Santa Clara County extends emergency contract despite protests

Despite pleas and protests from health care workers, Santa Clara Valley Medical Center has extended a contract with an Ohio-based medical group and allowed it to continue managing the hospital’s emergency physicians.

The county’s health care center extended its contract with U.S. Acute Care Solutions (USACS) until June 2023 after the terms expired Sunday. Emergency workers at VMC have spent the last two weeks protesting the contract’s extension via Zoom calls, emails to the Board of Supervisors and a staged walkout, claiming USACS prioritizes profits over patient care. This has led to staffing shortages among physicians and unsafe working conditions during some of the most challenging times in the COVID-19 pandemic, workers said.

The current average wait for many patients at the VMC emergency department is between eight and 14 hours, they added.

Hospital administration declined to comment on the contract after multiple inquiries from this news organization.

Feeling silenced

An internal email shared with San José Spotlight also shows the county will start a bidding process for a new medical company this summer. Some health care workers said they see that decision as progress.

“They are, at the minimum, addressing the concern of the department,” a VMC nurse told San José Spotlight, adding they understand cutting ties with USACS right away might further undermine the emergency department’s operation. “The fact that they’re going through (the bidding process) is a good indication of that.”

Physicians said they received an email about the extended contract Friday, but couldn’t get a confirmation from the county until Tuesday evening via email. The extended contract, while temporary, might lead to an exodus of doctors in an emergency department that is already overwhelmed with a high turnover rate, doctors said.

According to physicians at VMC, four full-time doctors left the department when USACS took over the contract last June because they refused to work for the group. Since then, three physicians and four physician assistants have submitted their notices to quit.

San José Spotlight learned another physician submitted a letter of resignation in the last week, with more physicians contemplating their departures.

“This feels like a toxic and hostile work environment,” a doctor told San José Spotlight. “We feel effectively silenced.”

San José Spotlight is not naming the health care workers due to concerns of potential retaliation. VMC doctors told San José Spotlight they could face retaliation or be blacklisted from other job opportunities for speaking up against USACS—one of the largest medical groups in the nation.

USACS is backed by private equity firm Apollo Global Management. The company could sue the doctors for pushing Santa Clara County to bring them on as county employees or bringing on a local medical group to manage them, according to a clause in their contracts that prohibits employees of USACS from undermining the company for up to a year after their last day of employment.

‘It’s the patients who suffer’

Doctors, nurses, physician assistants and technicians at VMC told the hospital administration and the Board of Supervisors in meetings and emails that the department had no confidence in USACS management. They claimed the company failed to address serious concerns about staffing levels and pay during the last six months, forcing many doctors and nurses to stay hours after their shifts to cover gaps in services.

The tension reached a boiling point last month when the company removed Dr. Jeff Chien, who others described as a trusted and beloved leader, from his medical head position without explanation.

“(USACS has) clearly demonstrated the lack of what it takes to run a Level I trauma center in the tenth largest metropolitan city in the United States,” the letter from VMC workers to the county executive and Board of Supervisors reads. “Our morale has already taken enough hits over the past few years, and this is only adding to our stress and frustration.”

After San José Spotlight reported on the issue last month, USACS hosted a Zoom call with physicians, where the company said it welcomed feedback from doctors and wouldn’t retaliate against them for voicing their concerns. Physicians read off a list of concerns, including staffing levels, the lack of routine COVID testing options and sick days.

“There was a lot of deflection or they said, ‘This is the first time this is being brought to our attention,'” a doctor who attended the meeting told San José Spotlight. “It’s the patients who suffer here. Those longer wait times are because we’re not adequately staffed.”

USACS representatives did not respond to multiple inquiries about the extended contract.

“We just have to figure out what this means moving forward,” a nurse told San José Spotlight. “Because sometimes you have to be careful of what you wish for.”