Doctors Strike

[Birdstrike]

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It's been a long time comin'.

Doctors strike, rally for contract with Allina

Union officials say Allina is offering less pay than the doctors currently make and is resisting demands for more physician control over decisions affecting patient care. Allina says the two sides have made progress but says any contract has to account for rising healthcare costs.

www.mprnews.org

 

[NYEMMED]

And can’t wait for the public comments that doctors make too much and who cares…..

 

[emergentmd]

As a Physician, I don't understand the point of unionizing and striking. Quit and find another job. There are plenty of better jobs rather than beating your head constantly against the C-suite.

 

[bravotwozero]

As a Physician, I don't understand the point of unionizing and striking. Quit and find another job. There are plenty of better jobs rather than beating your head constantly against the C-suite.

On an individual level, yes. I can appreciate that approach of voting with your feet. Will work well if you're in a field that's in demand.

On a systemic level, it accomplishes nothing. People will still face burnout level conditions, patients and physicians will both be worse off for it.

I'd say mobilizing and collective action is a bit more than 'beating your head against the c-suite'. Look at what happened at that hospital in OR.

We are in the post covid pandemic era. People are tired of being abused, and as time goes by, will become more likely to mobilize. Social media is also helping bad actors get a lot more bad publicity - something that might not happen without unionizing and striking.

 

[AlmostAnMD]

Airline pilots ultimately mobilized because of safety. There is a reasoned argument for the same level of control with doctors.

Unions are the only way to enforce the grunt's rights. True, you can vote with your feet and go to a "better shop," but I ask you, with the general way the healthcare landscape is backsliding all grass on the other side of the fence will be scorched earth at some point. And they'll find docs to work them, too....the worst jobs of the worst pay will still fill, perhaps not using docs from this country, but there will never be a true shortage.

The question really only becomes, "what mechanisms protect doctors?"

ABEM? loll
ACEP? rofl
AAEM, maybe, but that spirit bomb needs more energy donated

Ultimately, right now, it's nothing...thus the vote with your feet comment. Because the only human truly looking out for you is you.

 

[sloh]

And to the extent that unionizing would even affect meaningful improvement, it would probably only benefit the next generation of physicians.

 

[AlmostAnMD]

That's very true. But, let's not be like our forebearers. Our forebearers just watched everything burn around them and did nothing whilst selling out to emerging CMG's to enrich themselves. Instead of doing the same "FU got mine" attitude I'd advocate for making the system better, thereby making the specialty itself more appealing again.

Turning into an administrator has made me more wishful in this area. Largely because I've been quite successful at sticking it to insurance companies, I've learned that if you just keep pushing you can make real meaningful difference. Safe staffing and the elimination of private equity are attainable dreams, ones that could change--or save--lives.

 

[Bittersteel]

Airline pilots ultimately mobilized because of safety. There is a reasoned argument for the same level of control with doctors.

Unions are the only way to enforce the grunt's rights. True, you can vote with your feet and go to a "better shop," but I ask you, with the general way the healthcare landscape is backsliding all grass on the other side of the fence will be scorched earth at some point. And they'll find docs to work them, too....the worst jobs of the worst pay will still fill, perhaps not using docs from this country, but there will never be a true shortage.

The question really only becomes, "what mechanisms protect doctors?"

ABEM? loll
ACEP? rofl
AAEM, maybe, but that spirit bomb needs more energy donated

Ultimately, right now, it's nothing...thus the vote with your feet comment. Because the only human truly looking out for you is you.

That's very true. But, let's not be like our forebearers. Our forebearers just watched everything burn around them and did nothing whilst selling out to emerging CMG's to enrich themselves. Instead of doing the same "FU got mine" attitude I'd advocate for making the system better, thereby making the specialty itself more appealing again.

Turning into an administrator has made me more wishful in this area. Largely because I've been quite successful at sticking it to insurance companies, I've learned that if you just keep pushing you can make real meaningful difference. Safe staffing and the elimination of private equity are attainable dreams, ones that could change--or save--lives.

1) ER docs will never organize meaningfully. They are simps that love abuse.

2) The system and speciality are never getting better. We are firmly in frog in pot territory. Starting about 36 months ago, we are witnessing the collapse in real time.

