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The UAPD Pulse – By Stuart A. Bussey, M.D.

2019: Uncertainty…and Possibility

December 28, 2018

By Stuart A. Bussey, MD, JD, UAPD President

Tariff wars, Middle East and US Border tensions, government shutdown, stock market volatility. 2019 could be a difficult year for our economy and our country. On the other hand, unemployment is low, wages are slowly rising and the impact of Janus on public unions is lower than expected. UAPD will be shoring up our public sector while organizing our private markets. With streamlined staffing and consolidated offices, our union hopes to grow in size and strength. I ask that you, our members, participate and share your voices and ideas with us whenever you can.

The direction of your jobs, careers and health care delivery should be dependent on your increased professional input. Our union will continue to fight for better working conditions and health care for your patients. UAPD is more than just another non-profit corporation. It is a sisterhood and brotherhood. We need to communicate and help one another. I look forward to achieving our possibilities in the coming year.

State of Our Union in 2018 — DBA (“Doing Business As”) UAPD

November 19, 2018

By Stuart A. Bussey, MD, JD, UAPD President

Fellow UAPD members, staff, and honored guests, 

I will start this State of the Union address with a well-known quote from Ruth Stafford Peale… “Find a Need …and Fill It.” These words describe the essence of a successful business model. Whether a service or product, the customer’s needs must be satisfied in order for an organization to survive, to thrive. In the case of our nonprofit corporate entity, the Union of American Physicians and Dentists, the customers are you, the members. You pay dues, you support our staff and each other, and you give good care to your patients. Our job is to take care of you. Among the services that our union has provided to our members for nearly half a century have been to bargain contracts, to enforce their provisions by grievance and arbitration, to represent them in disciplinary actions, and to fight for a safe workplace.

Since 1977 public unions, including ours, were assured of a 100% “customer base” by virtue of the US Supreme Court decision Abood v. The City of Detroit. That court decided that members of bargaining units who didn’t want to be part of a union for whatever reason still had to pay their ”fair share” for the contracts and services their union provided them. But times have changed. Our country has changed. With the rise of an oligarchy, increasing corporate influence, technology, and global outsourcing, unions have lost their influence. In the 1950s 36% of workers belonged to unions. Now only 11% do.

Those who never fully embraced the philosophy of union membership seized upon this summer’s Janus Supreme Court decision to drop out of their unions, to become non-members. Across the country, public unions now face a reckoning. While some unions lost only a few members, others lost almost half of their membership. Despite our best efforts to convince them to remain or become full members, UAPD lost a fifth of its membership. Almost all of that loss was from the fair share sector. Only a handful of our loyal full members have dropped out. That is good news. But make no mistake. The fair share member loss has significantly decreased financial resources with which to serve our members.

Now UAPD must respond -just as any diligent business would-to a temporary adversity. We must continue to provide you, our loyal customers with good services, win back our old customers, and maintain financial stability. Here are some business strategies we will be employing. Think of them as keeping our economic bucket full.  Adding more resources and members into the bucket, while plugging up holes and excessive expenses at the bottom of the bucket. First, let’s look at those holes.

In the past year, we have tightened our belts by reducing or eliminating several staff positions and payroll without compromising our representation. We could do this because we were relatively overstaffed in some areas. With skillful staff reassignment and deployment by our Executive Director Zegory Williams in Sacramento and Charles Lester in LA, we have literally saved hundreds of thousands of dollars. Zegory, for those who don’t know, will be retiring at year’s end. I would like to formally congratulate and thank him for his 17 years of outstanding work at UAPD. He has made our union stronger, fairer, and a great place to work. The extra workload has been picked up by our remaining staff. Please stand up and be recognized. In addition to staff payroll, we are addressing other expenses that need reduction. Take our legal expenses. For the past couple of years, we have been spending money on lawsuits against Alameda Health System and Multicare Health Corporation in Washington. I am pleased to report we have had successes in both areas. Thanks to the solidarity of our AHS doctors, especially Dr. Milton Lorig,  Senior Representative Patricia Hernandez, and Leg. Staffers Doug Chiappetta and Adrian Mohammed, contracting out of our positions at AHS is now effectively prohibited. Our new legal team of attorneys David Rosenfeld and Ann Yen was instrumental in this victory. We are now on a financially streamlined monthly retainer with this firm. In Washington state, the Rosenfeld group will play an even bigger role in fighting Multicare and other health care employers. With these savings we will continue to provide our legal consultation fund to those members in need. Since 2010 this fund has aided dozens of members.

