Ascension St. John ER doctors, physician assistants unionize

A group of 43 emergency room doctors, physician assistants, nurse practitioners and lead advanced practice clinicians at Ascension St. John Hospital voted to create a labor union, according to the National Labor Relations Board.

It could be just the second such union of emergency physicians in the U.S., according to a St. John emergency department doctor who spoke to the Free Press on the condition of anonymity for fear of retaliation. The only other known emergency physicians union — the Southern Oregon Providers Association — represents about 20 employees and was established in April.

Documents filed with the NLRB show the group, known as the Greater Detroit Association of Emergency Physicians, initially filed an intent to organize a union in May. Emergency services at the east-side Detroit hospital are managed by TeamHealth, a Knoxville-based company owned by the private equity firm Blackstone.

In late June and early July, the physician group conducted a vote by mail. Of the 43 workers eligible to vote, 38 cast ballots. Seven of the 38 votes were contested. One vote was invalidated. Of the votes counted, all 31 were in favor of establishing a labor union, according to the NLRB.

"TeamHealth was notified by the National Labor Relations Board (NLRB) that on July 11, the affiliated emergency department clinicians at St. John Hospital in Detroit voted for union representation," said Josh Hopson, vice president of communications for TeamHealth, which operates 2,700 acute and post-acute health care facilities and physician groups nationally.

Ascension Health issued the following statement: "TeamHealth physicians are not employees of St. John Hospital. We respect their right to choose to be represented by a union in their relationship with TeamHealth."

Doctors criticize private equity ownership

The physician at St. John who spoke to the Free Press said that since TeamHealth took over control of emergency services at the hospital about a decade ago, wages and benefits fell, staffing levels plummeted and investments in medical equipment and upgrades also declined.

"When your bottom line is no longer dictated by physicians and health care workers but by private equity firms, they care mostly about making money ... at the expense of patient care," the physician said.

More: Michigan extends Medicaid renewal deadline, offering grace period until end of July

"They have decreased the number of nurses per patient, decreased the number of doctors and tried to scale down to nurse practitioners and PAs because they're cheaper. This group was started because we noticed a big decrease in physician morale and the enjoyment with our job and we also had some patient safety concerns."

St. John is designated by the state health department as a Level 1 adult trauma center and is considered Ascension Michigan's largest hospital. In 2020, the health system reported that St. John had 714 inpatient beds, more than 27,000 annual admissions and 105,882 emergency visits.

'The only way to advocate for the patients'

Emergency department workers, the physician told the Free Press, are committed to providing excellent care to the east-side Detroit community, where many of them also live.

"We're all very, very proud to work there," the doctor said. "But we are worried that we can enter a dangerous zone here if we continue to have private equity dictate what happens on ground with patient care. ... This felt like the only way that we could that we could best advocate for ourselves as a group and for the patients that we take care of in the community."

TeamHealth said the company's focus "remains working with our hospital partners on serving patients and supporting our front-line clinicians.

More: University of Michigan nurses approve contract with $5K bonuses, 22.5% raises over 4 years

"Patients and the community will see no impact from this outcome. For more than 40 years, TeamHealth has ensured that each of our clinicians has the resources available to deliver the highest quality care to patients. The outcome of the election does not change that commitment."

Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Free Press.

This article originally appeared on Detroit Free Press: ER doctors, others unionize at Detroit's Ascension St. John Hospital