Managing Cardiac Call Coverage – Employed Provider Dilemma

Due to the changing reimbursement environment and aging population, independent cardiologist practices have been failing within the south Florida market. In an effort to stabilize their cardiac surgery programs, large health systems have chosen to quickly employ cardiologists, interventionists, and cardiothoracic surgeons. To further complicate the equation, cardiologists have been leaving the region for stable markets where cardiologists can still practice within independent practices. Due to the lack of cardiologists within the region, interventionists have been forced to spend more time in the office with less time performing procedures. This imbalance has prompted health systems to scramble to protect their operating margins supported by cardiac surgical programs.

Managing the largest cardiac surgical program within the region, St. Peter’s Health System recently employed two of the largest independent cardiologist practices within its primary market. Both practices were combined within a single Medical PC which is a subsidiary of St. Peter’s Health System. If managing the dynamics of bringing two competing groups under one organization did not create enough challenges, the senior cardiologists and interventionists have approached St. Peter’s Chief Medical Officer requesting they no longer should be required to take call coverage and will only perform scheduled procedures. Knowing pushing all call coverage to the younger physicians will cause burn-out and increase turnover, administration is searching for an equitable solution. Compensating providers to take call will create inequities across the various employed & independent specialists and ultimately will increase operating costs.
How should St. Peter’s manage this request?

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