Valley Emergency Physician docs plan walk out for tomorrow

[alpinism]

The contract was recently acquired by USACS last year after they took over the VEP hospitals.

San Jose emergency physicians to walk off job due to understaffing

Emergency workers at the Santa Clara County Valley Medical Center are staging a walkout to protest staffing shortages and unsafe working conditions.

sanjosespotlight.com

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[EM_kindaguy]

Whoa, USACS taking bad press? Who'da thunk it

 

[Arcan57]

Late stage capitalism for the win.

 

[The kitchen sink]

Ive always heard about some vague law saying physicians aren’t allowed to strike. Can someone explain if this is or is not in violation?

 

[EctopicFetus]

Ive always heard about some vague law saying physicians aren’t allowed to strike. Can someone explain if this is or is not in violation?

I mean the first amendment gives us the right to free speech and with that we can protest (aka strike). This is more for show than anything else IMO. Good it got some press. Keep 💩 in on USACS they deserve it. Literally the worst group/company to work for.

 

[southerndoc]

Ive always heard about some vague law saying physicians aren’t allowed to strike. Can someone explain if this is or is not in violation?

They basically aren't striking as much as they are protesting. A strike is when you walk out. There is no way they are leaving the ED unstaffed. Those that are off that day are gathering to protest, and those that are scheduled are still showing up to work.

 

[GonnaBeADoc2222]

They basically aren't striking as much as they are protesting. A strike is when you walk out. There is no way they are leaving the ED unstaffed. Those that are off that day are gathering to protest, and those that are scheduled are still showing up to work.

And this is why we lose.

 

[EctopicFetus]

And this is why we lose.

Ethical responsibility is real and beyond that they know they can be replaced tomorrow. USACS can bring in their firefighters aka the equivalent of scabs.

 

[The kitchen sink]

Ethical responsibility is real and beyond that they know they can be replaced tomorrow. USACS can bring in their firefighters aka the equivalent of scabs.

‘Ethical’ and ‘moral’ responsibility are a double edged sword for us. More so than not, that concept serves as the chains by which physicians are bound too.

 

[bravotwozero]

They basically aren't striking as much as they are protesting. A strike is when you walk out. There is no way they are leaving the ED unstaffed. Those that are off that day are gathering to protest, and those that are scheduled are still showing up to work.

Actually not a bad strategy as long as it generates enough bad press about USACS…

 

[southerndoc]

And this is why we lose.

If docs left an ER unstaffed, do you think the public will sympathize with us or be extremely critical that we let patients suffer and die? It doesn't matter if the only patient in the ER was a stubbed toe, the news media will say that ER docs left dying patients to fend for themselves. Most states would probably have their AG's look for possible criminal charges against the physicians for doing this if they were scheduled (and thus had a duty to act).

I'm all for good work rights, excellent pay, etc., but I will not put a patient's life in jeopardy for me to cater to my own selfishness.

 

[Siggy]

Ive always heard about some vague law saying physicians aren’t allowed to strike. Can someone explain if this is or is not in violation?

There are two separate issues.

One, as touched on earlier, is the concept that the ED has to remain staffed and concern for patient abandonment.

When it comes to independent practices (e.g. group or individual practices for GI, cards, surgery, etc) it's more of an anti-trust issue. If one practice decides not to service a hospital because of the terms required, that's fine. If multiple individual groups (including single physician groups) band together and boycott a hospital in an organized manner, then that's collusion to engage in price manipulation. It would be like if Tenet and HCA banded together to refuse to take Blue Cross insurance unless Blue Cross raised reimbursement.

 

[GonnaBeADoc2222]

If docs left an ER unstaffed, do you think the public will sympathize with us or be extremely critical that we let patients suffer and die? It doesn't matter if the only patient in the ER was a stubbed toe, the news media will say that ER docs left dying patients to fend for themselves. Most states would probably have their AG's look for possible criminal charges against the physicians for doing this if they were scheduled (and thus had a duty to act).

I'm all for good work rights, excellent pay, etc., but I will not put a patient's life in jeopardy for me to cater to my own selfishness.

Ethics LOL. No one cares about ethics when teachers or air traffic controllers strike.

This is pretty easy. The docs give 24 hour notice of impending strike. This gives more than enough time for admin to set up EMS diversion, get boarding patients up to the floor (or send a hospitalist down to babysit), get patients transferred out, put out notices on media / highway billboards that the ER is shutting down, whatever else. Will never happen though cause physicians won't be willing to go 2 weeks without a paycheck.

