Doctors can spot a failing patient. Can they spot a failing hospital?

When a hospital replaces an established physician team, the beds can stay open while the care behind them quietly erodes. Shelly Haug Monti is a neonatologist, palliative care physician, and bioethicist, and a cofounder of Babies First Southern Oregon. This episode is based on her KevinMD article "Why physician outsourcing is a warning sign for hospitals." You will hear how her entire group of neonatologists at a community NICU was terminated and replaced by locum tenens physicians and nurse practitioners, why she compares a NICU team to a philharmonic orchestra, and why she rejects the idea that financial survival and clinical excellence are competing interests. She describes how her group built an advocacy movement with families, nurses, community members, and state legislators, and why advocacy is a skill set few physicians learn. She also explains how to recognize a deteriorating health care system, from clinical infrastructure to hospital governance and staff bylaws. Press play to hear how physicians can spot the warning signs before their own team disappears.

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