Voting with their feet

'Time is not your friend."

It is what Charlie Baker learned in his long, ultimately successful battle to save Harvard Pilgrim Health Care. Now Ellen Zane is learning that lesson, too, in her battle to save Tufts-New England Medical Center.

An important group of doctors -- nine in all -- are voting with their feet, bolting Tufts-New England's Floating Hospital for Children for Massachusetts General Hospital. It is a story rich with juicy subplots: Mass. General lost out to rival Children's Hospital in a bidding contest to partner with Floating Hospital, and now is acquiring one of the Floating's most important practice groups. Zane came from Mass. General's parent company, Partners HealthCare, and is now losing key physicians to her powerful former employer. Zane has threatened legal action to block the doctors from leaving, several executives said, an unusual tactic in the medical business to say the least.

Doctors come and go all the time. But for the Floating these are not ordinary doctors, and these are not ordinary times.

Mass. General is hiring six doctors from the Floating's pediatric gastroenterology unit, including the well-known head of the department, Dr. Aubrey J. Katz, and three others in training. The unit is an important source of patients and revenue at the Floating, and will roughly double the department at Mass. General.

This is not what Zane needs now. Tufts-New England is the sickest of Boston's important teaching hospitals, surrounded by larger, stronger hospitals that carry the Harvard brand name. It lost more than $50 million in the past two fiscal years; earlier this year the hospital reported its second quarterly profit in a row. But the place is far from out of the woods.

A key piece of Zane's strategy is merging its money-losing Floating with the much stronger Children's Hospital. The negotiations, first disclosed in October, were supposed to be completed in six weeks, but that hasn't happened. There has been much grumbling from inside Floating from unhappy doctors who feel as if they are on the losing end of a hostile takeover. Children's and Tufts-New England have reportedly had to bring in a mediator to resolve the issues outstanding.

"As you know," the hospital said in a statement, "Tufts-New England Medical Center's Floating Hospital for Children is in the midst of partnership talks with Children's Hospital. When we entered those discussions, we understood that some transition of our staff might occur as the process developed. We are committed to providing continuity of care for all of our patients."

Dr. Ronald Kleinman, associate chief of Mass. General's pediatrics unit, denied his hospital was poaching on its weaker rival, and said Katz's group had been talking to Mass. General and Children's Hospital for more than a year. "This is unfortunately a trend that has been going on for many years" at the Floating, he said. Katz didn't return my call.

Uncertainty is debilitating. And time, as Charlie Baker discovered, , is not your friend. Head-hunters start calling; your best people start listening. (See Testa Hurwitz & Thibeault, the failed Boston law firm.)

Harvard Pilgrim recovered and so has Beth Israel Deaconess. Tufts-New England, which traces its heritage to the old Boston Dispensary, founded in 1796, has deep roots in the community, and Zane has done an admirable job of cutting costs and selling off assets. Now comes the hard part: Can she get better contracts for insurers and increase volume through better alliances with suburban hospitals?

Tufts-New England can survive the loss of nine doctors. But Zane's job, the toughest in Boston healthcare today, got no easier with their departure.

Steve Bailey is a Globe columnist. He can be reached at bailey@globe.com or at 617-929-2902.