3) You're making more money for your system...ok?? How much of that is rolling downhill to the docs?

 

[JacobMcCandles]

2) The system and speciality are never getting better. We are firmly in frog in pot territory. Starting about 36 months ago, we are witnessing the collapse in real time.

Why 36 months ago? I’m over 10 years out and I’ve been told the entire time that the specialty was done. If you ask your older partners and they were honest, they’ve been under that impression their entire career. While I’m not saying it isn’t true but I will say that narrative is nothing new.

 

[Bittersteel]

Why 36 months ago? I’m over 10 years out and I’ve been told the entire time that the specialty was done. If you ask your older partners and they were honest, they’ve been under that impression their entire career. While I’m not saying it isn’t true but I will say that narrative is nothing new.

Something feels different over the past 3-4 years.

Patients more violent / aggressive / demanding.

More litigation.

PCPs not seeing acute visits and sending literally everything to the ER.

Admin more ridiculous.

It definitely fees worse than it did 10 years ago.

 

[JacobMcCandles]

Something feels different over the past 3-4 years.

Patients more violent / aggressive / demanding.

More litigation.

PCPs not seeing acute visits and sending literally everything to the ER.

Admin more ridiculous.

It definitely fees worse than it did 10 years ago.

I won’t argue that because I understand what you’re saying and I definitely agree. Patient expectations are at an all time high and patient manners are at an all time low. I think most other service-type industries are seeing something similar so that’s why I don’t think it’s necessarily different this time.

 

[AlmostAnMD]

1) ER docs will never organize meaningfully. They are simps that love abuse.

Sadly that's agreeable. I'm just saying it's possible. The group think is pretty rough in this speciality. The amount of people in my old shop complaining about the job but refusing to DO anything about it was depressing. Most docs with a brain are gone, which you can imagine what that did to residual quality.

2) The system and speciality are never getting better. We are firmly in frog in pot territory. Starting about 36 months ago, we are witnessing the collapse in real time.

Yeah, I bring it up largely because once the point of no return is crossed it's up to fate.

3) You're making more money for your system...ok?? How much of that is rolling downhill to the docs?

Zero! But professional services are actually the responsibility of individual group practices. Oddly enough when I try to coordinate with them (usually for prior auth issues they keep effing up that impact facilities) they refuse to cooperate because what i do is "too hard."

I work every other fee other than the physician fees. This pays for techs, nurses, and in fact a new children's hospital we are building!

 

[Bittersteel]

Sadly that's agreeable. I'm just saying it's possible. The group think is pretty rough in this speciality. The amount of people in my old shop complaining about the job but refusing to DO anything about it was depressing. Most docs with a brain are gone, which you can imagine what that did to residual quality.


Yeah, I bring it up largely because once the point of no return is crossed it's up to fate.



Zero! But professional services are actually the responsibility of individual group practices. Oddly enough when I try to coordinate with them (usually for prior auth issues they keep effing up that impact facilities) they refuse to cooperate because what i do is "too hard."

I work every other fee other than the physician fees. This pays for techs, nurses, and in fact a new children's hospital we are building!

You can't really do anything about it except find a new job, new field or quit. You're not changing the system.

 

[dozitgetchahi]

On an individual level, yes. I can appreciate that approach of voting with your feet. Will work well if you're in a field that's in demand.

On a systemic level, it accomplishes nothing. People will still face burnout level conditions, patients and physicians will both be worse off for it.

I'd say mobilizing and collective action is a bit more than 'beating your head against the c-suite'. Look at what happened at that hospital in OR.

We are in the post covid pandemic era. People are tired of being abused, and as time goes by, will become more likely to mobilize. Social media is also helping bad actors get a lot more bad publicity - something that might not happen without unionizing and striking.

Exactly.

Physicians have a long tradition of being cowardly, and avoiding confrontation regarding issues of patient safety, workplace conditions, pay, lifestyle etc.

I’m glad to see some folks standing up and pushing back. Good on them.

 

[thegenius]

Hasn’t striking worked pretty well in other fields? Autoworkers got substantial raises, and NYC nurses got enforceable staffing requirements. I get why someone would rather find a better job, but that leaves the same problems for whoever takes their place. I don’t know whether a physician strike would work, but I wouldn’t write it off.

