USCGhost, an Envision anesthesiologist for 7+ years, surely is privy to more insider information than I am. So, when s/he quotes chapter and verse, you should believe him (or her). But speaking in "generalizations" is not quoting chapter and verse.
Fountain Valley had two anesthesia groups on its campus. One served the hospital. The other served the OSC. When Envision took over the contract for all Tenet Hospitals, Envision kept the hospital group. The outpatient group wanted nothing at all to do with the hospital group or Envision. In September or October, Fountain Valley announced that they would be closing two of the four outpatient center operating rooms effective November 1 (the day Envision took over).
So, yeah, nobody asked shareholding anesthesiologists should they shutter a facility. That is true. But what appears equally obvious is that Envision's inability to staff four outpatient operating rooms caused administration to close two rooms immediately. (And, again, this probably was--by sheer luck and coincidence--good for the anesthesiologists. If the same number of OSC cases are now going to be done in half the rooms, those rooms should be good, efficient rooms.) But, not even four weeks into Envision's reign, Fountain Valley is now closing a 4-OR surgical center altogether.
Of course, there could be a host of other reasons--and undoubtedly those USCGhost elucidated were among them. But until somebody on the inside of the hospital group proves otherwise, it is a very reasonable and safe assumption to believe that Envision couldn't recruit enough warm bodies to staff an inefficient hospital and an inefficient surgical center--even at $37/unit (which is generally believed to be greatly in excess of the blended unit value for Fountain Valley). Now that they are the monopoly power in anesthesia staffing (which wasn't the case when there were two dueling anesthesia groups), Envision was able to unilaterally tell management they had to schedule their operating rooms efficiently.
From an anesthesiologist's perspective, this is an unalloyed good. No question. And, if--as I am speculating--Envision is to thank for the decision (tough decision, but the right decision), they get all the credit. All of it.
But surgeons are going to be pissed and they'll be taking their cases elsewhere. And good OSC staff is not going to be happy to join the call-taking staff of a struggling hospital on the bottom rung--so there's going to be an exodus of good staff.
Sure, that's not Envision's fault. And that doesn't make an otherwise good job necessarily bad.
But, the notion that Envision can't recruit at $37/unit, the notion that a group already privileged at the hospital and familiar with its surgeons would decide to walk away from Envision's $37/unit guarantee, and the fact that the hospital IS CLOSING ROOMS (and, in fact, entire centers), leads me to believe that, contrary to what USCGhost maintains, Envision's offer is not the best Orange County has to offer.
But, to reiterate, USCGhost is the only one of the two of us speaking with "insider insight."
