A South Jersey emergency department has lost veteran doctors and staff over its new contract
Nearly two dozen employees have exited Our Lady of Lourdes after Virtua Health switched a staffing provider for the emergency room, according to former employees.
Al Sacchetti and his team have saved countless lives during his 41 years as an emergency room doctor at Virtua Our Lady of Lourdes.
Members of the crew keep themselves energized with jokes and endless Philly soft pretzels. Some patients say the doctors at Lourdes are the only reason they’re still here today.
Now, Sacchetti is one of nearly two dozen people, the majority of his team, exiting the hospital after Virtua Health switched staffing providers for the emergency room. The ER’s three leaders, including Sacchetti, say they were not offered contracts with the new provider, though they were offered roles at other Virtua hospitals that they declined. A Virtua spokesperson said the provider switch was to create consistency across the company’s health system.
A crowd of Sacchetti’s colleagues, patients, friends, and family gathered outside the hospital on Sept. 29 to celebrate his final shift. They held confetti cannons and signs with Sacchetti’s face on them. They cried. Staff inside the building banged on the second-floor windows and waved.
The send-off was organized by Ross Simcoe, Lourdes’ former clinical operations director, who lost his job alongside Sacchetti and medical director Monika Smith.
“I wanted him to not be able to deflect praise onto other people,” Simcoe said. “To see how important he was. He couldn’t give us all the credit.”
The last day for Virtua’s contract with Envision Healthcare — a company that works to recruit and retain clinicians in support of hospitals — was Sept. 30, Smith and other former staff said. Starting Thursday, TeamHealth, another firm, took over managing Virtua’s staff of doctors, physician assistants, and other APPs, advanced practice professionals.
Aliese Polk, an Envision spokesperson, said the healthcare company is proud of the work its doctors have done in Camden.
“Their impact extends far beyond the care they delivered, and we are proud to have worked alongside them,” Polk said.
The new vendor did not renew ER leadership contracts and offered other employees the option to stay — but with pay cuts, according to several staff members.
“The hospital wanted to make a change, and that’s why I’m not there anymore,” Sacchetti, 72, said.
A Virtua spokesperson said the company wanted to move Lourdes onto the same subcontractor for staffing management, TeamHealth, used by Virtua’s six other emergency departments. In 2019, Virtua acquired the Lourdes Health System in a roughly $60 million deal that gave Virtua ownership of the Camden hospital and Virtua Willingboro Hospital, formerly Lourdes Medical Center of Burlington County.
“With Lourdes being the one outlier, there was a desire for consistency across the entire enterprise to move to the other provider at all seven locations,” the spokesperson said. “That’s what motivated that change.”
Virtua Health declined further comment on the contract and staffing changes. TeamHealth also did not respond to multiple requests for comment.
The Inquirer spoke to three Lourdes emergency department physicians who weren’t offered new contracts, several physician assistants and doctors who chose not to accept the new contract, multiple current employees, two former nurses, two paramedics, and several patients treated by Sacchetti and his team.
Virtua’s chief operating officer told Smith, the former medical director, that the contract change was “intended to provide greater consistency and economies of scale,” according to an email reviewed by The Inquirer.
It’s not unusual for community health systems like Virtua to use outside vendors to staff their emergency departments, and having more than one staffing company would add to the cost. Virtua’s main vendor, TeamHealth, is the largest in the nation, according to a recent report by the Private Equity Stakeholder Project.
“What we experienced happens more than just at Lourdes. It happens everywhere around the country,” Smith said. “But the work we do, you can’t compare that to any other business. You’re dealing with humans and human lives. I hope physicians and mid-levels have more to say about how we practice medicine.”
Turning it down
Smith, Lourdes’ former medical director, immigrated to the U.S. decades ago from Poland to pursue her dream of becoming a doctor. At home, women weren’t expected to have a professional life, she said, so she pushed to attend medical school in South Jersey.
She discovered Lourdes during her rotations and hoped for a job there.
Her dream came true in 2007, after an interview with Sacchetti.
Smith, now 50, spent years caring for patients as an emergency physician, and in 2020, in the midst of the COVID-19 pandemic, Sacchetti appointed her medical director.
TeamHealth representatives called the trio earlier this year and said they couldn’t stay at Virtua Lourdes, Smith said. They were told they could be moved to another Virtua location, but all three declined. When Smith asked to be stripped of her leadership title to stay at Lourdes as a doctor, she said she was told no.
“I wasn’t going to just be tossed around to another institution of their choice,” Smith said. “I was going to make that choice.”
The rest of the emergency team, 21 doctors and APPs, were offered new contracts by TeamHealth, according to Smith, but only one person chose to stay, and a few more will work only on an as-needed basis.
Three employees who didn’t accept the new contract said the ER is losing decades of institutional knowledge.
“We had over 100 years experience that they just let go,” one former physician assistant said, who asked not to be named for fear of retribution.
Several staff members, including a former doctor and multiple physician assistants, said the new contracts offered them wages 20% to 30% lower than they were making before.
But aside from the proposed pay cut, past and present Lourdes employees said changing the ER’s leadership team would’ve made it difficult to stay.
“Some people, no matter what they were offering — it could’ve been double what they were making — they would still turn it down,” said another physician assistant, who asked not to be named for fear of retribution.
Despite the staff changes, the Virtua spokesperson said the emergency department “is fully prepared and able to support the needs of the community through the transition to TeamHealth.”
‘Too stubborn to be done yet’
Sacchetti has spent decades working fast-paced days as an emergency room physician at Lourdes, writing articles and textbook chapters, giving lectures, volunteering at the Cherry Hill Free Clinic, and uploading what he learns to YouTube. He does podcasts with the main medical consultant from The Pitt and submits example cases to the show every year. His cases made it on TV both seasons.
He’s not ready to retire.
“If the word ‘retirement’ is in this article, he’s going to lose his mind,” said Jessica Aitken, a nurse who has worked with Sacchetti for more than 20 years. “He’s too stubborn to be done yet.”
Aitken, who has worked at Lourdes since she graduated nursing school, decided to stay at the hospital despite recent leadership changes. Sacchetti taught her to stay prepared, to be a team player, and to cry away from patients. She was among the staffers who called him Dad.
In his next role, Sacchetti will work part time at Inspira Health’s emergency room in Vineland, Cumberland County.
Among the Camden first responders who will miss the team is Brian Ball — a Virtua paramedic, Cherry Hill firefighter, and the son of Robert Ball, whose life Sacchetti once saved.
In 2008, Robert Ball, in his early 60s, returned home from an exhausting shift as a volunteer paramedic and fell asleep without his continuous positive airway pressure (CPAP) machine. He went into cardiac arrest and was revived by his own crew.
At the hospital, Sacchetti and his team kept Robert alive, covering him with ice packs and cooling blankets for eight hours, then a relatively novel treatment.
With time, Robert returned to shifts as an EMT and a substance abuse counselor, where he helped people struggling with addiction. He became a grandfather, and in a few months, he expects to be a great-grandfather.
Brian has brought numerous patients to Sacchetti over his own 29-year career and taken Sacchetti’s medical emergency classes.
Simcoe and Smith aren’t ready to be done, either. Simcoe is headed to Phoenixville Hospital, and Smith will fly out to Kentucky a few times a month to keep working for Envision Healthcare, while she looks for a full-time gig. Leaving Camden, Smith said, feels like losing the love of her life.
“I think I have another decade in me to continue to care for my patients,” Smith said, “and I hope things get better.”
Inquirer South Jersey