 

[thegenius]

“Just find another job” only gets you so far if every employer has the same problems. Competition should push employers to treat people better, but it doesn’t always work that way. That’s where unions have value: workers can push for better conditions without having to uproot their lives.

 

[JacobMcCandles]

Hasn’t striking worked pretty well in other fields? Autoworkers got substantial raises, and NYC nurses got enforceable staffing requirements. I get why someone would rather find a better job, but that leaves the same problems for whoever takes their place. I don’t know whether a physician strike would work, but I wouldn’t write it off.

Who are you expecting to give the physicians a raise? I guess those who work for a hospital could try to get it from them. For those of us who are self-employed, it's most common for insurance contracts to be based off of Medicare rates. The government isn't going to raise their rates, they couldn't care less. Insurance companies aren't going to renegotiate contracts just to give out better contracts because of a strike, they couldn't care less. I think strikes work better in other industries because the other industries aren't as dysfunctional as healthcare.

 

[Apollyon]

Doctors are like truck drivers. We are all small groups, with many of them.

 

[emergentmd]

Strikes have a lot to do with Optics.

Poor nurse making $80K/yr gets sympathy. Doctors making $400K/yr gets little sympathy. This is similar the public backing the screenwriter's guild but would be laughing if Brad Pitt was picketing after pocketing $50Mil.

Strike if you want, I will support docs who do. The hospital will throw docs a bone but I doubt it will end up being anything substantial.

 

[Birdstrike]

Strikes have a lot to do with Optics.

Poor nurse making $80K/yr gets sympathy. Doctors making $400K/yr gets little sympathy. This is similar the public backing the screenwriter's guild but would be laughing if Brad Pitt was picketing after pocketing $50Mil.

Optics ever stopped professional athletes from striking. Their average salary has increase 30 fold since their first strike in the 1970s and another strike is on it's way (MLB in 2027). They think they're worth it. But we doctors? "I can't have anyone not like me, (wiping tears). I guess we're just screwed." Physicians and their leadership have a defeatist and defensive attitude (with the exception of some surgeons' groups.) Suicidal empathy doesn't have to be the default option.

If you can make a non-breathing person live, give someone a new heart, save the life of a baby or ease a suffering person's agony, maybe you deserve a raise and a very big one. That shouldn't be a radical thought. What is radical is that a back up quarterback who carries a clipboard for a living earns 10X what a doctor does and people will gladly give them money they can't afford to watch them do it. Yet we feel "guilty"?

Change your thinking, change your life, change the World.

 

[JacobMcCandles]

Optics ever stopped professional athletes from striking. Their average salary has increase 30 fold since their first strike in the 1970s and another strike is on it's way (MLB in 2027). They think they're worth it. But we doctors? "I can't have anyone not like me, (wiping tears). I guess we're just screwed." Physicians and their leadership have a defeatist and defensive attitude (with the exception of some surgeons' groups.) Suicidal empathy doesn't have to be the default option.

If you can make a non-breathing person live, give someone a new heart, save the life of a baby or ease a suffering person's agony, maybe you deserve a raise and a very big one. That shouldn't be a radical thought. What is radical is that a back up quarterback who carries a clipboard for a living earns 10X what a doctor does and people will gladly give them money they can't afford to watch them do it. Yet we feel "guilty"?

Change your thinking, change your life, change the World.

Entertainment is valued much more than physicians. The 60 year old vasculopath doesn’t want to go without his sports. His doctors “never do anything” for him because they can’t solve the underlying issues of a non-compliant obese smoking semi-alcoholic. The average American thinks they have zero responsibilities for their problems. It’s a societal issue and it’s partly why healthcare is so dysfunctional. You’re not fixing that with a strike.

 

[Bittersteel]

Make your money and quit.

You're not changing a thing.

 

[anonperson]

Entertainment is valued much more than physicians. The 60 year old vasculopath doesn’t want to go without his sports. His doctors “never do anything” for him because they can’t solve the underlying issues of a non-compliant obese smoking semi-alcoholic. The average American thinks they have zero responsibilities for their problems. It’s a societal issue and it’s partly why healthcare is so dysfunctional. You’re not fixing that with a strike.