Office consolidation is another area where we are saving money. As many of you know, we consolidated the Oakland and Sacramento offices in September into one office in Sacramento, thereby saving $168,000/year. The transition has worked out well. There has been little problem absorbing extra staff into our Sacramento location. In Los Angeles, we are looking to purchase a small office building and sublet our oversized rental space in El Segundo. We signed a broker contract last week. And anticipate a major saving. Lastly, meetings and transportation costs need to be reined in. We plan on using hotels that are comfortable, economical, and accessible. Staff meetings and small member-rep meetings will be done with Skype or Webex whenever possible. We will conduct more board and larger member meetings in our own UAPD offices.

To fill up our bucket with dues-paying members we will employ numerous strategies. First, we are polling nonmembers about why they are not in our union. We must also utilize organizing methods that other right to work unions have employed for years. That is, we must still honor the right of representation and earn the trust and loyalty of non-members. At the AFSCME international Convention held this past July this strategy was hotly debated. The rationale is that if nonmembers are treated with less vigor than members then a two-tier union will be created and the employer will use that to undermine us. We have already seen some successes converting non-members back into the union. To win back our non-members we will need the continued effort of our great corps of ambassadors, our UAPD stewards. Please stand up and give yourselves a hand. Without a doubt, you are the backbone of our union. Without you, we could not function. The other group I want to recognize today is our bargaining team members. They battle through difficult negotiations which affect all of our lives. Please stand up. One of the realizations of this past year during my site visits is that many of our members do not feel heard or appreciated. In the past, we have been a union closely tied to the Democratic politics of California. However, a significant portion of our members is not Democrats. These members must be heard. The direction and culture of UAPD should not be based on whether members are a Democrat, Republican, Libertarian, white, black, brown, male, female, straight, or gay…it should be based on our common identity as health care providers. We are an increasingly diverse melting pot of physicians, dentists, NPs, PAs, Pharmacists, Podiatrists and most recently, veterinarians. I would like to recognize LA Vet Dr. Amy Raines. Our Vice President, Dr. Ron Lewis, and others will be working this year to provide a sounding board, a non-partisan caucus, to hear all points of view.  Listening to different opinions is what makes an organization strong. Speaking of communicating, we continue to increase and improve upon our website and teleconference meetings-both for business purposes, as well as camaraderie. We just initiated a monthly happy hour teleconference in September to trade travel, union news, and hobby tips. This type of exchange is the glue of an organization. I welcome any suggestions from you to learn about and from each other.

For a business to thrive it must diversify its service lines while shoring up its traditional base. Here I am referring to the eroding State of California work sector. Once an 1800 employee state sector we are down to around 1000 members. With a reduced pension ceiling thanks to the PEPRA law, an aging membership, and an anemic hiring effort by the state, the outlook for state union jobs is not robust. But with a more union-friendly Governor likely next year we will attempt to fill our 400 plus vacancies with a more transparent state hiring process. The major diversification UAPD is attempting in the post-Janus world is the creation of private provider bargaining units under the NLRB. Thus far we have been successful in organizing four groups in the Seattle/Tacoma area- Auburn Medical Center, Legacy Urgent care, Indigo Urgent care, and Swedish Urgent care. With persistent bargaining and collective member action, we are on the verge of completing contracts for the first two groups. I would like to formally recognize the efforts of our Tacoma staff—Laura Anderson who retires next week, John Diel, and organizers Joe Crane and Gabrielle Hanley. These people are pioneers and innovators. There are other NLRB type units in California that our staff will be organizing. Other health care groups are interested in affiliating with UAPD. Medical students, who emerge from professional school with a quarter million dollar debts or more are looking for guidance to find their place in the brave new medical industry. Bradley Heinz, a UCSF medical student, was at our Board meeting last night and represents a potential giant alliance.

Finally, we need to cement old relationships with our union partners and forge new ones with like-minded professional groups. We have been affiliated with AFSCME international now for 21 years. They have provided valuable support, research, and organizers for UAPD during our campaigns-most recently in Washington. We need them and they need us. I would like to introduce our AFSCME  International Western Organizing Director, Walter Blair and California Political Director, Brian Allison. In order to garner political leverage, AFSCME depends on its 1.4 million members to enroll in the PEOPLE program, which costs members only a $100 per year. I would like to recommend that every one of our members here today enroll or remain in the program.  One last comment before I review UAPD’s issues of the last three years. I had the privilege of attending the third world medical union meeting in Lisbon, Portugal last month. Doctor unions from dozens of countries were represented. The doctors were an affable and fascinating group. Even though they are paid far less than American doctors, their top issues were their own personal safety and that their employers, usually their government, exploit them by excessive workload and hours.  Personal time is becoming the most important currency. I am proud to report that UAPD will be hosting the fifth international medical union meeting here in San Francisco in the Fall of 2020.

