SOUTH DENVER ANESTHESIOLOGISTSPRESIDENT'S EVALUATION FORM

SDA Board,

The President’s mid year evaluation is being conducted online and we are looking for your participation in this important process. We are asking for this to be completed no later than June 30, 2010.

The following statement is a mid year recap from Dr. Sankel:

I spend as much time as possible managing SDA’s day to day physician issues. Like yourselves, I’m in the OR almost every day so I do my best to share and publicize group information as time allows.

January and February were spent dealing with the ramifications of the lawsuit. This still continues but at least now I’m only awake a couple nights per week rather than every night. I tried to be as open and clear on this issue as possible and continue to be. I’ve already pushed the envelope regarding attorney-client privilege to be open with information.

The Board and I have tried to increase ‘transparency’. Frankly there is nothing really hidden. Since the beginning of the year, I’ve tried to increase the opportunity and frequency for comments, input and involvement in the larger issues affecting SDA. Even I’m surprised that things change slowly but I assure you they do move forward. We’ve avoided bad or reflex decisions. SDA has avoided becoming paralyzed by inaction.

We have implemented the Cash Balance Plan. Comments and feedback from physicians resulted in some modification from the original concept. In the end, over 2/3 of the physicians elected for contributions above the minimum level.

This year there has been a paradigm shift in how SDA views its relationship with the surgeons with whom we work. Surgeon preferences remain very important. However if there is a conflict with an SDA physician we are exploring and investigating this to a greater degree. The current plan is to try to re-approach the surgeon in six to twelve months and try to repair the damaged working relationship. More than one SDA physician will investigate complaints.

Last summer the Board approved hiring 1-2 physicians for August 2010. This immediately became two. By Fall we increased the number to 3. This winter we decided to hire a fourth new physician. In 2010 we increased the work days of Dr. Wassill. We hired Dr. Bailliet two days per week. We’re hiring two additional physicians to start this fall. So far, we’ve had attrition of one physician. On certain days manpower remains tight. The four new physicians should help.

Another paradigm shift this year is that SDA is occasionally asking our facilities and surgeons, radiologists, gastroenterologists with whom we work to be flexible with some case start times. Greater independence, especially at Skyridge, has been emphasized to manipulate the schedule to allow for better use of manpower. In a generalized sort of way, we are prioritizing the surgeons and surgical locations. SDA is trying to work smarter and not just harder. So far this plan is working and SDA has not seen negative results, at least not yet. If a problem occurs we will continuously modify this plan.

This year we are trying to move away from being the nighttime and weekend default for surgeons who typically do not use SDA during weekdays. A handful of surgeons have been notified. To date, all have been reasonable and understand this to be a natural business decision on our behalf. Granted, the understanding only occurred after I spoke to each surgeon.

The office based surgery, is attractive because of its $90-100/unit payer mix. The Medicare GI cases are being moved to better fit our availability. At Parker, we remain focused on trying to work with the surgeons who have the better paying patients.

During the first half of this year, SDA renegotiated the Anthem, United and Aetna contracts. These represent our three biggest commercial payers. We were able to obtain between 0 – 3% increases to our 2009 rates. I don’t foresee significant increases next year.

Several operational documents important to SDA were significantly outdated. So far this year the employment agreement and stock purchase plan have been addressed. I believe we have much more current documents now.

Relationships with our core facilities remain strong. Neither I nor the Board can take credit for that. It is certainly due to the strength and commitment of all the SDA physicians.

Prediction for next six months: I’m not going to sugar coat it, I think we’ll be pretty busy especially throughout the summer. We’ll likely be busy throughout the fall as well. As a corporation we remain solid. We will probably not expand much further. We will place even more emphasis on shoring up service within our core facilities. With an increase in manpower, we will be better able to adhere to our regionalization concept.

Jordan H. Sankel, MD

President Eval - SDA Board - 6/10