safety. He alleges that the cost-cutting went beyond skimping on anesthesia.
• 1:4 supervision ratio. Kaiser forced anesthesiologists to simultane-
ously care for an unreasonable number of patients and supervise 4
CRNAs, up from a 1:2 ratio, even during pediatric procedures. Dr. Franck,
a father of 2 school-aged boys, told management, "I would not want my
child to have surgery under that anesthesia model."
• Insisting on 7:30 a.m. surgical start times. Kaiser demanded that
cases start at 7:30 a.m., even if the patient had complicated medical
issues that required a time-consuming pre-op evaluation. "Take the
patient in with their street clothes on if you have to," the chief of anesthe-
sia reportedly said. The suit claims that this once led to administering a
patient's spinal anesthesia in pre-op and transporting him to the OR
unmonitored.
The suit also claims that anesthesiologists were discouraged from
entering the OR during cesarean sections "unless absolutely necessary"
and often had to work without the support of anesthesia techs, leaving
them and CRNAs to restock the carts as they "used supplies throughout
the day as it may not get done otherwise."
Kaiser calls the claims "meritless" in a statement. "We are confident the
facts will readily reflect that."
Efforts to reach Dr. Franck and his lawyer were unsuccessful, but you
get the sense by reading Dr. Franck's suit that he's not the type to take
injustice lying down or to meekly do what he's told. He openly challenged
authority and fired off group e-mails that called into question his superi-
ors' decisions.
But if patient safety at Northwest Permanente is as low a priority as Dr.
Franck makes it out to be, then he is to be commended for standing up to
his bosses and sticking up for his patients.
For if there's one thing you never skimp on, it's the well-being of your
patients.
OSM
M A Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 1 1
