Envision Bankruptcy: AAEM-PG Lawsuit Will Continue

Today’s news that private equity-backed, physician-staffing company Envision Healthcare initiated a Chapter 11 bankruptcy filing underscores the risks of Contract Management Group (CMG) influence in emergency departments.

Envision’s bankruptcy filing does not, however, change the status of our lawsuit against the company looking to prohibit it from taking over the emergency department contract at Placentia Linda Hospital, part of the Tenet system, in California.

Here’s why.

Bankruptcy would not mean Envision would go away. More likely, it means the company would be restructured. The hospital, its contracts, independent contractors and practice model would continue to exist.

We are suing for a declaration that the Envision model of practice is illegal under California Corporate Practice of Medicine laws. To be clear, we are not suing for monetary damages.

The members of our Academy work in a difficult profession in consistently high stress situations. They are charged with treating vulnerable patients in need of emergency care. Patients that put complete trust in the physicians treating them.

It is our view that CMGs compromise the care of those patients and the well-being of our doctors by exploiting the process. Doctors are pressured to put dollars ahead of medicine. They are required to work longer hours and handle higher patient volumes. Some are pushed to upsell services. Doctors burn out under these conditions. Consequently, they eventually leave the emergency room. As a result, we lose the best doctors where we arguably need them most.

This, of course, leads to an even more adverse effect on our patients. Board certified physicians are replaced by some less qualified. Decisions can be made more in the interest of the corporation than the patient. Treatment is compromised. The quality of healthcare suffers.

This is a consequence we simply cannot tolerate. This is why we must continue our pursuit of this action regardless of Envision’s impending bankruptcy filing.

We must continue our course so medical professionals maintain an adequate stake in emergency room practices. So, they have complete control in how they treat patients. So patients receive the highest quality care possible.

We are the American Academy of Emergency Medicine. We represent 8,000 physicians around the world. But we represent so much more. We represent the idea that a physician’s primary duty is to the patient not profit. That the integrity of the doctor-patient relationship requires control of their own practice free of outside interference. We aspire to a future in which all patients have access to high quality care from board certified emergency physicians.

If we do not pursue this cause who will? We are the AAEM. We are the conscience of emergency medicine. It is our duty to champion the rights of patients and the doctors who care for them.

We are “all in” for this fight. A fight for our patients. A fight for our doctors and ultimately a fight to determine who is going to control the practice of medicine – physicians or corporations. 

We will continue to keep you informed of any developments. In the meantime, please reach out to us with any questions.


Jonathan S. Jones, MD
American Academy of Emergency Medicine

PS: The investment in this lawsuit is critical, but significant. We encourage every AAEM member to contribute to the AAEM Foundation to support the effort. If you aren’t currently a member, join AAEM today.