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Doctors Question Motives In Palomar Health's Contract Change

People walking in front of Palomar Medical Center Escondido emergency room, July 1, 2021.
Alexander Nguyen
People walking in front of Palomar Medical Center Escondido emergency room, July 1, 2021.

Palomar Health has signed a contract changing the provider that staffs its hospitals in Escondido and Poway with doctors.

The hospital system said the change will help improve patient care and the savings will help pay for new equipment such as CT scanners and MRI machines. The doctors who work there aren’t too sure.

Doctors Question Motives In Palomar Health’s Contract Change
Listen to this story by Alexander Nguyen.

Palomar Medical Center Escondido's chief of staff Dr. Sabiha Pasha said the change is more about money than patient care.

“Buying MRI machines and CT scanners, sure, if you have the money we'll do it," she said. "But you don't do it at the cost of jeopardizing that core business that we do. And that's a business to take care of people.”

Vituity Healthcare & Medical Staffing Services was the provider that staffed Palomar Medical Center in Escondido and Poway with emergency room doctors, hospitalists and intensivists — they're doctors who care for patients after they've been admitted to the hospital from the ER.

RELATED: Nurses Protest At Palomar Health Poway Over ICU Working Conditions In Pandemic

The new company is called Emergent Medical Associates or EMA. Pasha said the new provider plans to apply a staffing model that will increase doctors' workload.


“They brought a staffing model that would require each physician to see 25 patients a day in a 12-hour shift," she said. "So you do the math on that — less than 20 minutes per patient, and then you have to do all your documentation. How do you take care of sick people like that?”

Pasha said Palomar hasn't been straightforward and transparent of about its reason for changing providers. Vituity has been providing Palomar with doctors for more than 40 years.

For the most part, hospitals in California are not allowed to directly employ doctors. Instead, they go through a third party.

Pasha said Vituity has been doing a good job and she doesn't understand why Palomar decided to make the change. Palomar said it's standard practice when contracts end to go through a bidding process. Plus, the hospital has not gone through a bidding process before, so it's good to field other options.

EMA, Vituity and a third company, Sound Physicians, submitted bids and EMA was awarded the contract on June 25.

The change will only affect doctors who work exclusively at the hospital and won’t affect family doctors or specialists. The new contract goes into effect Aug. 1.

RELATED: Palomar Health To Lay Off 317 Employees, Citing Lack Of Revenue

Pasha was on the subcommittee that reviewed the bids. She said the financial aspects were redacted, but based on performance and quality, she couldn't see any benefits from switching. The committee recommended not to change providers, she said.

Because of the lack of transparency in the bidding process, doctors issued a rare vote of "no confidence" against Palomar Health's administration June 23.

In a statement, Palomar's president and CEO Diane Hansen admitted the move was about money but said it was done with patient care in mind.

“Our community and patients expect us to be good stewards of our resources,” she said. “EMA’s proposal allows us to retain all our staff, plus reinvest saved resources to upgrade patient care.”

In an email, EMA president Dr. Irv Edwards said no cuts or changes in staffing are planned.

“There is a plan to increase efficiency and quality over time using proprietary management tools we have developed,” he said.

EMA said it will keep things running the way they are for 90 days. Afterward, it will re-evaluate and make any necessary changes. And that is what worries Pasha.

The majority of the more than 110 doctors at Palomar are not planning on signing with the new company, she said. EMA said it already has commitments from 50 or so doctors.

Doctors Question Motives In Palomar Health's Contract Change

Corrected: June 4, 2023 at 6:46 AM PDT
Editor's Note: A previous version of this story incorrectly stated Palomar Health doctors issued a vote of "no confidence" against the board of directors. It was against the administration. KPBS regrets the error.