St. Anthony’s Medical Center Eyeing New Employment System for ER Docs

By Mary Jo Feldstein, St. Louis Post-Dispatch

Jan. 26–A proposal by St. Anthony’s Medical Center to no longer directly employ its emergency room physicians has left some of those doctors unhappy and looking for work elsewhere.

St. Anthony’s emergency room physicians are currently paid on an hourly basis by the south St. Louis County hospital. They can choose how many hours they work. They can also choose to work in the emergency rooms of other area hospitals, said Lois Kendall, a spokeswoman for the hospital.

For about a year, St. Anthony’s has been negotiating with its physicians to change this system. Most hospitals staff their emergency rooms using one of three models: employing the physicians directly; contracting with a third-party agency to provide physician staffing; or using a physician-owned group to staff the emergency room. Most area hospitals either employ their emergency room doctors directly or contract with a third party.

St. Anthony’s said it’s working with its emergency room physicians to move from the hospital-employee model to one of the other two. It expects a final plan will be reached in the next few months.

“No specific model has been chosen,” said Mary Sherfy, St. Anthony’s director of marketing. “The goal is to have the physicians find the model that works best for them.”

St. Anthony’s hopes this transition will help its emergency room doctors work more efficiently and cohesively, shortening emergency room wait times for patients.

While some physicians have embraced the idea of working for themselves in a physician-owned group, others have resisted it.

“It is a change for St. Anthony’s,” Sherfy said. “Change brings challenges.”

The fluid nature of St. Anthony’s employment arrangements with its emergency room physicians makes it difficult to quantify how many have left in recent months or will leave once the change is finalized. At least three emergency room physicians have cut ties with St. Anthony’s completely, though the hospital said not all left because of the pending change.

St. John’s Mercy Medical Center in Creve Coeur, which employs its emergency room doctors, has hired one full-time emergency room physician from St. Anthony’s and expects to add another, said Dr. Dennis Keithly, chairman of St. John’s emergency department. Five emergency room physicians from St. Anthony’s are transitioning to full-time, part-time or as-needed positions at Des Peres Hospital, which also employs its emergency room doctors, said Deb Wilke, a registered nurse and director of Des Peres’ emergency department. At least some of those physicians are continuing to work some hours at St. Anthony’s, she said.

As to why the physicians are making the change, Wilke said, “I don’t know specifics, but I know that they’re not happy.”

None of the physicians leaving St. Anthony’s could be reached for comment Friday.

mjfeldstein@post-dispatch.com

314-340-8209

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