 

[EctopicFetus]

‘Ethical’ and ‘moral’ responsibility are a double edged sword for us. More so than not, that concept serves as the chains by which physicians are bound too.

It’s one of the reasons we keep getting abused. Totally agree. If you ever worked for a cmg that needed staffing this is their go to.

 

[bravotwozero]

Ethics LOL. No one cares about ethics when teachers or air traffic controllers strike.

Funny you mentioned air traffic controllers…what ended up happening to them when they went on strike?

 

[Birdstrike]

Ive always heard about some vague law saying physicians aren’t allowed to strike. Can someone explain if this is or is not in violation?

Employed physicians are able to unionize and strike. Private practice physicians are not.

 

[GonnaBeADoc2222]

Funny you mentioned air traffic controllers…what ended up happening to them when they went on strike?

This is the risk you take when you take a stand.

The strongest negotiating position is a true willingness and ability to walk.

I laugh when physicians, especially ER docs complain about this or that. "Admin need to do X, Admin needs to do Y." Admin actually doesn't need to do ****, so long as you keep showing up to work and bill. Either swallow it and do your job, or walk. It's black and white.

 

[Birdstrike]

The contract was recently acquired by USACS last year after they took over the VEP hospitals.

San Jose emergency physicians to walk off job due to understaffing

Emergency workers at the Santa Clara County Valley Medical Center are staging a walkout to protest staffing shortages and unsafe working conditions.

sanjosespotlight.com

Any time I see physicians standing up for themselves and playing hardball, I applaud it. Playing Mr. Nice Guy has done nothing but led to physicians ceding control of their profession to people that don't have their best interest in mind and who are happy to abuse, disvalue, ignore, and treat them like discardable, hourly help. Until physicians are willing to play smash-mouth, down-in-the-dirt hardball to improve their working conditions, they'll continue to lose more and more job satisfaction. Why is burnout sky high among physicians? Because physicians take abuse, complain, take more abuse, complain, repeat cycle.

 

[Dr Mantis Toboggan]

Ive always heard about some vague law saying physicians aren’t allowed to strike. Can someone explain if this is or is not in violation?

In WV they absolutely did to get tort reform and it worked.

 

[The kitchen sink]

Employed physicians are able to unionize and strike. Private practice physicians are not.

They should. Or at the very least start with refusing to bill.

 

[southerndoc]

They should. Or at the very least start with refusing to bill.

Refusing to bill = not getting yourself paid.

If EP's walked out of an ER, they would be out of a job and replaced with the onslaught of residents just waiting for jobs. As mentioned earlier, what happened to the air traffic controllers? Perhaps an AG, Governor, or even the President sees that EP's abandoned patients and instructs the DoJ to institute criminal charges or to revoke their license.

You think it won't happen? Well I don't want to be the test subject to try it. Despite all that people complain about, the grass is not greener on the other side. There are so many people who complain yet never offer realistic suggestions for improvement.

 

[The kitchen sink]

Refusing to bill = not getting yourself paid.

If EP's walked out of an ER, they would be out of a job and replaced with the onslaught of residents just waiting for jobs. As mentioned earlier, what happened to the air traffic controllers? Perhaps an AG, Governor, or even the President sees that EP's abandoned patients and instructs the DoJ to institute criminal charges or to revoke their license.

You think it won't happen? Well I don't want to be the test subject to try it. Despite all that people complain about, the grass is not greener on the other side. There are so many people who complain yet never offer realistic suggestions for improvement.

Refusing to bill = you don’t get paid — true but it effects if the hospital gets paid too, right?

I agree, the grass is not greener, and if there are no viable solutions, the only outcome will be that the ROI for certain specialities will just not be worth it, at least if practiced in their traditional model.

You could say let the free market decide, but medicine is too highly regulated, for better or for worse, for that to be the case.

I think thats why most physicians ultimately decide they can’t change this ever so fragmented system, and so they will just take care of themselves, perpetuating this continual race to the bottom.

 

[Lexdiamondz]

Refusing to bill = not getting yourself paid.

If EP's walked out of an ER, they would be out of a job and replaced with the onslaught of residents just waiting for jobs. As mentioned earlier, what happened to the air traffic controllers? Perhaps an AG, Governor, or even the President sees that EP's abandoned patients and instructs the DoJ to institute criminal charges or to revoke their license.

