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WORKERS: Legacy Health hospitalists
UNION: Pacific Northwest Hospital Medicine Association
NUMBER OF EMPLOYEES: 200
LABOR ACTION: A union vote
Health care has been hell since the pandemic.
Doctors and nurses are burned out after three years of serving surly patients who yell at them, spit on them, and even try to choke them out. Hospitals, meantime, say they are struggling to stay afloat amid higher costs for labor and supplies and lower revenue from procedures.
The struggles have led to strife, with health care workers saying they don’t want to work insane jobs for prevailing wages and hospitals claiming they can’t pay any more.
Legacy Health is a local battleground in this war. In September, doctors, nurses and physician assistants told Legacy that they planned to organize—joining nurses at select Legacy locations who are already represented—in part because “a pervasive emphasis on revenue over patient safety and staff well-being permeates our work environment.”
Legacy, however, says it has to stop the bleeding. In a July video on Legacy’s “financial crisis,” chief operating officer Jonathan Avery said wages had risen 31% since 2020 and the cost of supplies was up 19%. Revenue rose just 13%, though, putting a squeeze on the 3% operating margin that nonprofit hospitals like to run so they can invest in their business.
The Pacific Northwest Hospital Medicine Association, an affiliate of the American Federation of Teachers, is pushing ahead with its organizing plans but has decided to narrow the focus at first to just “hospitalists,” the primary care doctors who work only in hospitals.
Kevin Mealy, a spokesman for the Oregon Nurses Association, an AFT affiliate that’s helping with the effort, says organizers wanted to get the union vote done sooner rather than later because it must be overseen by the National Labor Relations Board, a federal agency that could be out of service if Congress can’t pass a budget to keep the government open after Nov. 17.
The time and place of union elections are negotiated between employers and unions, overseen by the NLRB, which makes the final decisions.
The depth of distrust at Legacy is evident from those negotiations alone. The vote will be held in person at Legacy facilities Nov. 14-16. Voting will be open 6-8 am and 2:30-4:30 pm. Hospitalists must vote at their primary workplace.
The union is crying foul. It wanted workers to vote by mail, Mealy says. Barring that, the union recommended longer hours and letting employees vote at any facility. Not only is voting restricted to one’s primary workplace, it’s being held in obscure rooms in the bowels of Legacy buildings, Mealy says.
“Doctors who have worked at these places didn’t know where these rooms are,” Mealy says. “They will be making maps for people in their own facilities.”
All of these hurdles add up to one thing, Mealy says: Legacy is trying to curb turnout.
“One hundred percent, Legacy is trying to suppress the vote,” Mealy says.
In almost all cases, unionized workers make more, so it’s easy to see why an institution that’s struggling to contain costs might harbor an anti-union sentiment. Legacy denies that.
“The decision by the NLRB is consistent with industry standards adopted at other health care facilities in the region represented by the Pacific Northwest Hospital Medicine Association,” Legacy said in a statement. “Legacy is pleased with this decision as it respects the unique circumstances and perspectives of physicians across different facilities, ensures compliance with labor laws, and acknowledges providers’ individual needs and interests.”
On Monday, Don Tran, president of Legacy Medical Group, sent an email to hospitalists offering his “personal viewpoint” on unions.
“I’m not sure I would want to give up my individual voice and our current collegial approach,” Tran wrote. “The union representative is not there to represent your individual interests, but will instead decide the priorities and agenda of the larger group.”
Watch out, Tran wrote: “You may want all hospitalists to be treated equally, while others may want seniority to have first preference in selecting schedules and getting time off.”
Tran will find out soon enough if vacation seniority is top of mind, or if it’s something else.