Oregon Employed MD's Ratify First Union With Hospital

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drusso

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Perhaps more employed MD's to follow...


Sacred Heart Doctors Ratify Union Contract, First in the Nation

The hospitalists at Sacred Heart Medical Center in Springfield have signed off on the very first collective bargaining agreement between an American hospital and its employee physicians. The new union, which was borne of a revolt to outsource their jobs to an independent contracting agency, had held out over a hospital resource committee which could affect staffing levels.
Chris Gray

A group of 27 hospital physicians ratified a union contract Thursday with their employer, PeaceHealth Sacred Heart Medical Center, marking the dawn of a new day in the history of the American labor movement, and opening up other health systems to collective bargaining for doctors.

“We got a lot of what we asked for,” said Dr. David Schwartz, a hospitalist and chief negotiator for the Pacific Northwest Hospital Medicine Association, the only union or union chapter of its kind. “The new contract will allow us to have a good say in what’s good medicine and what’s not.”

The push for a union was catalyzed when Sacred Heart unveiled plans to fire all of its hospital physicians -- or hospitalists -- and outsource their work to an independent contractor. The decision to outsource the doctors produced a backlash, and even after the administration backed off, the doctors decided to band together to protect their interests.

The union organizers had planned an informational picket for Thursday, but backed off after breakthroughs in negotiation with the hospital last week.

Schwartz said the financial aspects of the contract -- salaries and most benefits -- had already been hammered out and agreed upon months ago. The doctors held out on two key points -- ensuring that all of them would be covered by liability insurance, as well as so-called “tail” insurance when they leave -- and a more balanced hospital committee that will give them more say on staffing levels and patient safety.

The new Hospital Medicine Resource Committee will be evenly composed of management and hospitalists, and votes will be based on a simple majority, not a consensus. The decisions are not binding, but if the administrator vetoes their decisions, the committee members will have the right to go to mediation, a key sticking point for union negotiators, Schwartz said.

“As medicine becomes more and more corporate, there are more conflicts between those who know what’s good medicine and those who don’t,” said Schwartz. “You can’t have a successful medical practice if you’re not practicing good medicine.”

On the horizon, Schwartz said that Sacred Heart was working towards having all hospitalists work as universal providers, capable of treating across the spectrum of conditions. He said that he and the other doctors supported this idea on principle, but current staffing levels were insufficient to provide this level of care.

The medicine resource committee would ensure that management would not try to push this service with too few doctors. He said one study showed that they may need as many as 25 new doctors or nurse practitioners to work as universal providers, but a more realistic assessment would come down to 15 new providers.

Research released last month from the Johns Hopkins Bloomberg School of Public Health showed that Sacred Heart was one of the ten-most profitable hospitals in the nation, with $171 million in net profit from patient services in fiscal year 2013.

The high level of operating margins has created a window where Sacred Heart’s employees -- both its physicians and front-line workers -- have been able to leverage to earn either higher wages or a better work environment through collective bargaining.

In addition to the new collective bargaining contract with the Pacific Northwest Medicine Association, the Service Employees International Union Local 49 organized and won a contract for 1,100 of the hospital workers, which has afforded them a 21 percent pay raise.

However, in recent comments from The Infinity Group, it was argued that Sacred Heart’s financial strength comes only after a turnaround from a weak position in earlier years. PeaceHealth spokeswoman Anne Williams did not respond to questions about this story.

Jun 27 2016

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So maybe if we play our cards right, we can also pay union dues on top of MOC, DEA, state license fees, mandated CME, worthless society membership fees, etc. I'm in!!!;)
 
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being a member in a union implies the threat of a strike. the union really has no teeth unless the threat is real. will the docs actually strike if push comes to shove? id like to see how this plays out.
 
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being a member in a union implies the threat of a strike. the union really has no teeth unless the threat is real. will the docs actually strike if push comes to shove? id like to see how this plays out.
It's happened in England.
 
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being a member in a union implies the threat of a strike. the union really has no teeth unless the threat is real. will the docs actually strike if push comes to shove? id like to see how this plays out.