You think it won't happen? Well I don't want to be the test subject to try it. Despite all that people complain about, the grass is not greener on the other side. There are so many people who complain yet never offer realistic suggestions for improvement.

Considering those residents wont be able to practice until July and would still need time to get on-boarded and credentialed, they're an irrelevant factor in the discussion for now.

 

[BoardingDoc]

Ethics LOL. No one cares about ethics when teachers or air traffic controllers strike.

This is pretty easy. The docs give 24 hour notice of impending strike. This gives more than enough time for admin to set up EMS diversion, get boarding patients up to the floor (or send a hospitalist down to babysit), get patients transferred out, put out notices on media / highway billboards that the ER is shutting down, whatever else. Will never happen though cause physicians won't be willing to go 2 weeks without a paycheck.

As @bravotwozero alluded to, people very much care when ATCs strike. In '81, the national organization for air traffic controllers organized a strike. 13k ATCs went on strike. Regan ordered them to get back to work within 48 hours or he'd fire them all. ~1000 did. The other 12k assumed he was bluffing. He wasn't. He fired all 12k of them and banned them from working for the federal govt in any capacity for life. Took a long time to get staffing back up to normal.

 

[WilcoWorld]

Funny you mentioned air traffic controllers…what ended up happening to them when they went on strike?

As @bravotwozero alluded to, people very much care when ATCs strike. In '81, the national organization for air traffic controllers organized a strike. 13k ATCs went on strike. Regan ordered them to get back to work within 48 hours or he'd fire them all. ~1000 did. The other 12k assumed he was bluffing. He wasn't. He fired all 12k of them and banned them from working for the federal govt in any capacity for life. Took a long time to get staffing back up to normal.

Good counterexample for me to recall next time someone tries to argue "This is America, you can't force people to do things here."

Yes we can, and we do, and one of the clearest examples of this was done by none other than The Gipper.

 

[EctopicFetus]

Considering those residents wont be able to practice until July and would still need time to get on-boarded and credentialed, they're an irrelevant factor in the discussion for now.

Emergency credentials
Can be done in a couple of hours.

 

[deleted941485]

Good counterexample for me to recall next time someone tries to argue "This is America, you can't force people to do things here."

Yes we can, and we do, and one of the clearest examples of this was done by none other than The Gipper.

I’m not convinced the two scenarios are the same.

 

[EctopicFetus]

I’m not convinced the two scenarios are the same.

No one has to work in the Ed. Like nurses call off docs can call off too. We don’t. But doc a says I got the covid. No one else picks it up. It can happen. It won’t but it can’t. Could bring down the system to its knees. Tons of options. Don’t chart for a month. Hospitals will get the message. So will your employer. They may withhold pay depending on your contract but likely they won’t especially if it’s well organized. Imagine 0 envision charts being completed for a month. Their cash flow would be screwed.

 

[bravotwozero]

Yeah we don’t have to resort to drastic measures as striking.

If the docs that are FT employed could just agree for example that any time a locums recruiter calls them they demand a rate of $350/hr plus travel and lodging, that would put considerable pressure on employers and raise rates for the docs that do need a locums job…

 

[WilcoWorld]

I’m not convinced the two scenarios are the same.

I'm not arguing for equivalency between Air Traffic and the ED. Perhaps we don't understand each other?

 

[The kitchen sink]

As @bravotwozero alluded to, people very much care when ATCs strike. In '81, the national organization for air traffic controllers organized a strike. 13k ATCs went on strike. Regan ordered them to get back to work within 48 hours or he'd fire them all. ~1000 did. The other 12k assumed he was bluffing. He wasn't. He fired all 12k of them and banned them from working for the federal govt in any capacity for life. Took a long

As @bravotwozero alluded to, people very much care when ATCs strike. In '81, the national organization for air traffic controllers organized a strike. 13k ATCs went on strike. Regan ordered them to get back to work within 48 hours or he'd fire them all. ~1000 did. The other 12k assumed he was bluffing. He wasn't. He fired all 12k of them and banned them from working for the federal govt in any capacity for life. Took a long time to get staffing back up to normal.

So umm what is the point of a union if they cannot strike effectively?

 

[bravotwozero]

So umm what is the point of a union if they cannot strike effectively?

Exactly the point.

Unions are toast in America.

The Gipper ended up writing the book on how to break them.

 

[DoctwoB]

So umm what is the point of a union if they cannot strike effectively?

Differing labor dynamics for ATCs because it is both a monopoly (one provider) and a Monopsony (one employer). That means that one employer can say F U and fire everyone, and the only one that gets hurt are the consumers.

