Medical

How We Found Our Voice As Hospitalists

Approximately a year ago, our CEO hired a healthcare performance company to evaluate our hospitalist group’s performance and make recommendations as to how to cut costs and improve efficiency. What soon followed was a Request for Proposal (RFP) which was released in the summer of 2014. Our CEO was searching for a third-party company to take over management of our hospitalists and save our non-profit corporation the cost of employing and managing the hospitalists. Needless to say, this was more than upsetting for the 37 employed hospitalists. Were our jobs secure? Were we going to be fired and have to apply to be hired by this third-party corporation if we wanted to stay in this community?
Many hospitalists immediately started putting in their resignations and sought more stable employment elsewhere. Physicians who had lived in this community for years and decades, who had kids in school, owned homes that they planned to retire in, spouses who had jobs in this community – all uprooted and moved to other places of employment. It absolutely devastated our hospitalist program.
It was announced in December 2014 that our corporation was “pursuing a relationship” with a chosen national for-profit hospitalist management company, presumably to take over the hospitalist function for our hospital: a company we learned made money by overworking its physicians and overbilling. Those of us who wanted to stay in our community, remain employees of our company, and had no intention of working for this third-party company had to find a voice. And so, as is our right under national labor laws, we unionized as part of the American Federation of Teachers (AFT) – and became the first hospitalist union in the nation.
With nearly half of our work force now gone and flu season about to start, we started telling our story to anyone who would listen, campaigned to get support from the specialists, the outpatient physicians, nurses, and the community we are a part of. We were seeing unsafe numbers of hospitalized patients, working extra shifts, working very long hours, and were ourselves at high risk for burn out.
It has been an incredibly rough year, but because we unionized, we have been able to have a voice in the matter, and have already had several victories. Our corporation announced that they would not be outsourcing the hospitalists to a third party for-profit corporation and would end RFP process. We hospitalists would remain employees of our community hospital. The administration has finally started a hiring process to replace the physicians we lost due to the threat of being outsourced. Administration has decided to build an internal management structure and hire a medical director. We have also been able to implement a cap on the number of patient encounters per day to maintain patient safety.
With the help of AFT and the Oregon Nursing Association (ONA), we continue to work on contract negotiations. And it was announced this month that our CEO has resigned.
We share our story because we were able to find a voice, we were able to stay in our beautiful community, continue to work at our community hospital with amazing and supportive colleagues. We are very proud of our union, the Pacific Northwest Hospital Medicine Association.
Today (5/5/15) my colleague sent us this note, which I think sums up everyone’s feelings about the last year:
For the record, and to close this horrid chapter, this is [our CEO’s] official last day at PH. It comes, I believe, almost exactly one year after the RFP was announced. Congratulations to all remaining members of PHM. As painful as it has been, we truly did win this fight – a fight we didn’t instigate and didn’t deserve. With the amazing assistance and support of the ONA, AFT, and countless colleagues, we prevailed. But without the strength and perseverance of each and every one of you the outcome would have been uncertain at best. Let’s move on now to our well-deserved bright future. But let’s never forget what happened to us and how we prevailed. We must never again let the machinations of administrators put our patient’s lives and our own careers at risk. Never.