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Contracted emergency workers threaten strike at Ascension St. John

Hannah Mackay


Contracted physicians and physician assistants at Ascension St. John Emergency Department are threatening a strike in nine days if their union's demands for better staffing and work conditions are not met.


The threat, made in a Monday news release, came after the health care workers last summer formed a union, the Greater Detroit Association of Emergency Physicians, and have been in negotiations about their first-ever contract for roughly seven months. The union represents contracted doctors, advanced practice clinicians, physician assistants and nurse practitioners in the Emergency Department at Ascension St. John, which sits on the border of Grosse Pointe and Detroit.


While the union's contract is with St. John Emergency Services in Detroit, the workers are employees of TeamHealth, a private, Tennessee-based physicians and hospital management company. An Ascension spokeswoman told The Detroit New last month that the emergency medicine physicians and other providers are not employed by the hospital, but their services are furnished through a contract with TeamHealth.


TeamHealth has received official notice that clinicians affiliated with the union will go on strike for 24 hours beginning April 18, Vice President of Communications Josh Hopson said Monday.


"Patients needing critical emergency care during this time should continue to come to the emergency department at Ascension St. John Hospital," Hopson said. "We expect to keep the emergency department fully staffed and day-to-day operations will not be interrupted."


Federal law prohibits labor organizations from striking at a health care institution without giving at least 10 days notice to the institution and the Federal Mediation and Conciliation Service. 


The union is advocating for better staffing and work conditions. The 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 in 2015 and accused them of not negotiating in good faith.


"It is sad that it has come to this," Emergency Room physician Michelle Wiener said in the news release. "We've put up with 15-hour wait times in the ER. We've been understaffed. We've had terrible working conditions."


The union is hoping to negotiate benefits such as sick pay, recommended safe staffing ratios, security commitments, pay parity compared with other Metro Detroit hospitals and more transparency on billing for services in its first contract, Weiner told The News last month.


TeamHealth has rejected the union's claims of long wait times, a lack of pay parity and inadequate staffing levels.


"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," Hopson said. "TeamHealth has provided clinicians with support and resources for over 40 years to deliver high-quality patient care, even in the face of material reimbursement pressure from private insurers and Medicare."


Hopson also reaffirmed that the the company has negotiated in good faith with the union.

"We invite the union’s leadership to return to the bargaining table and secure a resolution on reasonable and sustainable terms," Hopson said.


The union is also committed to working in good faith with St. John Emergency Services representatives but said "time has run out."


The strike notice comes one week after U.S. Sen. Gary Peters, D-Bloomfield Township, announced he is seeking information on private equity firms' involvement in business operations, staffing decisions and patient care in several hospital emergency departments, including Ascension St. John. TeamHealth is owned by Blackstone, a large international asset manager and private equity group. Peters, who chairs the Senate Homeland Security and Governmental Affairs Committee, sent a letter to Blackstone and TeamHealth executives on April 1.


The committee's staff spoke with Ascension St. John emergency physicians who had concerns about staffing levels and patient safety, according to the letter. Peters also expressed concern that private equity-owned physician staffing companies like TeamHealth that previously engaged in balance billing or surprise billing tactics may be engaged in other cost-cutting efforts that risk patient safety and care.


Hopson confirmed Tuesday that TeamHealth received Peters’ letter and is still reviewing its contents.


"As a matter of practice, TeamHealth has not balance billed patients in its 44-year history, keeping patients out of the middle of any dispute with an insurer for underpayment," Hopson said. "The top priority for TeamHealth and our clinicians is always delivering high-quality, safe patient care. We look forward to engaging with the Committee and demonstrating our uncompromised commitment to our clinicians and communities."


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