Don't have to strike: Work slow downs, sick outs, etc. Union Bosses have all kinds of tricks up their sleeves for harassing the owners/management. I just wonder how physicians will consider prospective job opportunities with the union card in play. Will residents out straight out of training be more or less attracted to working for union shops, non-union shops, or straight private practice.

Would you join a union?
 
As to how a strike would work, it would work the same as all strikes do- Union lets them know beforehand, they have to hire locums for the entire hospital which they'll have to keep around until they negotiate a contract. That provides a lot of bargaining power, as locums/temp workers are expensive. When I was an RT, I got offered $75/hr to work during a strike- can't even imagine what a temporary staffing agency would have to pay a physician.
 
Don't have to strike: Work slow downs, sick outs, etc. Union Bosses have all kinds of tricks up their sleeves for harassing the owners/management. I just wonder how physicians will consider prospective job opportunities with the union card in play. Will residents out straight out of training be more or less attracted to working for union shops, non-union shops, or straight private practice.

Would you join a union?

Rest assured, owners/management has just as many cards up their sleeves: preferential shifts and/or work assignments, etc.

If either side wants to play nasty, it can certainly be done. Or the flip side - both sides can work together in relatively good faith once the animus dies down and if egos can be held in check long enough to rebuild trust.
 
Don't have to strike: Work slow downs, sick outs, etc. Union Bosses have all kinds of tricks up their sleeves for harassing the owners/management. I just wonder how physicians will consider prospective job opportunities with the union card in play. Will residents out straight out of training be more or less attracted to working for union shops, non-union shops, or straight private practice.

Would you join a union?
I did , during residency... Apparently I got free parking out of it... By the way the world is exiting union contracts, why would physician groups elect for it? Push should be for free enterprise practices
 
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Rest assured, owners/management has just as many cards up their sleeves: preferential shifts and/or work assignments, etc.

If either side wants to play nasty, it can certainly be done. Or the flip side - both sides can work together in relatively good faith once the animus dies down and if egos can be held in check long enough to rebuild trust.
I'm not sure that's true. Physicians have the ultimate trump card: there are more jobs that need us than there are physicians who need jobs.

I'll give you an example - this time last year I was getting screwed over by a hospital system. I basically said "make X happen or I'm out". They didn't change their ways so I left. A year later my job is still open and they're operating at 1/3rd the hours they were in that clinic because of it. They can absorb that because it was just 1 doctor our of 4. Had 1 or 2 of the others said the same thing, they would either a) comply b) hire locums which cost easily 50% more than we do c) close the very lucrative clinic.
 
I'm not sure that's true. Physicians have the ultimate trump card: there are more jobs that need us than there are physicians who need jobs.

I'll give you an example - this time last year I was getting screwed over by a hospital system. I basically said "make X happen or I'm out". They didn't change their ways so I left. A year later my job is still open and they're operating at 1/3rd the hours they were in that clinic because of it. They can absorb that because it was just 1 doctor our of 4. Had 1 or 2 of the others said the same thing, they would either a) comply b) hire locums which cost easily 50% more than we do c) close the very lucrative clinic.
Hospital systems are to arrogant to concede to anyone physician, no matter who you are. They rather take the temporary loss, since they are flooded with three times the site of service revenue... I can't see hospital systems sustaining long term, total waste of health care expenditures.... Just my opinion of course. Also these ACOs are surprisingly making smaller efficient practices busier.
 
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If youre smart and really hate hospitals, as I clearly do(lol), rent land to major national urgent care centers trying to sift business out of the ERs. As most of us know, the ER is the hospitals most lucrative referral source....
 
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im worried that using such trump cards will ultimately backfire, and wonder if it might be contributing to hospitals having greater interest in hiring "professionals" that are more numerous, cheaper, more easily replaced, more pliable and willing to accept less than ideal working conditions (cough "associate practice partners"/"midlevels" cough)
 
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im worried that using such trump cards will ultimately backfire, and wonder if it might be contributing to hospitals having greater interest in hiring "professionals" that are more numerous, cheaper, more easily replaced, more pliable and willing to accept less than ideal working conditions (cough "associate practice partners"/"midlevels" cough)
They have to hire more mid levels do due population growth and healthcare cost containment. The point I'm making, is make hospitals less potent by supporting competition. This is the current populist movement occurring around the world, with or without your trump cards...
 
