The American Academy of Emergency Medicine (AAEM) is dismayed to hear the news of the planned closure of the CHRISTUS Spohn Emergency Medicine Residency Program in Texas. Reports are that this decision was made by the CHRISTUS Spohn administration for financial reasons and without the involvement of the Emergency Medicine Residency Program leadership or of the residents. The specific reason for the decision remains unclear.
This decision comes at a time when morale in Emergency Medicine is particularly low, with well documented rates of burnout among emergency physicians and historically poor results in the recent match. First and foremost, AAEM is heartbroken because of the impact this announcement will have on the current residents at CHRISTUS Spohn Emergency Medicine Residency. They chose this residency because of the desire to become emergency physicians and train at a hospital with faculty committed to providing that education. They have now learned that while their faculty may be committed, the hospital is not. While CHRISTUS states that the program will remain open until June of 2026 the impending closure will undoubtedly impact the confidence these residents have in their ability to obtain excellent training especially with the anticipated departure of multiple faculty members. Many residents will likely relocate to complete their training resulting in disruptions to both their personal and professional life and will come at a significant financial cost to the impacted residents. AAEM calls on existing programs to evaluate and publicize their capabilities to accept in transfer any of the current residents at CHRISTUS Spohn Emergency Medicine Residency. Additionally, the closure of a residency program as well as departure of faculty and residents will have an unprecedented negative impact on the ability of local patients to receive high-quality care.
Secondly, this announcement highlights the long-standing viewpoint of the Academy that corporate goals and motives are often not compatible with the mission of Graduate Medical Education and quality patient care. “The decision to do so was made with incredible consideration to our ministry’s available resources and it was ultimately determined that our ability to sustain this program for the long-term future was limited.” While the fiduciary duty of a corporation is to remain profitable, the commitment of academic physicians is to the education and training of medical students and residents in the provision of the highest level of care to all patients. In this case, CHRISTUS Spohn Hospital and its parent company, CHRISTUS Health appear unwilling to sacrifice corporate needs for the goals of graduate medical education.
Lastly, the local faculty and residents were precluded from being involved in this plan. We are also gravely concerned that this decision is yet another example of the outcomes of allowing the illegal corporate practice of medicine to operate unchecked. Management of the physicians at CHRISTUS is handled through SCP Health, a large, national contract management group. While the closure of the residency was undoubtedly a complex decision ultimately related to financial reasons, the presence of a PE backed rent-seeking corporate entity which adds no quantifiable clinical benefit while siphoning away funds for shareholders did not help. It is probable that a local independent physician-led group would be more willing to sacrifice to prevent the closure of a residency and a disruption in patient care. Incidentally, SCP and CHRITUS recently announced a national partnership for emergency medicine services. As always, the Academy will continue to fight against the abuses forced upon emergency physicians and patients by illegal and unethical business arrangements.Download PDF