Hospital cancels pact with doctors

All 20 anesthesiologists who work at Northwest Hospital & Medical Center said they were simply looking for fairness and respect when they recently went to management and asked for more than $2 million.

They said they just wanted the CEO to make up for telling them they were doing a lousy job.

Instead, late last week the North Seattle hospital responded by canceling their contract — essentially firing them all.

Late Wednesday the sides said they were reopening negotiations and the hospital head said he hoped to reach an "amicable solution." But if not, the bitter breakup could mean the hospital would have to scramble to find enough specialists, possibly meaning delays in surgeries.

And for all but a few of the snubbed anesthesiologists, it could mean scrambling to find new jobs.

"These are very good doctors ... we wish they'd stay," Northwest CEO Bill Schneider said. "But we don't wish they'd stay enough to pay them money we don't have."

Responds Dr. Scott Norquist, the president of the anesthesiologist group: "The whole thing wouldn't have happened if he hadn't been so rude to us. We weren't even looking for more money — we just wanted to be treated fairly."

Meeting with CEO

The seeds of the breakup were sown about three months ago, when Schneider called a meeting with Northwest Anesthesiologists, the company that has contracted with the hospital for more than a decade to provide anesthesia services.

Under the arrangement, those doctors get exclusive rights to provide anesthesia to Northwest patients, and to bill the patients or their insurers.

Many hospitals contract with doctors to provide services inside the hospital, from emergency-room coverage to care for inpatients. But as doctors increasingly balk at providing services hospitals once expected for free — such as on-call coverage or coordination of services — the financial negotiations between the two sides have become more testy.

According to Norquist, Schneider announced at the meeting he was renegotiating the hospital's contract with the group, and told the leaders the anesthesiologists hadn't been performing well.

"It was so humiliating," Norquist said. "I've never been treated so badly in my life."

Afterward the anesthesiologists asked surgeons at the hospital to rate their performance, and the surgeons gave rave reviews, Norquist said.

When the doctors talked to other anesthesiology groups around the country, they found many were being paid more, he said. So they hired a consultant and negotiator to represent them at Northwest.

"We were very hurt and aggravated and scared," Norquist said. "We did what we thought we had to do."

The negotiator told the doctors they ought to be earning about $436,000 a year — substantially more than they were making. So they asked Schneider for a "subsidy," a lump sum of more than $2 million, for services the doctors said they had been providing the hospital for free — such as being on call for the hospital's obstetric unit, or coordinating anesthesia services in operating rooms.

The doctors figured the hospital would come back with a compromise, Norquist said. "Negotiation means to me that you start high, and go lower," he said.

But Schneider said the doctors' demand was simply exorbitant. And he strongly denies that he was ever rude or told the doctors they were doing a bad job. In fact, he said, he was "very courteous" in the original meeting, and has always had a "very good relationship" with the doctors.

But a "multimillion subsidy" was out of the question, Schneider said this week.

Talks start again

The doctors' contract is still in effect until the end of the month, and then the hospital will contract with a new group called Seattle Anesthesiologists, which will include at least three of the axed anesthesiologists.

"Anybody who wants to join this new group, we invite them to do so," Schneider said.

Meanwhile, on Wednesday some of the doctors reportedly were meeting with Schneider.

But Schneider said the hospital is prepared to rely for a while on temporary doctors, and he expects "no significant disruption of service, perhaps no disruption of service."

As the dust settles, Norquist acknowledges that all sides may have overreacted.

"We loved working there — all of us did," he said. "It was a great job."

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com