There were no promises to operate at a specific hospital in return for the patient business. Money or employer pressure was never part of the equation. For years, primary care doctors referred patients to us knowing they would get excellent care. Our group had been in business for close to a half-century, serving patients at two hospitals with no financial strings attached. We had to let go of the past in order to survive the present. It was a perfect storm blowing, affecting practices throughout the country. In addition to the hospital using its clout to stifle our referrals, the bureaucratic costs of running a business were rising. We had no “extra” financial incentives to entice new surgeons into joining our practice.
We could not compete in the recruiting process to replace them. Two of our senior partners were also retiring. Despite our historical reputation for stellar surgical care, corporate competition, and salary inflation left us mortality wounded. Sadly, the sun was quickly setting on our group surgical practice. The competing hospital across town was going through growing pains and had no interest in buying up practices. His goal was to “complete” his surgical department by adding our group to his staff. Our referrals were already diminishing because of the competing surgeons hired by this very same CEO. Physicians in small towns have long memories, especially those who get undermined by broken promises. When it came to following through with commitments to physicians, his performances over the last two decades were mediocre at best. From the beginning, we were skeptical of his motives. Months earlier, he approached us wearing a Grinch-like smile, talking about “joining his team.” Our practice was to be the next domino to fall.
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