Let’s review what UAPD has accomplished since the past triennial and the specific challenges that lie ahead for the next term. First, some history of our State Sector. BUs 16 and 1 were organized by our founding President Sanford Marcus and then ED Gary Robinson and were established in State law by Governor Jerry Brown in the early 1980s.The increase in the inmate population in state prisons and mental hospitals meant a need for more physicians to treat and care for them. When the Plata, Coleman and Perez class action suits were decided in 2006, the Prison Receivership was born. More money and resources flowed into the prison system. More physicians and psychiatrists (like Drs.Agarwal and Aramandia of Stockton, Dr. Kamen of Avenal, and Dr.Mehari of DVI) were recruited to satisfy the primary goal of Federal Judge Henderson-to provide prison health care equal to that of outside society. The Receivership thus far has accomplished much to improve and organize the prison health care. Sixteen of 35 facilities have passed court audits. But sadly, like all bureaucracies, it has taken on a life of its own. It has become its own weather system with layers upon layers of supervisors. Meanwhile, Governor Brown has reduced the inmate population from 163,00 to its current level of  115,000. Scores of our rank and file positions in hard to fill geographic areas have been filled by our telepsychiatrists. Based upon a rosy CDCR report regarding telepsychiatry the State and inmate attorneys were on the verge of eliminating 20% of our psychiatry positions. But this plan came to a grinding halt last week when Chief CDCR psychiatrist and whistleblower Michael Golding, MD forwarded a 160-page report to Coleman Court Judge Muller. This sealed report details alleged misrepresentations and exaggerated data that CDCR has published about the virtues of CDCR telepsychiatry. UAPD is a stakeholder in this drama and will not sit idly by. California’s inmates, doctors, and taxpayers deserve to know the truth and formulate a better mental health delivery and hiring system at CDCR. Over the next year, UAPD intends to intervene, hold public hearings, and publish its own treatise on how to effectively staff and service the CDCR.  As far as our CDCR Plata physicians their vacancy problem is less than the 44% vacancy rate of their psychiatrist colleagues, but still significant. Several of our members have to take call several times a week. (Dr. Greenberg, Dr. Neubarth)They skip lunch and breaks to finish endless paperwork. Last year UAPD was able to limit the mandatory use of laptops by physicians for calling in orders while on call. But the CDCR continues to stretch the scope of our physicians. They are pushing for a Medication Assisted Treatment (MAT) Program to detoxify addicted inmates. Our physicians have expressed serious professional judgment concerns and UAPD will vigorously defend their position.  Regarding the new governance policies and professional practices executive committee (PPEC) UAPD has met several times this year with the Receiver’s representatives to increase our rank and file presence on this committee. Many thanks to previous PPEC members Ron Lewis and Gabe Borges for their years of service. I would be remiss for not mentioning our CDCR dentists who deliver care to inmates in a difficult environment (thanks to those  here today –Drs. Landers, Fransdal, Frier and Edwards)

Now to the Department of State Hospitals (DHS). Besides the chronic DSH vacancy problems, especially at Atascadero and Patton State Hospitals, the issues of the past three years involved management’s preoccupation with timekeeping our members and the ill-advised and overreaching Office of Law Enforcement Security (OLES). First, I am happy to report that a long overdue management housecleaning has occurred in the last couple of months at both Patton and in Sacramento. This has resulted in much-improved morale and a more realistic attitude and practice regarding our overworked members. Many thanks go out to those who saw the timekeeping issue for what it really was—a flawed attempt to retaliate against several of our more outspoken members. The latest bureaucratic attempt to keep state police fully employed is OLES. UAPD has already acted to curtail this group’s incursions into the clinical practices of our members. We have proposed at minimum a subject matter expert panel (SMEP) of DSH directors to screen patient complaints before they go to the OLES police. Some of these complaints have already resulted in anxiety-producing criminal accusations. We will continue to seek further remedies that ensure fairness for both patients and doctors. (My thanks to Drs. Wartena, Dang, and Yang)