Not so for doctors, who work in a market with many providers of physician services (despite consolidation) and many employers. So say USACS doctors strike. Sure USACS could fire them, but they would be completely devaluing their own company, while the doctors could move to any other job willing to hire them.

 

[Vandalia]

Ive always heard about some vague law saying physicians aren’t allowed to strike. Can someone explain if this is or is not in violation?

The issue that sometimes can come into play is that once a patient-physician relationship is established, it generally cannot be immediately ended by the physician. Depending on the state, this generally requires a certified letter and an agreement to provide 30 days of emergency care. This is independent of any contractual relationship between the physician and an employer.

So, if physician X is in a specialty that has long(er) term physician-patient care, then she may not necessarily be able to "go on strike" at 2359 on 25 January 2022 without risking a suit for patient abandonment.

Now, obviously, this does not apply in the same way to emergency medicine, anesthesiology, radiology, etc. There is not necessarily a requirement to pick up NEW patients, but you do have to provide care to the ones for which that physician-patient relationship has been established. So barring some specific state law to the contrary, you could say that effective at 2359 on Wednesday we will not take any new patients.

The other potential issue would be a possible antitrust violation if the physicians were not employed.

 

[southerndoc]

Georgia's medical board requires six months notice before a doc can "fire" a patient. :O

 

[WilcoWorld]

Georgia's medical board requires six months notice before a doc can "fire" a patient. :O

Dang, y'all should get a security deposit from new patients.

 

[Siggy]

Considering those residents wont be able to practice until July and would still need time to get on-boarded and credentialed, they're an irrelevant factor in the discussion for now.

Granted, it was during the pandemic, but by the time I finished my fellowship I had emergency credentials at 2 of the hospitals my group covers and had my first solo shift on July 1st.

 

[namethatsmell]

One thing docs tend to blow way out of proportion when discussing a possible union and/or strike: our image.

But nobody else cares.

How many times have nursing unions across the country striked in recent decades? Too many to count. Perhaps in the moment, the locals express outrage at both them and their employers. But within days to months...nobody cares again. They are just happy "service" is restored.

And despite multiple nursing unions and strikes -- and claims of "abandoning" patients in the process -- the general public still loves them.

Could the DOJ et al file charges against striking ER docs who give their employers 24 hours notice? I'm not sure. But I do know that as soon as the dust settled, negotiations concluded, and a new news cycle began...the general public would quickly reset to it's baseline view of physicians.
And hell, that view and general sentiment may actually improve if they realize they can't take physicians for granted as docs are truly willing to stand up for what they believe in even if it means being willing to walk. Maybe this is part of why nurses are so admired by the public.

 

[The kitchen sink]

One thing docs tend to blow way out of proportion when discussing a possible union and/or strike: our image.

But nobody else cares.

How many times have nursing unions across the country striked in recent decades? Too many to count. Perhaps in the moment, the locals express outrage at both them and their employers. But within days to months...nobody cares again. They are just happy "service" is restored.

And despite multiple nursing unions and strikes -- and claims of "abandoning" patients in the process -- the general public still loves them.

Could the DOJ et al file charges against striking ER docs who give their employers 24 hours notice? I'm not sure. But I do know that as soon as the dust settled, negotiations concluded, and a new news cycle began...the general public would quickly reset to it's baseline view of physicians.
And hell, that view and general sentiment may actually improve if they realize they can't take physicians for granted as docs are truly willing to stand up for what they believe in even if it means being willing to walk. Maybe this is part of why nurses are so admired by the public.

QFT

I completely agree and I would be willing to take the risk of being villified and hated for the greater good

 

[emergentmd]

So glad I got out of the ED mess. My old partners at a very well run hospital ER are now finally leaving in droves too. They will fill b/c its one of the most sought after city to live but bunch leaving says alot.

 

[MechEDoc]

So glad I got out of the ED mess. My old partners at a very well run hospital ER are now finally leaving in droves too. They will fill b/c its one of the most sought after city to live but bunch leaving says alot.

Coeur d'Alene Idaho?

 

[VA Hopeful Dr]

One thing docs tend to blow way out of proportion when discussing a possible union and/or strike: our image.

But nobody else cares.

How many times have nursing unions across the country striked in recent decades? Too many to count. Perhaps in the moment, the locals express outrage at both them and their employers. But within days to months...nobody cares again. They are just happy "service" is restored.

