When Mount Sinai Hospital took more than Continuum Well being Partners in 2013, major well being care executives and physicians from both systems had one particular believed: Had been their jobs safe?
They had superior explanation to worry. As soon as the dust settled over the merger, lots of senior-level workers have been gone as the two systems consolidated operations to save cash. Some of these laid off are nonetheless job-hunting or have resorted to consulting. Other folks moved out of state to locate equivalent employment. Half of the eight physicians on Crain’s list of leading-paid workers who worked at Continuum in 2013 are now gone.
One particular former executive called the reorganization “a scorched-earth” method and cited eight former colleagues who took out-of-state jobs.
“When you get to this level, there are not that several jobs for people who want to go to another institution of related size,” said the executive, who like several other individuals interviewed for this story asked not to be identified.
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In the previous three years, at least 17 neighborhood hospitals in the New York City area have joined larger systems, and the bargains show no sign of abating.
NYU Langone Medical Center last week finalized a partnership with Brooklyn’s Lutheran Hospital Maimonides Health-related Center, also in Brooklyn, is in discussions to become element of the North Shore-LIJ Overall health Technique.
As hospitals in the 5 boroughs join forces or expand their attain into wealthy suburbs by way of takeovers, there are fewer spots in the C-suite, and in the tiers of middle management and clinical leadership. People as soon as at the pinnacle have located themselves jobless, forced to change fields or to reinvent themselves.
For the reason that economies of scale drive mergers, some job losses are to be anticipated. When North Shore-LIJ took more than Lenox Hill Hospital in 2010, downsizing management was a aspect in creating the Upper East Side institution lucrative again. Within days of the takeover, the system decimated the middle ranks.
“All the management is gone from Lenox Hill” that was in spot prior to the merger, North Shore-LIJ’s chief executive, Michael Dowling, told Crain’s final July. “We’ve gotten men and women angry, oh yes.”
The culling normally is heavier in the administrative ranks than amongst clinical staff, said Mark Murray, a senior consultant at Towers Watson, which typically advises wellness care entities on mergers.
“If the hospital is in a good shape, you happen to be not talking about trying to take out the nursing contingent or specialties,” Mr. Murray mentioned. “It tends to be in the higher-ups exactly where the excess resides: senior executives, a entire host of middle managers, a whole assortment of backroom operations.”
Well being care jobs are developing nationwide. But most of that expansion is in clinical activities and decrease-paid positions the portion held by best executives is anticipated to stay at just .7% of the sector’s workforce via 2022, according to the Bureau of Labor Statistics. The percentage is forecast to remain stagnant for management jobs overall, which now represent 3.2% of all jobs in wellness care.
An evaluation of the New York-Presbyterian system’s listing of corporate officers shows that eight names have been removed because 2012, during which time the hospital absorbed or affiliated with three smaller sized institutions. A LinkedIn search shows that only one particular of them is working in complete-time employment in a hospital, in Texas. Two other folks are consultants.
Considering the fact that the merger with Mount Sinai, numerous of Continuum’s former leading executives have not updated their LinkedIn profiles with new jobs, have an employment gap of about a year or have became consultants. Most have huge severance packages attached to nondisclosure agreements and declined to acknowledge a reporter’s query.
Gail Donovan, who earned extra than $1 million as executive vice president and chief operating officer at Continuum, left the merged technique in January 2014. Kevin Molloy, formerly the COO of Mount Sinai Beth Israel, departed in November 2014 and is now a consultant and adjunct professor.
Frank Cracolici, who had earned $888,462 at Continuum as president of St. Luke’s-Roosevelt Hospital, went to California and consulted ahead of joining Cardinal Wellness in February. Kathleen Kearns, at Continuum considering the fact that 1997 and a senior vice president of improvement when she left in March 2014, joined the New York Genome Center a year later.
Leading 50 highest-paid hospital executives/workers
Clinicians also are squeezed out by consolidation: There can be only one division head of a merged hospital.
Right after a series of modifications eliminated a program at a single Manhattan hospital, a department head said he located himself unable to see the number of individuals his contract stipulated. The medical professional felt the monetary hit when a paycheck came in at one particular-third much less than he had expected. Following complaining to his department, he was told his contract would not be renewed.
“There was no attempt to adjust the targets of my contract. It was all based on earlier circumstances,” he recalled. “There is never ever been any claim that I wasn’t doing my job.”
Now job hunting, the doctor said he’s “optimistic” about obtaining perform elsewhere&mdashthough it may perhaps not be in Manhattan or at the same salary.
“I am largely concerned with not allowing this to be the final chapter of my career in medicine,” he stated. “I’m at the major of my game, and it feels like a terrible waste.”
One particular former executive at a Manhattan hospital, exactly where he had worked for decades, filled the employment gap immediately after his layoff by briefly working as a cashier at a department store.
“I had no duty for the very first time in my life. I didn’t have to worry about scheduling, individuals coming in late, obtaining perform done,” recalled the executive. “For me, it was just a matter of [undertaking] something to hold me busy.”
Downsized wellness care administrators might find it even more hard to land jobs in the future as systems continue their geographic expansion. Candidates who are not a good fit for a particular hospital in that program theoretically can be ruled out for the whole network.
“In a giant well being program, they have one particular human sources division,” stated Andrew Goold, vice president of the Healthsearch Group. “If an person is not satisfactory to the 1 HR division, that signifies 18 hospitals” are proficiently out of the operating as possibilities.
His employer, based in Ossining, N.Y., has itself felt the reverberations from wellness care’s taste for mergers.
“Our organization at 1 time had 35 recruiters. Now we’re down to 20,” Mr. Goold stated. The lower has been driven by a quantity of reasons, “1 of which is [institutional] cost-saving,” he added.
A job title that is particularly at threat: CEO. Stand-alone hospitals that turn out to be aspect of bigger systems no longer have a require for that function.
Keith Safian, the longtime leader of Phelps Memorial Hospital in Sleepy Hollow, N.Y., ahead of the Westchester hospital joined the North Shore-LIJ method in January, concluded several years ago it was inevitable that Phelps would lose its independence.
“It became clear we required to join a larger organization,” he said. “We had been pretty lucrative, so there was no monetary stress, but we saw the writing on the wall.”
Mr. Safian, who mentioned his exit “was as fantastic as I could hope for,” is upbeat about his future. He stays in touch with five other former CEOs of community hospitals and is thinking about joining a well being care consultancy or private-equity group.
“There’s a wealth of opportunity” in well being care, he stated. “But not for hospital CEOs.”
Date: April 6, 2015