Exclusive anesthesia contracts: History, theory, nuts and bolts

Exclusive contracts for anesthesia services bring both benefits and burdens to the individuals and groups that hold them. This article begins with the history of the trend from open staffed anesthesia departments, in which each anesthesiologist is a competitor, to closed staffed arrangements in which all anesthesia care is provided through an exclusive contract arrangement. It presents the issues inherent in the exclusive contract relationship, discusses in detail each of the major deal points usually contained in an exclusive contract, and offers suggestions for the negotiation of an agreement favorable to anesthesiologists.