One way doctors are pushing back on how hospitals are run | Opinion
Today, in the era of corporatized healthcare, most physician employment contracts allow “termination without cause.” Basically, the clause ensures hospitals can fire any physician without providing a specific reason for doing so. The best-known example is Dr. Ming Lin, an emergency medicine physician who suggested patients and physicians should wear masks in the hospital during March 2020. He had been working at PeaceHealth St. Joseph Medical Center in Bellingham, Washington, for 17 years before being fired for voicing his safety concerns. Peace Health denied any wrongdoing, stating Dr. Lin was terminated for “creating a toxic work environment.”
While the U.S. Labor Departments holds that it is illegal to retaliate against employees reporting unsafe working conditions, dozens of physician colleagues have been “terminated without cause” after speaking up about improving patient care. Recently, Mary Bridge Children’s Hospital in Tacoma seemed to be a place where early retirement, unexpected resignations, and terminations were increasing significantly, especially in the neurology, urology, surgery, and ear, nose, and throat specialties.
Increasing physician turnover is often a symptom of difficult work environments or unsafe working conditions. So, I was not surprised to learn that in April, a group of 65 pediatric hospitalists, emergency physicians, and surgeons filed a petition for voluntary recognition of a physician union, which would have facilitated the collective bargaining process to engage with hospital leadership and improve patient care. Tracy Kelly, a pediatric hospitalist for 19 years at Mary Bridge said the goal was to “have a seat the negotiations table as soon as possible.”
Unfortunately, Mary Bridge denied the physicians’ request for voluntary recognition, so a petition was filed for an election with the National Labor Relations Board. Soon, the initial group of 65 grew to 100 pediatric specialty physicians, including endocrinologists, ophthalmologists, and pulmonologists. Most of the physicians I spoke with for this column shared that they were not fighting for higher wages; they were fighting to improve the safety and well being of their patients.
Dr. Derek Tam, an emergency physician, summed up how the movement took hold. He told Northwest Public Broadcasting that, “we have tried to have a lot of dialogue with hospital administration, and it hasn’t really gotten anywhere.” Tam pointed to staffing changes and how patients are being moved through the emergency department as examples of the disconnect between physicians and administration that did not “align with how he and his colleagues want to practice medicine.”
I know first-hand that Dr. Tam is right. Two years ago, I wrote about the inefficiencies of triage in the emergency department at Mary Bridge while waiting with my son who was ill with acute appendicitis. In the middle of the night, the surgeon and I wheeled my son’s bed down to the operating room together to move things along faster. A year later, a different son of mine was accidentally discharged from the Mary Bridge emergency department after being transferred there for a surgical emergency. And a few weeks later, another patient in need of surgery was mistakenly discharged. After the patient returned to my office, got re-examined, and still needed surgery, I sent them back to Mary Bridge a second time for the operation they were originally sent to have.
It is important to point out that, in my opinion, these errors were highly uncharacteristic of the quality of care provided by Mary Bridge physicians. None of these mistakes were about incompetence. They exposed something more alarming: a lack of resources necessary to support those who are providing care for ill and injured children. And these cracks in the system drove Mary Bridge physicians to take matters into their own hands.
The science behind the value of unionization is clear: it improves the health and well being of employees by holding employers accountable for safe, non-abusive working conditions. As corporations continue monopolizing healthcare across the nation, unionizing will likely become the best way physicians have to improve the safety and care of their patients. And when unionized physicians voice safety concerns, the union can ensure those employees have due process protections in promotions, dismissals, or terminations — an option that was unavailable to Dr. Lin in March 2020.
The bottom line is that healthcare suffers when those providing it suffer. On Wednesday, May 21, 82% — an overwhelming majority — of specialty physicians at Mary Bridge voted to unionize. Every Mary Bridge physician I spoke with was focused on the same goal: to improve patients’ safety and care, by ensuring physicians had the resources and support for the staff necessary to do their job.
And here is why their successful unionization should matter to you: it is about letting doctors be doctors and putting patient care decisions back where they belong, in the hands of physicians and patients.