At the Department of Social Services (DSS) there have been the usual attempts to increase workload and case quotas beyond what our contract has always stated. The expectation and workload memo mandate that our Medical Consultants complete their work within two business days. That has always been unrealistic, especially with the ever-increasing caseloads. Ask Drs. Bitonte and Resnik. Other issues relate to an onerous vacation leave policy. UAPD will be polling the DSS MCs about this shortly. Some good news is that the department has recently clarified that our members are eligible for alternate workweek flextime. The Department of Health Care Services (DHCS) UAPD has objected to the Department’s asking that our MCs enter into individual “Results, Accountability, Flexibility and Teamwork” (RAFT) agreements. We see no imperative for this after many years of successful MC productivity. I would like to recognize our long-time stewards from LA—Drs. Ken Seiff and John Haight, who retired this summer for their years of loyal service to UAPD. Kudos to Brian Kennedy and Ralph DiLibero in Sacramento. Regarding the Department of Developmental Services, we received notice this past winter about the future closure of the centers. Nevertheless, BU 16 members continue to accrue quarterly retention stipends to encourage them to remain on the job during phase I of the closures. In addition, MOD calculations are now being done correctly. I would like to recognize our SEPA Board President Peter Conroy for his loyal service and innovative ideas in service of DDS. At the Department of Veterans Affairs in Redding, new security cameras are being installed. In light of the mass shooting at Yountville VA two years ago, we think this is a good idea. The Department of Public Health and the UAPD are involved in ongoing talks about the department’s reorganization.

The University Student Health Centers are represented by about 80 of our doctors at the CSU campuses (BU-1), including Drs. Gamo, Thomas, and Tringale and well over a hundred doctors at ten UC student health centers (Drs. Alper and Nelson). Recruitment and membership at CSU is on the rise with increased enrollment and a great contract negotiated this year by Rep Jake Baxter. We are now initiating a Labor-management committee regarding legal representation and geographic differentials. At the University of California health centers, there are many separate policies and, thus, many separate issues. We have active grievance systems and stewards at each site. UC contract negotiations start shortly with Tim Jenkins as lead negotiator.

There has been much positive growth in our county sector over the last few years. Leading the way is Los Angeles. Our membership there has increased under the organizing efforts of Charles Lester and his staff. In the past, we had membership in the 40% range but we currently stand at 67%. The UAPD is working with DMH, DHS, and DPH about physician recruitment and how we can use loan repayment to recruit doctors. We already have obtained several commitments from psychiatrists to work in LAC. They will receive $50,000 per yr for up to 5 years. In addition, UAPD is making changes to recruitment brochures and reaching out to the Committee of Interns and Residents (CIR). UAPD has a seat on the Integration and Advisory Board which oversees the integration of the three departments into one health agency. (thanks to our LAC leaders here today -Drs. Glinicki and Pedneault). We also have rank and file health agency transformation advocates, positions used for union and management projects. This partnership is aiming to make the workplace a better working environment. UAPD has already used the Just Culture algorithm to solve grievances both informally and formally. Also, we just had our first interdepartmental CME on Burnout at Harbor hospital, sponsored by UAPD. Finally, we are in the midst of bargaining with the County on all three unit contracts—301,324,325. We could have them all wrapped up by year’s end. The LA County Ambulatory Joint Labor Management Committee will meet regularly to improve operations at the clinics At the Twin Towers correctional facility our doctors are now under the authority of DHS. Understaffing there has led to the creation of retention bonuses and loan repayment opportunities. Regarding the Pharmacists, in BU 01 they are one of our best-represented groups, at 90% membership. Pharmacist Sandhya Radhakrishna is now one of our UAPD Board members. (Drs. Ogun-Buraimoh, Nwanze, To and Wong). Thank you. The new Director of Pharmacy, Jean Peralles, is considering the need for Advanced Practice Pharmacists.

Other county units are also thriving. To Help Everyone Health and Wellness Clinic (T.H.E) has grown in the past three years from 8 to 13 members. They are in bargaining now. San Francisco County has been ably represented by Rep Tim Jenkins. With a good contract and membership at nearly 95%, our SF members deserve lots of praise. (Drs. Behrman and Wu have been instrumental)Proposition F appointments have allowed our members to remain retired annuitants. A wildcat strike at the Potrero Hill Clinic was recently avoided when a disruptive clerical employee agreed to leave. County of Sacramento personnel officers are having a hard time activating our contract incentives. UAPD (Dr Padilla)is working with them to resolve this issue. In Santa Clara County bargaining (Drs Wong and Yazgan) will begin in the spring. One thorny issue is the payment of tuition reimbursement. Doctors can get $4500 in a year and rollover this benefit once to the next year, but the process is too slow and onerous. A Santa Cruz County doctor successfully rebutted a poor performance appraisal. In San Mateo County our union, led by Dr. Herbert, is challenging the contracting out of physicians at the new jail. The solution may lie in what UAPD did for the Alameda Health System (AHS) last year. We passed a bill into law which precludes AHS from contracting out unit positions without clear and convincing evidence of cost savings. UAPD is considering similar legislation on a county by county basis. Nearby in Alameda County Senior Rep Patricia Hernandez recently completed an excellent contract for her members with large market adjustments for psychiatrists. Again, political intervention helped to persuade the employer to settle up. Other good contracts have gone into effect at San Joaquin County (Drs. Nelson, Soofi), Gardner Family Health Center, Northeast Valley Health Corporation (NEHVC) and Santa Barbara County. The latter two were engineered by UAPD Rep Glynnis Golden Ortiz. Thanks to all here today.

