EDITOR’S NOTE: This story has been updated with comment from Vituity.

The health care giant that operates Long Beach’s St. Mary Medical Center will not renew its contract with emergency room doctors there, executive officials told the medical staff Thursday, April 2.

Dignity Health’s current contract with emergency room doctors expires June 30; beginning July 1, Vituity, a health care organization based in Emeryville, will take over emergency services at St. Mary’s.

“We will begin planning for the transition and credentialing new physicians immediately,” Carolyn Caldwell, the hospital’s president, wrote in a memo to staff, which the Press-Telegram obtained. “As part of that transition, we support and encourage Vituity in its plan to consider the engagement of current ER physicians.”

Vituity will replace Long Beach Emergency Medical Group, which only serves St. Mary Medical Center and Providence Little Company of Mary Medical Center in San Pedro.

Long Beach Emergency Medical Group employs roughly 30 doctors, and 20 nurse practitioners and physician assistants.

Although the company providing the services will change, it’s possible Vituity could choose to hire St. Mary’s current emergency room doctors so they can remain at the facility. But that decision would be up to Vituity, not Dignity Health.

“Our intention is to objectively assess new and current providers,” Vituity’s vice president, Dr. Savoy Brummer, said in a statement, “through the lens of ensuring continuity and the high-quality level of care patients deserve.”

Christina Zicklin, a spokeswoman for Dignity Health, said her company would work with Vituity “to make the transition as smooth as possible.”

Doctors at the hospital, though, said Thursday they are concerned about what the decision will mean, particularly in the midst of the coronavirus pandemic.

“This announcement, today, in the midst of the worst public health crisis our city, our country, this planet, has seen in generations,” Dr. Mauricio Heilbron Jr., a surgeon at the hospital, said, “is inexplicable. Indefensible. Reckless. Potentially dangerous.”

Dr. Visal Nga, who works in the hospital’s internal medicine department, agreed.

“In the current situation, when you have a pandemic like this,” he said, “we need everyone to be all hands on deck, and we need stability, especially in our community and especially in our emergency room positions.”

As of Thursday, 153 Long Beach residents had tested positive for the virus; two residents have died, both with underlying health conditions. L.A. County, meanwhile, has reported 4,045 cases so far, including 78 deaths.

Vituity, for its part, said it is prepared for what’s to come.

“As we look ahead, there are many challenges including coronavirus that we are planning for,” Brummer said, “in order to ensure the transition is smooth and that excellent care is maintained.”

Caldwell, for her part, told staff the change — a process that she said began “well prior to the current pandemic” — would not impact patient care, especially when the community needs it most.

“I would be remiss if I did not address this important decision in the context of the ongoing COVID-19 crisis, which is on the forefront of all of our minds right now,” she wrote. “Our ER is delivering excellent medical care to the Long Beach community, and we will continue to do so as we prepare for the July 1 transition. We are confident that the resources and personnel that Vituity brings to SMMC will be invaluable as we continue to combat this global health crisis.”

Caldwell also noted that Dr. Jeffery Tsai and Dr. Phil Piccinni, two former St. Mary Medical Center doctors, “will both play a critical role during the transition.”

Although the impacts of the decision may be magnified during the current public health crisis, it’s not the first staffing change that has caused anxiety among staff. For more than a year, doctors have expressed concern over a series of decisions by Dignity Health to end contracts with the medical groups that have served the community for decades: first the anesthesiology group, then the radiology group and now the doctors in the emergency room.

Most of the hospital’s anesthesiologists, at least, were re-hired by the new provider — but, like with emergency services, that decision was at the sole discretion of the company that St. Mary’s hired for the job.

In February 2019, St. Mary’s doctors said they believed forthcoming changes in medical staff, which would effectively mean layoffs for many of the hospital’s physicians, were rooted in retaliation because those in the impacted departments had been publicly critical of Dignity Health.

Dignity Health, then and throughout the many changes that have come to the hospital since, has denied that any decisions were made based on retaliation.

“As hospital leaders, we review each contract prior to renewal,” Caldwell wrote in a February 2019 memo to medical staff, “to ensure that we meet the needs of the hospital, our patients and our medical staff physicians.”

Along with those concerns, members of the facility’s medical staff have pointed out the wide-ranging impact of losing doctors who have spent so much time serving the same community.

“I’m not sure that you can hire one group of doctors and say that everybody will be comfortable with the care that they’re providing just because they’re licensed,” Douglas McFarland, who was the chief of staff for St. Mary’s Medical Executive Committee at the time, said last February. “There’s a lot of bad doctors out there practicing, and I suspect most of them are the ones that would be willing to work for less money than our higher quality doctors.”

The turmoil appeared to come to a head in June, when doctors unanimously approved a vote of no-confidence in Caldwell.

“There were no votes in support of Ms. Caldwell’s leadership abilities,” the letter, which was signed by 58 doctors, said. “Several votes of ‘no confidence’ included a request by those doctors that their names not be included on the below list for fear of retaliation by the administration.”

But Dignity Health officials said they continued to believe in Caldwell’s ability to manage the facility.

“Our commitment to patient quality is one of our top priorities,” Julie Sprengel, the company’s Southwest Division president, said in a statement at the time. “We have every confidence that Carolyn Caldwell’s leadership will meet and exceed the highest levels of patient care for St. Mary’s, Long Beach and its surrounding community.”

Doctors, meanwhile, have expressed worry throughout the process that the changes would impact patient care. On Thursday, multiple doctors said it appeared the impact of Dignity Health’s changes could be felt more by patients than ever before.

“We don’t need our front line to be replaced, especially right now,” Nga said. “It’s hard already going to work and going to face the coronavirus and putting your life on the line. But then, at the same time, you don’t have the support from your hospital to do that.

“By doing this, I think they’re showing they don’t really care about the community,” he added, “and I think that’s what the bottom line is.”

Zicklin, with Dignity Health, meanwhile, said the “excellent medical care” St. Mary’s ER currently delivers will continue.

“As with previous department transitions, the process will not disrupt any of the current operations of the hospital,” she said. “Delivering the best patient care to the local Long Beach community has always been our hospital’s top priority, and all decisions we make are with that in mind.

“Our ER is delivering excellent medical care to the community we serve here in Long Beach,” Zicklin added, “and we will continue to do so as we prepare for the July 1 transition to Vituity.”

Timeline of events

February 2019: Doctors publicly announced that Dignity Health planned to terminate physician groups, effectively laying off doctors.

April 2019: Dignity Health notified doctors that the health care company would not renew the longtime contract with St. Mary’s anesthesiology provider.

May 2019: Doctors at St. Mary’s unanimously approved a vote of no confidence in the hospital’s president, Carolyn Caldwell.

August 2019: Dignity Health notified doctors that the contract with St. Mary’s long-serving radiology provider.

April 2020: Dignity Health notified the St. Mary’s medical staff that the long-standing contract with the hospital’s emergency services provider would not be renewed.