There may not be any doctors working at Santa Clara Valley Medical Center in a few weeks.
Health care workers at county-run facilities are ready to strike, following two years of stalled negotiations with the county, increased workloads and decreased staffing. Valley Physicians Group, a union representing 450 doctors, authorized the right to strike this week with 93% approval. Members say poor working conditions are impacting their own mental health and patient care.
“It is unprecedented for the physicians to take a strike vote,” Dr. Steve Harris, president of Valley Physicians Group, told San José Spotlight. “This is a last option that none of us want to do, but we have tried everything else.”
Doctors will decide whether to strike based on negotiations with the county set for Friday. Harris said if they see steps that address their concerns, they will forgo the strike. If not, the union will strike and give a 10-day notice before beginning.
Harris said the strike is not about salaries—the union and county agreed to a salary structure for their contract last week. He said working conditions impacting patient care and physician mental health need to be resolved.
“We don’t expect everything to improve all at once. We expect this is going to be a path we journey together,” Harris said. “To do that, there are a couple tangible first steps that will show us physicians, that the county is not just paying lip service.”
Those steps include decreasing the patient caseload from 11 to 10 patients per half day; hiring more specialist physicians; and additional time to complete paperwork, respond to emails and do tests like biopsies and X-rays.
Doctors are being asked to do more with less resources. Over the summer, workers protested a county plan to tie bonus pay for doctors to the number of patients they see per hour. They have also been speaking out about ongoing worker shortages and old equipment. Patients are waiting months for appointments, tests and non-invasive scans such as MRIs and CTs.
County leaders including Executive Jeff Smith, have repeatedly said the health care system has no issues, downplaying physicians’ concerns as a tactic to win a favorable contract. Officials told San José Spotlight they hope to reach an agreement soon.
Looking to leave
Dr. Rachel Ruiz, the only full-time pediatric gastroenterologist at Santa Clara Valley Medical Center (VMC), said having additional workers would make a world of difference. Some areas of specialty have only one or two physicians, meaning those doctors are essentially on-call 24/7. Ruiz’s department, which helps kids get Legos out of their esophagus and addresses bleeding ulcers, has a waitlist of six months.
“We are physicians because we want to help others, so it’s really frustrating and demoralizing to feel like we’re the ones carrying this burden to make sure that every child gets seen,” Ruiz told San José Spotlight. “When you go above and beyond, if you’re overbooking or seeing patients outside of your clinic hours, that just leads to burnout and morale injury. And we have been doing it for years.”
Ruiz has been at VMC for about four years, but is already looking to leave. It’s heartbreaking, she said, because she thought she found her “forever job” serving her hometown.
She isn’t alone. A recent union survey found nearly two-thirds of doctors plan to leave VMC in the next three years. The county already lost 65 primary care doctors over the last five years, and has not been able to retain people from its residency program over the same period. Typically 16 new doctors start work at VMC after completing residency—this past year only one stayed on, Harris said.
Dr. Eon Rios, a dermatologist who works at VMC, said morale is at an all time low following one physician dying by suicide this summer. Worker protests around the same time led to some doctors being disciplined and placed on temporary unpaid leave, including Rios.
“I hope we do not have to go on strike. I hope that the county comes to the table seriously,” Rios told San José Spotlight. “But if we need to do this to advocate for our patients, or show the administration that our concerns are serious, then this is what we will do.”
Contact Jana Kadah at [email protected] or @Jana_Kadah on Twitter.