As Skagit Regional Health’s new staffing contract with Vituity for hospitalist services takes effect this month, multiple physicians have left the hospital rather than work for the California-based contractor. 

Physicians across departments are raising safety and labor concerns over the hospital’s selection after a reportedly chaotic and opaque transition from previous contractor Sound Physicians to Vituity resulted in multiple revoked job offers and anti-labor allegations. Skagit Regional Health operates hospitals in Mount Vernon and Arlington.

Clinicians at the hospitals who spoke with Cascadia Daily News on the condition of anonymity out of fear of retaliation say a period of rushed planning ensued, in which Vituity left the hospitals with a patchwork July schedule. They also noted that despite Vituity being physician-owned — usually favored by providers over corporate-owned models — the company has a contested reputation in the industry nationwide.

Brian Ivie, Skagit Regional’s chief executive officer, said the hospitals have no say over who the contractor hires or what model is implemented, but that the benefits, both clinical and staffing, of the new group will show after the transitional kinks are resolved.

Hospital leaders and clinicians gave conflicting numbers when asked how many hospitalists are staying and leaving. Hospitalists are defined as physicians, nurse practitioners and physician assistants who specialize in general hospital care and treat admitted patients. 

Dr. Jenny Benson, Skagit Regional’s chief medical officer as of June, told CDN that 27 hospitalists are staying, adding that a number of the hospitals’ recently graduated medical residents are joining Vituity. But due to the departures of multiple physicians, Vituity is now partially relying on about eight out-of-town employees, or “traveling ambassadors,” to temporarily staff part of the health system’s two hospitals as of July.

Multiple physicians said that up to 14 hospitalists who worked at one of the health system’s two hospitals for Sound Physicians are not returning, citing concerns over patient safety, compensation and scheduling under Vituity. Two with visas are moving to Canada, several have found work in other states and Washington, and others are taking temporary work or are still searching for employment, the hospitalists said.

Other hospitalists who had agreed to or expressed interest in staying to work with Vituity had their offers revoked in recent weeks, including an attending physician and teacher of hospital residents, multiple clinicians told CDN. 

Four hospitalists and non-hospitalist physicians who spoke with CDN claim the majority of the hospitalists who weren’t offered contracts with Vituity or had their offers rescinded were the same workers who led unionization efforts last year while employed by Sound Physicians or testified to the state in favor of the union’s unsuccessful joint employment bid, which Skagit Regional opposed. Since Sound Physicians’ contract wasn’t renewed after the providers unionized and Vituity has an employment model that likely prevents unions, the decision drew allegations of anti-unionism.

Physicians question why all interested providers weren’t retained when Vituity is still hiring for multiple physician positions at Skagit Regional as of July 1, according to its careers page.

Ivie disputes these claims, saying there is “absolutely not” a linkage between who was offered positions and union involvement. 

“I can’t say that there are not individuals who might have been pro that effort, who are not joining Vituity,” Ivie told CDN. “There was no linkage to the decision to go with Vituity or the hiring that Vituity is handling based on what happened a year and a half ago.”

Skagit Regional selected Vituity, which operates nationwide, for a three-year contract after 10 years of contracting with Sound Physicians, the corporate contractor part-owned by UnitedHealth’s OptumHealth and Summit Partners, a private equity firm. 

The move saves the hospital money, said Ivie, who, when asked how much, said he didn’t know. The decision, however, “was not based on financial challenges,” he added.

Vituity didn’t respond to repeated requests for comment.

A pattern of pushback

Health systems’ contracting decisions are often scrutinized for corporate creep and cost cutting. Skagit Regional’s pivot from a private equity-owned group to a physician-owned organization comes as nearby and competing health systems have recently drawn immense pushback for doing the opposite. However, Skagit Regional said its motivation wasn’t to cut ties with a corporate medical group.

Instead, Ivie said he simply prefers the services of Vituity. 