And despite multiple nursing unions and strikes -- and claims of "abandoning" patients in the process -- the general public still loves them.

Could the DOJ et al file charges against striking ER docs who give their employers 24 hours notice? I'm not sure. But I do know that as soon as the dust settled, negotiations concluded, and a new news cycle began...the general public would quickly reset to it's baseline view of physicians.
And hell, that view and general sentiment may actually improve if they realize they can't take physicians for granted as docs are truly willing to stand up for what they believe in even if it means being willing to walk. Maybe this is part of why nurses are so admired by the public.

Not really a fair comparison given how pre-COVID y'all were averaging 4X or more per hour than nurses.

People also really like/trust nurses. They're the main point of patient contact, patient centered and all the other stuff the nursing PR stuff goes on about.

 

[EctopicFetus]

Differing labor dynamics for ATCs because it is both a monopoly (one provider) and a Monopsony (one employer). That means that one employer can say F U and fire everyone, and the only one that gets hurt are the consumers.

Not so for doctors, who work in a market with many providers of physician services (despite consolidation) and many employers. So say USACS doctors strike. Sure USACS could fire them, but they would be completely devaluing their own company, while the doctors could move to any other job willing to hire them.

This only holds true when there is a balance. Reality is there are tons of docs and many places are already using inferior mlps to do the job of a physician.

 

[EctopicFetus]

QFT

I completely agree and I would be willing to take the risk of being villified and hated for the greater good

Also remember no one goes to my Ed to see ectopic. The real harm frankly goes to the reputation of the hospital. Patients don’t know usacs envision teamhealth. They 100% tie their Ed experience to that of the hospital.

It’s never teamhealth sucks. It’s hospital x is terrible.

 

[EctopicFetus]

Coeur d'Alene Idaho?

He is in Texas. My guess is austin.

 

[EctopicFetus]

The contract was recently acquired by USACS last year after they took over the VEP hospitals.

San Jose emergency physicians to walk off job due to understaffing

Emergency workers at the Santa Clara County Valley Medical Center are staging a walkout to protest staffing shortages and unsafe working conditions.

sanjosespotlight.com

In other news the ACEP prez has cum out to defend usacs. Maybe it’s cause they have 2 ACEP board members? Seems odd. People wonder why (not on this board) there is a concern about ACEP taking cmg money since cmgs can’t be members. It’s clear ACEP can be bought. (Again we already knew).

 

[turkeyjerky]

In other news the ACEP prez has cum out to defend usacs. Maybe it’s cause they have 2 ACEP board members? Seems odd. People wonder why (not on this board) there is a concern about ACEP taking cmg money since cmgs can’t be members. It’s clear ACEP can be bought. (Again we already knew).

Link?

 

[Vandalia]

One thing docs tend to blow way out of proportion when discussing a possible union and/or strike: our image.

West Virginia physicians went on "strike" over medical malpractice reform. However, as someone interviewed in the article was clear to point out, it was simply "taking annual leave."

It was mostly surgeons, again, they generally don't have longer term patient-care responsibilities. It is also a lot more dramatic: Having your knee replacement delayed has more of an impact than your annual physical delayed for a couple of weeks.

However, it did work. It is difficult to say if it was mostly the "strike" or the rapid change in state politics.

Surgeons Strike In West Virginia

One Patient Transferred 90 Miles Away For Operation

www.cbsnews.com

 

[deleted239798]

In other news the ACEP prez has cum out to defend usacs. Maybe it’s cause they have 2 ACEP board members? Seems odd. People wonder why (not on this board) there is a concern about ACEP taking cmg money since cmgs can’t be members. It’s clear ACEP can be bought. (Again we already knew).

Yeah that was just… really gross of her. Also just a dumb thing to do. Obviously she and ACEP leadership are in cahoots with Usucks, just like in national politics us plebs will never know the extent or nature of their relationship barring some leak, but to just come out swinging for them on a public forum is shameless.

For anyone curious it’s on EM Docs on Facebook. Gillian Schmitz, who has never posted about initiatives to combat residency expansion or midlevel encroachment came out guns blazing against this story, calling it fake news, and then scuttled away.

 

[EctopicFetus]

Yeah that was just… really gross of her. Also just a dumb thing to do. Obviously she and ACEP leadership are in cahoots with Usucks, just like in national politics us plebs will never know the extent or nature of their relationship barring some leak, but to just come out swinging for them on a public forum is shameless.

Dildo move. No shock.