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.
I would have said that you can't practice good medicine when continually placed in ethical dilemmas due to and by the corporatization of health care, for arbritary reasons.
Of course the hospital doesn't want to pay the tail insurance - the fees are exorbitant and serve as a financialy penalty when a physician wants to leave a dysfunctional system or practice. Since the hospital has to pay, now they have an added financial interest in listening to their physicians, instead of being able to ignore them so easily.
I don't have strong feelings for or against unionization, but certainly, physicians need to unify.
Dr, Mike Henderson