Internally, however, hospital administration has touted the benefits of pivoting to a physician-owned group, implying it wants to minimize its work with groups that can be categorized as operating within the corporate practice of medicine — like Sound Physicians — according to multiple physicians. Not only did Ivie dispute this as the premise for selecting Vituity when speaking with CDN, but Skagit Regional also opposes statewide legislation aimed at prohibiting the corporate practice of medicine.

Some clinicians aren’t convinced Vituity’s business model matters.

“It’s a corporate-owned medical practice that’s physician-owned, but they operate as a corporation that has power to dictate,” one Skagit Regional hospitalist said.

Vituity has expanded nationwide in recent years, including in Washington, where earlier this year it recently landed a contract in Everett with Providence. The company also has contracts with Swedish in Edmonds, with PeaceHealth in Longview as of 2022, and PeaceHealth in Friday Harbor as of 2025.

With more than 9,000 clinicians nationwide, Vituity has accumulated a track record of pushback in the communities it has entered. After a Connecticut hospital signed a contract with Vituity, 15 doctors left the hospital rather than work for the new contractor. In California, providers sued a hospital in an attempt to prevent it from contracting with Vituity last year, saying patient care would be disrupted and the local group could go out of business. Also in 2025, Vituity agreed to pay $8.75 million to settle a class action lawsuit in which its employees alleged the company mismanaged their 401(k) plans. 

As in Connecticut and California communities, providers in Skagit County are fearful for their patients’ care under temporary clinicians. Meanwhile, Vituity promotes its seemingly transient roles.

“With Vituity, if you ever need to move, you can take your job with you,” some Vituity job descriptions say.

Ivie and the health system’s chief operating officer, Danny Vera, previously worked at Mercy San Juan Medical Center, a California hospital that also contracts with Vituity. Their past experience provided one of multiple helpful references in the hospital’s decision to contract with Vituity, Dr. Connie Davis, Skagit Regional’s former chief medical officer, told CDN in April.

Many of the hospitalists aren’t lamenting the loss of Sound Physicians, but the change to Vituity feels like a lateral move from one national corporation to another. The providers long for the days of employment by a local group.

Safety concerns 

According to two hospitalists, Vituity’s regional director told physicians the contractor has a “yes culture,” meaning they say “yes” to what the hospital wants, and that providers should keep any concerns to themselves. 

“There’s a sense among the medical staff that if you speak out, you’re not safe,” a non-hospitalist physician at Skagit Regional Health said.

Ivie said he’s “not aware” of this and “certainly” hasn’t seen it in action.

The various staffing models that hospitalists say Vituity has floated in recent weeks introduced a range of concerns for providers, from decreased staffing with higher patient loads to hampering Skagit Regional’s residency program that depends on teaching hospitalists. 

Some models proposed by Vituity, according to multiple hospitalists, include one less rounding team, meaning individual hospitalists would round on more patients and handle more admissions since hospitalists’ swing shifts may begin two hours later than currently scheduled. Vituity also proposed dropping the night team from two hospitalists to one, the providers said, adding that multiple night hospitalists didn’t return. 

During the gap, one hospitalist said, “the swing team that’s focused on doing admissions will have to cross-cover the 100 patients that are in the hospital that they have no relationship with, as well as supervise residents that they won’t be working directly with.”

“At the end of the day, it’s cost-saving for the hospital,” one hospitalist said.

One hospitalist spoke out in recent weeks, saying this was unsafe and unsustainable. The next day, according to multiple hospitalists, their offer was revoked in an email from Vituity saying the company no longer has “a business need for your services.”

Ivie said while there may be changes during the interim, there are no plans for long-term changes to the model.

“They have a responsibility to staff the service, and that is their responsibility,” Ivie said.

Owen Racer is a Report for America corps member who covers healthcare and public health in Whatcom and Skagit counties. Reach him at owenracer@cascadiadaily.com; 360-922-3090 ext. 101. Learn more and donate at cascadiadaily.com/rfa.