The Alameda County Medical Center (ACMC) Board of Trustees voted last week to replace 45 staff doctors at John George Psychiatric Pavilion in San Leandro with contracted psychiatrists and physicians, but a motion for a preliminary court injunction filed by the employees’ union could scuttle the deal.
The John George facility provides psychiatric inpatient and outpatient services, psychiatric emergency services, and substance abuse treatment for Alameda County residents.
The board voted 8-2-1 to tentatively approve a 25-month $9.5 million contract with Pleasanton-based Becton Healthcare Resources for John George after ACMC CEO Claude Watts told trustees that the move would save the medical center $1.8 million over two years.
The decision affects 40 staff psychiatrist and five staff physician positions who currently manage inpatient care at John George. A spokesperson for ACMC said in a telephone interview that doctor employees at hospitals are now the exception rather than the rule, and that most hospitals contract out for services by doctors who are employed by physician associations.
Whether the contracted services will equal a reduction in staff is unclear.
In an accompanying letter to the board, Watts said that Becton currently provides oversight management for some John George services, and that an agreement with the company for all of John George care would “provide consistency in care and a single point of reference of patient care issues.”
But Trustee Dr. Floyd Huen of Oakland disputed the savings figure, saying that the “full cost of the proposed contract needs to be more fully investigated.” He said he feared a loss of inpatient coverage if the service contract is ratified.
“Even if it turns out that the Becton contract is cheaper, we don’t just want a cheaper contract,” Huen said. “We want one that works.”
Watts told Huen, “If you look at the individual line items on the Becton proposal, it looks as if their proposal would result in higher costs,” but said that the savings would come from Becton’s ability to consolidate services between the different portions of John George care.
Huen, the husband of Oakland City Councilmember Jean Quan, voted against the proposed contract along with Board President Dr. Theodore Rose of Oakland. Former Pleasanton Mayor Tom Pico, a new member of the board, abstained.
In a letter to the trustees, one of the John George psychiatrists, Dr. Judy Bertelsen, had said that the Becton proposal could not be trusted.
“Previous experience with Becton has involved contracting to provide services at a specified rate and then presenting ACMC with an emergency demand for large amounts of additional funds or threatening to pull out within 30 days,” she said.
The contract had been scheduled to begin on June 1 and run through June 30, 2007, but immediate implementation was blocked by court proceedings even before last week’s trustee vote was taken. On a motion filed by the Union of American Physicians and Dentists (UAPD) for a temporary restraining order against ACMC, Superior Court Judge James Richman ruled that the proposed contract could not be ratified until a June 7 hearing in Superior Court in Oakland.
UAPD attorneys are arguing that contracting out the John George inpatient services violates UAPD’s labor agreement with the County Medical Center. UAPD and ACMC are presently in the meet and confer process over the proposed Becton.
A UAPD representative told board members that it was “improper for the board to make a decision on the contract before the union and the center decide whether a contract should be let out.”
In its decision, ACMC trustees went against the wishes of a string of professional speakers talking against the contract, as well as a petition opposing the contract signed by 35 ACMC psychiatrists.
In their petition, the psychiatrists said they were “deeply troubled” by what they called the “rapid decision to contract out our services.”
One of the psychiatrists who signed the petition, Suzanne Bruch, suggested to trustees that if they wanted to save money at John George “you could allow us to bid on the contract as a physician-run group. That would eliminate the middle man, and we could pass on the savings to the hospital.”.