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Why? Riverside officials offer few details on why local anesthesia company's contract wasn't renewed

Riverside Regional Medical Center says its decision to end a long-standing relationship with a local anesthesiology group was years in the making, but the turning point apparently was an incident that took place in the hospital on Feb. 18.

In a letter posted on its website and published as an advertisement in the Daily Press, Riverside said of the anesthesiology group: "There were management shortcomings so severe that they undermined the service we delivered. That situation was intolerable and unsolvable under the previous contract, thus the decision to make a change."

Virginia Anesthesia and Perioperative Care Specialists President Paul Rein acknowledged the group and Riverside hospital administrator Dr. Patrick Parcells disagreed on the handling of a case on Feb. 18.

But if relations were deteriorating for years, it was news to Rein.

"They weren't deteriorating for years," Rein said. "They are the ones who gave us a contract on February 18."

Rein said he met with Parcells that day and received a new contract to replace the one expiring in April. He and other Virginia Anesthesia representatives made arrangements with Parcells to sign the contract on March 18.

Instead, Parcells informed the group they that had been replaced, less than three weeks before their contract was due to expire.

Riverside officials acknowledged that the Feb. 18 incident factored into their decision to end their relationship with Virginia Anesthesia, but they refused to say what happened.

"It's been an ongoing frustration over the years," said Jerry Allen, hospital board chairman. "I'd have to say the incident probably brought it to a head. I really can't elaborate."

According to Rein, the case at issue involved postponing an unscheduled surgery because it was getting late, and the operating staff was down to one team. After 11 p.m., the team tries to be available for trauma cases. That night, the emergency department was treating a gunshot wound victim. The anesthesiologist decided to postpone the unscheduled surgery in case the gunshot victim needed emergency surgery, Rein said.

"Had we done that case, we would've waited for a call team to come in. Rather than do that, this is the path that was chosen," Rein said. "We didn't put a patient in harm's way. A patient got inconvenienced. But an inconvenience to a patient is not a reason to throw an entire group out."

During the course of negotiations, Parcells asked Rein to relinquish his post as chief of anesthesiology.

Rein complied but, Parcells said, "he was still a major player in running the anesthesia department here."

"Management issues and contractual negotiations had an influence on patient care," Parcells said.

When asked whether there was a threat to withhold services, Parcells did not answer yes or no.

"Patient care issues, in my opinion, were used as a wedge for contractual interactions," he said.

Rein said his group never made a threat about patient care.

"There was never a situation that we put any patient into harm," he said. "We never make a judgment on patient care based on what's in the contract. The contract has nothing to do with that."

Parcells discussed the problems with Virginia Anesthesia at the hospital's board of directors meeting in February.

"My job is to run the hospital as best I can," Parcells said. "The board's job is oversight."

Allen said the board did not get into specifics, and he agreed that negotiations are an administrative responsibility.

"It's not the board's responsibility to negotiate contracts," Allen said. "The board did pass a resolution supporting Dr. Parcells and his decision to move away from VAPCS (Virginia Anesthesia and Perioperative Care Specialists)."

Allen said he couldn't go into detail about why.

"There's some confidential information that I'm not able to share about the previous anesthesia group," Allen said. "We supported Dr. Parcells' decision, based on the information that he provided."

Alan Witt, chairman of the board of Riverside Health System, the hospital's parent company, said contracts at individual hospitals aren't the responsibility of the health system's board.

"The health system's board doesn't deal with the day-to-day operations in each facility, although certainly we're absolutely concerned about the overall quality about our health-care system and the effectiveness of our management," Witt said.

He learned of the anesthesia change at a social function March 30.

"Individually, those anesthesiologists are very, very capable physicians that have had a career of providing good service to that community. When they come together, they are a vendor," Witt said. "I think the hospital board and administration has a duty to examine whether a current vendor is appropriate, whether the relationship between that vendor and the administration is working as it should and whether there are others out there that could provide better service."

Parcells stands by his decision to replace Virginia Anesthesia.

"We would not make a decision like this without a valid reason," Parcells said.

"I would implore patients and the community to realize we have the community and patients' best interest in mind with this change," Parcells said.

"The goal is to provide the best care in general, anesthesia included. That's my job," Parcells said. "Reasons may not be obvious, but I wouldn't want to make a decision of the magnitude of this without good reasons, and I am committed that we have good anesthesia care at Riverside."

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What happened Riverside Regional Medical Center ended its relationship with Newport News-based Virginia Anesthesia and Perioperative Care Specialists when the firm's contract ended April 7. The new company Riverside contracted with, Soma Health Partners LLC, came under fire after Virginia Anesthesia president Paul Rein aired concerns about it in a YouTube video. Riverside cut ties with the new company last week.

Copyright © 2014, The Baltimore Sun
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