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Hospital systems are to arrogant to concede to anyone physician, no matter who you are. They rather take the temporary loss, since they are flooded with three times the site of service revenue... I can't see hospital systems sustaining long term, total waste of health care expenditures.... Just my opinion of course. Also these ACOs are surprisingly making smaller efficient practices busier.
I agree, which is why they let me leave easily but might have changed had even 1 other guy at that office threatened to do the same.

Interestingly, I have an uncle who is also an FP and is a VP for an CHS hospital and at their last big corporate meeting apparently the CEA even predicted that most hospitals weren't going to survive the next 10 years - lots of intensive outpatient treatment for common admitting issues instead of overnight stays. I've recently seen where some ortho groups are doing outpatient joint replacements, there's that new 10d course of essentially vancomycin given as 1, 3-hour IV infusion (say goodbye to those easy but well paid cellulitis admissions). You're also getting some fierce backlash against hospital owned practices thanks to ACA high deductible plans and the increased press that facility fees and just generally higher prices are getting.
 
im worried that using such trump cards will ultimately backfire, and wonder if it might be contributing to hospitals having greater interest in hiring "professionals" that are more numerous, cheaper, more easily replaced, more pliable and willing to accept less than ideal working conditions (cough "associate practice partners"/"midlevels" cough)
Let them. I get several new patients/month who want to make sure my practice doesn't use nurse practitioners or PAs as they are tired of paying the same prices and "never seeing a doctor".
 
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I did , during residency... Apparently I got free parking out of it... By the way the world is exiting union contracts, why would physician groups elect for it? Push should be for free enterprise practices
The trouble is that we exist in a market that is largely shielded from free market forces. In such situations, collective bargaining makes sense, as your employer has little financial incentive to do so.
 
The trouble is that we exist in a market that is largely shielded from free market forces. In such situations, collective bargaining makes sense, as your employer has little financial incentive to do so.
True... Similar to cable, Tele, insurance, etc. but medicine can still be more like a banking model, with more competition and interstate commerce. Frank Dodd has ruined banking in similar fashion to the ACA . We need a revolution not more unions. ducctape can you say TRUMEXIT....
 
If you're an employed MD I think it would be stupid to NOT have a union standing behind you. Alternatively, and preferably in my mind, employed MD's would band together and form their own independent group and leverage size and cohesiveness to bargain with the management for better pay and conditions. But, COHESIVENESS is the key. Right now the large physician employers benefit by either directly controlling MD's or keeping them siloed
 
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problem is, look at all the forces that work at tearing cohesiveness apart amongst physicians.

there are conflicts between physician specialties ("its IM's problem"; "this is a surgical issue", "its all in 101Ns head")

there are conflicts with other health care professionals - ie national NP and PA associations - and their scope of practice

there are conflicts with administration

there are conflicts with CMS
 
problem is, look at all the forces that work at tearing cohesiveness apart amongst physicians.

there are conflicts between physician specialties ("its IM's problem"; "this is a surgical issue", "its all in 101Ns head")

there are conflicts with other health care professionals - ie national NP and PA associations - and their scope of practice

there are conflicts with administration

there are conflicts with CMS
Don't forget UNIONS also have conflicts as well. Europe is a great example. In the USA union members don't necessarily agree with the "bosses". That being said, can one imagine physicians getting along in a union.... That would be harder than keeping the European Union together .
 
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yes, agree, but it just feels that we physicians are less united and are torn apart from one anothe much more than the typical union worker....
 
yes, agree, but it just feels that we physicians are less united and are torn apart from one anothe much more than the typical union worker....

my concerns would be nearly diametrically opposite from a PCP's. the divide would be between specialists and generalists
 
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Yes, nurse-managers and the government suck... Jk, no i'm not.
I have these wonderful day-dreams during slow days where bunches of doctors recreate the torches and pitchfork scenes from Frankenstein movies but instead of a scarred up monster we're going for nurse-managers...
 
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