Dear Resident Physicians of Oregon Health and Sciences University,
Congratulations on joining the AFSCME union! We learned of your successful efforts recently. I am a representative for the AFSCME union doctors from Eugene and Springfield, Oregon, and we joined in Summer 2017. We are the primary care physicians union bargaining unit with Local 2831, and we take care of under-served patients at the Community Health Centers of Lane County.
For the first time in May 2019, a American Medical Association study found that most physicians were employed by others rather than self-employed. This is a sea change in medicine and much of the economic and system responsibilities have been given over to healthcare administrators. Younger physicians and women are more likely than others to be employed physicians. This matters because doctors do not often make the system changes alone now.
We joined AFSCME to empower doctors to seek the best patient care possible for the people with the greatest needs – those with Medicaid, Medicare, or no insurance. Our clinic serves everyone regardless of their ability to pay. We are a Federally Qualified Health Center (FQHC). Primary care faces a shortage nationally, and this affects FQHC patients the most. Recruiting is challenging, and we need to retain doctors. We need to give doctors a voice so they improve their clinics because that is what will ultimately preserve their relationships with patients.
Patients who have good relationships with their doctors trust them more, adhere to their medication and testing plans, and this affects emotional health and resolution of symptoms. When doctors welcome information from patients and respond warmly and empathically, patients are happier and more likely to return for more care. Building this kind of environment in which we can practice the art of medicine is at the heart of what physician unions are for.
We are glad to share with you what we achieved during our first contract:
- Creation of a Provider Advisory Council comprised of physicians, nurse practitioners, physician assistants, and behavioral health specialists who meet monthly to tell our managers what our medical group needs to give excellent patient care with adequate support. We also address system issues and economic challenges for which our managers need input. We also have the ability to vote about future scheduling changes, including the number of patients we see each day.
- Union membership for physicians who work twenty hours or more per week, with medical, dental, and retirement benefits.
- Two pay increases in 2019 and one in 2020 with a Cost-of-Living Adjustment each year after that. This brings us closer to the pay of contractors who work without benefits, and temporary physicians. This was after four years without raises.
- An increase in our CME budgets.
Subtle and important benefits can also come from unions. You are all familiar with the much-used and seldom illuminated term “physician burnout.” Rich Joseph, MD, MBA, a resident wrote, “When we feel a loss of control in a situation, it is human nature to act in a powerless manner and overlook opportunities for relief and change. This so-called ‘learned helplessness’ is strongly correlated with depression and is highly prevalent in hierarchical systems.” In joining the union, you have helped draw a generation of physicians closer to each other, to their patients, and centered yourselves on your purpose. This is a tremendously energizing moment for doctors. Indeed it ignites what I like to call “burn in”—that moment when you know why you do this tremendously challenging and fulfilling work.
Empowerment can make doctors happier, and it can also save lives. I was inspired to help organize doctors when I learned of a friend’s struggles with suicidal thoughts during residency. It moved me to hear about your loss of a fellow resident. Organizing ensures that we all have each other to go to in our darkest hours. There is a net there to catch us, and we are that net.
The benefits of unions extend beyond patients and doctors to include the medical system. Unions have the potential to be an enormous communication tool for managers and physicians to work together toward their common goals. We can provide thoughtful, thorough, constructive solutions in increasingly complex environments. You and your program leadership, and healthcare administrators can all nurture each other’s strengths to serve Oregon. Your union is, indeed, a win for everyone.
Excellent work!
Best Regards,
Moxie Loeffler, DO, MPH
Internal Medicine and Addiction Medicine
AFSCME Local 2831 Representative
