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Contracted doctors, physician assistants at Ascension St. John go on strike

Detroit — Contracted physicians and physician assistants at Ascension St. John Emergency Department kicked off a 24-hour strike Thursday afternoon amid demands for better staffing and work conditions.

The strike comes after the union, the Greater Detroit Association of Emergency Physicians, threatened to take action last week after ongoing negotiations for their first-ever contract with employer TeamHealth, a private, Tennessee-based physicians and hospital management company. The union represents contracted doctors, advanced practice clinicians, physician assistants and nurse practitioners in the Ascension St. John's emergency department. Those hospital workers are not directly employed by the health care system.

More than a dozen physicians and physician assistants in their white coats walked out of the hospital at 2 p.m. Thursday, grabbed picket signs and marched along Moross Road near the entrance of the hospital’s emergency room. They carried signs that read “No more profits over patients” and “Safe staffing saves lives.”

"We're fighting against a massive corporation, TeamHealth, for unfair labor practices, which include severe understaffing that cost the community resources itself,” said Casey Kolp, a physician assistant with the hospital since 2020. “We're fighting against wait times of 17 hours. At any given time, multiple areas of the emergency department are closed that leads to these times. And when you put profits of a company over the well-being of the patients, the community suffers, the morale of the institution suffers. So we decided that enough was enough and the corporate medicine needs to stop.”

Kolp said that just because a person walks into the waiting room and doesn’t appear really sick at the moment, it doesn’t mean they don’t need immediate attention.

“That abdominal pain that you came in for might be appendicitis,” she said. “In six hours, that is now life threatening. These are the things that are sitting in our waiting room because there's no beds, there's no staff, there's no one to transport patients, no one to draw labs on patients. And they sit there. They sit there for 17 hours scared, wondering.”

In an emailed statement Thursday afternoon, TeamHealth vice president of communications Josh Hopson said that TeamHealth is working closely with St. John Hospital to maintain a fully staffed emergency department.

"Patients needing critical emergency care during this time should continue to come to the emergency department at Ascension St. John Hospital," he said. "TeamHealth’s top priorities are delivering high-quality patient care and supporting our frontline clinicians, as they care for our communities 24 hours a day, 365 days a year. TeamHealth has provided clinicians with support and resources for over 40 years, even in the face of material reimbursement pressure from private insurers and Medicare. We have negotiated in good faith with the union, and any statement to the contrary is false. We invite the union’s leadership to return to the bargaining table and secure a resolution on reasonable and sustainable terms.”

The company said Thursday that its median door to doctor time at Ascension St. John Emergency Department was 25 minutes in 2023. It said that time has dropped to 15 minutes in 2024. TeamHealth says that the emergency room is fully staffed with clinicians seeing an average of 1.9 patients per hour, down from an average of 2.6 patients per hour in 2014, before it took over the St. John emergency department.

John Bahling, a pediatric emergency medicine doctor, said the emergency room wait times and staffing levels have worsened over time since TeamHealth took over services in 2015. Bahling has been affiliated with the hospital since medical school in 2000 and has been a full-time attending doctor for six years, he said.

“Since that's happened, we have seen a significant delay in patient care and resources available, updating of resources and investment into the population,” he said. “Things like mental health doesn't pay. You don't get money for that.”

Bahling said his biggest concern is a lack of adequate staffing.

"Not just physicians, but of the people that help us do our job," he said. "The nurses, patient care technicians that help you clean up after you vomit or take you to the CAT scan machine. All of our ancillary services are cut to the bare minimum. Social workers and mental health providers. So patient safety is a major is the number one issue."

Hospital workers have previously said wages, benefits, staffing levels and investment in medical equipment have all declined since TeamHealth and St. John Emergency Services took over management and staffing of the emergency department. They've accused the company of not negotiating in good faith.

"We don't have maternity leave," he said. "We don't have paid time off if we get sick. Either we come to work sick or don't get paid. That's what we're told. We don't have the basic benefits that everybody else has. There's a significant injury occurring to your physicians. We work nights, we work weekends, we work holidays. We're away from our families. ... You're putting us in a unsafe work environment. We're not going to do it anymore. We could all have been dermatologists. We could all have been podiatrists. We chose this high-risk field because we felt an obligation to take care of people at their worst day of their lives. But we won't be treated poorly while we do it."

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