We just want more money and less work. Your typical union goals

 

[JacobMcCandles]

We just want more money and less work. Your typical union goals

I think you just described everyone everywhere.

 

[thegenius]

Who are you expecting to give the physicians a raise? I guess those who work for a hospital could try to get it from them. For those of us who are self-employed, it's most common for insurance contracts to be based off of Medicare rates. The government isn't going to raise their rates, they couldn't care less. Insurance companies aren't going to renegotiate contracts just to give out better contracts because of a strike, they couldn't care less. I think strikes work better in other industries because the other industries aren't as dysfunctional as healthcare.

Sure, it’s different if you’re self-employed. But the Allina docs have an employer, and pay isn’t the only thing they can negotiate. I don’t expect a strike to fix healthcare or change how patients behave. If it gets them better working conditions and more say in patient care, isn’t that enough to make it worth trying?

 

[thegenius]

Strikes have a lot to do with Optics.

Poor nurse making $80K/yr gets sympathy. Doctors making $400K/yr gets little sympathy. This is similar the public backing the screenwriter's guild but would be laughing if Brad Pitt was picketing after pocketing $50Mil.

Strike if you want, I will support docs who do. The hospital will throw docs a bone but I doubt it will end up being anything substantial.

You went from “I don’t understand the point” to “I’ll support docs who do,” so maybe we’re making progress. But “the hospital will throw docs a bone” is still a better outcome than waiting for the C-suite to spontaneously improve things. I’m not sure why quitting is considered practical while negotiating together is wishful thinking.

 

[JacobMcCandles]

Sure, it’s different if you’re self-employed. But the Allina docs have an employer, and pay isn’t the only thing they can negotiate. I don’t expect a strike to fix healthcare or change how patients behave. If it gets them better working conditions and more say in patient care, isn’t that enough to make it worth trying?

Absolutely but physicians have basically dropped the ball in every way imaginable on positioning themselves to negotiate. Look at how nurses have positioned themselves to receive sympathy from the public. Even NPs had success with their ridiculous “heart of a nurse, brain of a doctor” slogan.

 

[thegenius]

Absolutely but physicians have basically dropped the ball in every way imaginable on positioning themselves to negotiate. Look at how nurses have positioned themselves to receive sympathy from the public. Even NPs had success with their ridiculous “heart of a nurse, brain of a doctor” slogan.

Then we probably agree more than I thought. We’ve done a lousy job organizing and advocating for ourselves. I just see that as a reason to start, and these docs are trying.

 

[AlmostAnMD]

Then we probably agree more than I thought. We’ve done a lousy job organizing and advocating for ourselves. I just see that as a reason to start, and these docs are trying.

Understatement of the year. ED docs are so scatter brained organizing en masse is too much of an ask for most of us

I didn't know what a functional, goal-oriented organization actually looked like until I left EM and it made me sad to think ACEP even exists by comparison

 

[Bittersteel]

Then we probably agree more than I thought. We’ve done a lousy job organizing and advocating for ourselves. I just see that as a reason to start, and these docs are trying.

Theres a whole line of new grads from clown car residencies willing to take their places.

 

[Bittersteel]

Understatement of the year. ED docs are so scatter brained organizing en masse is too much of an ask for most of us

I didn't know what a functional, goal-oriented organization actually looked like until I left EM and it made me sad to think ACEP even exists by comparison

ACEP is a joke.

 

[Porfirio]

Only way your life changes is if you walk away to another pasture. Physicians are in various stages of life.

The newly graduated physicians are trapped by having less than nothing and no other alternatives (until PRN relationships are established).

The established physicians are stuck by geographic ties. This group has to sacrifice these ties to break the cycle.

The closer we get to retirement/FI the less we care about working conditions/pay.

This is how we are preyed upon.

 

[bravotwozero]

Theres a whole line of new grads from clown car residencies willing to take their places.

New scabs being spawned every year.

 

[alpinism]

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[JacobMcCandles]

They’re likely to get a bunch of green residents with that $100k sign on bonus. Godspeed to those who can’t see they’re making a deal with the devil.