PhysEmp Insights

Twenty of the 27 cardiologists at the only cardiology practice in Schenectady County, New York, have sent resignation letters to their employer, according to Becker’s ASC. They plan to start at a rival hospital in January. The reason this belongs in Physician Recruiting & Hiring Insights is that nobody recruited twenty individuals. One hospital signed a team, and the contracts between two institutions determined whether it was allowed to.

The sequence matters. St. Peter’s Health Partners, an Albany-based Trinity Health system, acquired the practice in 2021. Merger talks with Ellis Medicine, the Schenectady hospital that now stands to gain the cardiologists, collapsed in June after six years. According to Becker’s reporting on Ellis’s August lawsuit, St. Peter’s gave notice on June 15 that it was ending the cardiology services agreement effective Dec. 14, and the physicians’ new employment agreements, effective Jan. 1, carried one-year noncompetes. Ellis argued those noncompetes conflict with its contractual right to hire the group once the services agreement ends.

The group is large enough that the stakes are not abstract. Ellis said the 27 cardiologists and 15 physician assistants serve more than 50,000 patients a year, and that about $75 million in annual procedure revenue could move elsewhere if it cannot employ them. The same filing put Ellis at roughly $50 million in cash, about 50 days, against about $70 million in debt. A hospital in that position is not running a recruiting search in the usual sense. It is acquiring a service line through hiring.

When the unit being hired is a practice rather than a person, time-to-fill stops being the relevant metric. The binding constraint is who holds the right to make the offer, and that right was set years earlier in a merger agreement.

By October the numbers had moved. Four cardiologists are staying with St. Peter’s and one has retired, so the departure is 20 of 27 rather than all of them. Ellis told Becker’s that the 20 have signed employment agreements for a Jan. 1 start, that ten advanced practice providers from the cardiology team have signed as well, and that it is recruiting two more cardiologists from outside Schenectady. It plans to use locum physicians during the transition.