins.”

So they’re also smart enough to know that many critical eyes are watching them.

“There has been a lot of media attention,” Hieb said. “It is safe to have anesthesia at Enloe. We’re doing everything we can to make it safe as possible. You don’t have to worry about care here.”