Cate Pelletier, MD, well remembers the day it all fell apart. It was late October, and she said one of the chief officers of Roxborough Memorial Hospital called to offer her a contract with Prime Healthcare, the company that owned the hospital if she would show up for her midnight shift.

She said that I promised that a contract at a higher rate of pay would be on her desk when she got to the hospital. "When I got to work that night, there was no contract on my desk ," she said.

When another doctor offered the same deal came in the next morning , the two of them asked the administrator to come to the ED. He was angry and abrupt when he showed up, she said, telling them that he could not make a contract for Prime and that they should not be "absurd."

"'You made a verbal contract with two physicians ,'" she said she told him. "'And after all that, you come down here after I have worked another eight hours for your institution and make it sound as though you expect to be paid is absurd. I'm done. ' I resigned at that moment. "

Emergency physicians

Many of the 50 or so emergency physicians and physician assistants at Roxborough in Philadelphia, Lower Bucks Hospital in Bristol, PA, and Suburban Community Hospital in East Norriton, PA, have found themselves in the same situation since late October.

That's when they said they were told that Legacy Physician Partners, the Brentwood, TN, staffing agency that held their contracts, was bankrupt. Less than three days later, they said, they were told that they were not negotiating and that Prime, Progressive Emergency Physicians (PEP, another management firm), and Legacy, led by CEO Donald Bivacca, were negotiating to transition the ED contract to PEP.

The physicians were independent contractors with Legacy, which had held the Prime Contract at the beginning of the year. Legacy provided malpractice coverage as part of their employment, they said.

Gerald O'Malley, DO, one of the contracted emergency physicians , said the physicians believed the Legacy contract would continue until February 2019, but they received an email saying the hospitals had contracted with PEP, a group in Uniondale, NY.

"So Prime Healthcare had a contract with Progressive to staff all three emergency rooms beginning in February 2019," he said. "But in late October, we got an email saying that Legacy had just declared bankruptcy." (A search for federal bankruptcy filings and information not on it.)

Three days after that, they received another email saying Legacy had not filed for bankruptcy. Its website, however, has been taken down and its management could not be reached.

The immediate concern was whether the physicians had malpractice coverage , Dr. O'Malley said. "People were showing up for shifts and being told they did not have malpractice insurance," he said.

"Subsequent to that, we received a bunch of emails that reassured us that we had malpractice insurance and we would have paid, but we needed to show up for shifts. Many of us did, "he said.