As I mentioned previously our goal in the post-Janus era is to diversify our membership into the Private Sector. As most of our independent private doctors have retired or gone salaried the UAPD Board earlier this year decided to dissolve our dwindling and unprofitable IPA. That was a difficult, but necessary business decision. At this time I would recognize the giants of our private sector- Drs Weinmann, Sinaiko, Sutton, Statti) In its place we continue to explore the world of corporate medicine, where providers and younger doctors are taking high paying jobs to resolve their debts. The best place to develop this service line is in Washington State. There are relatively friendly labor laws in the northwest and plenty of overworked doctors and providers interested in unionizing. For the past two years, we have been organizing hospitals and urgent care centers. We just recently organized Indigo and Swedish urgent care clinics. We are on the verge of completing two contracts—one with Auburn Medical Center and one with Legacy Urgent Care. Both are units of 50 providers and doctors in Tacoma. The final sticking points are compensation for AMC and closing policy for the Legacy providers. The latter issue lies at the heart of provider burnout and may soon require collective actions by our members and public pressure to convince the employer Multicare. Corporate employers are a different breed than what we are used to. Although they claim non-profit status they are singularly focused on the bottom line and demand that providers earn every penny of their salaries. That means long working hours and constant access to patients. I want to recognize our Washington staff and Indigo members who are here today—Sara Pedersen and Daryl Browne. The long-distance relationship with our Washington providers has required a long-range outlook. To succeed in a new territory requires skill, patience, and financial commitment. I want to thank our Board, our members and our Washington staff for staying the course. We will succeed and make history in the northwest. Our organizers have been receiving calls from doctors around the country who are rooting for us to stand up for those on the assembly line of industrial medicine. We are looking to chronicle this adventure. Yesterday Robyn Symon presented the burnout problem with her incisive documentary Do No Harm.  We hope that her next movie about UAPD will be called “The Empire Strikes Back”

Besides competent staffing, marketing and communication, and legal support, unions such as ours need political and legislative cover. Whether in LA, Sacramento, or Seattle, our legislative staff of Doug Chiappetta, Chris Ige and Adrian Mohammed are up to the job. They have proven time and again that contracts, benefits, recruitment, and employee advancement depend on both negotiations and political pressure. Contracting out and hiring transparency bills will be written next year in California. Covenant not to compete and Certificate of Need bills in Washington. Our UAPD members who are currently in the legislature, and those seriously considering entering politics, like Dr. Kevin Jetton, are necessary for our union to thrive. They are the vanguard in the battle to restore control of our once proud profession back to where it belongs—to doctors and providers. We need a tough business attitude more than ever to represent and protect our members in the new industrial world of medicine. We intend to apply those principles to make our union bigger and ever stronger. Long live the UAPD!

End of Summer Update — Time for a Happy Hour

August 24, 2018

By Stuart A. Bussey, MD, JD, UAPD President

Vacations are ending and school is back in session. Two months have passed since the Supreme Court ruled for Mark Janus and against mandatory fair share fees. I am pleased to report that our members have remained steadfast and loyal to UAPD. Many of our former fair share members have signed on as full members. This bodes well for UAPD solidarity.

Speaking of coming together, we will convene our 15th UAPD Triennial Convention in San Francisco October 26-27. You will be receiving a letter and packet in a few days describing convention activities and how to become a delegate. I look forward to meeting you and exchanging ideas with you there. The topic of our free CME on Friday morning is “Heal Thyself.”

Part of professional healing is being able to open up, communicate and learn from your fellow colleagues. That could involve anything from sharing new ideas, expressing frustrations and triumphs, telling stories and humorous anecdotes—call it “UAPD Happy Hour.” Our officers and I plan to host this teleconference forum for UAPD members across the state and Washington on the third Tuesday of each month, from 6-7 pm. This time should provide a good opportunity to get to know our union and each other better. Details on how to participate will be forthcoming after Labor Day. Meanwhile, thanks for being a loyal member of our Union.

Doctors, Unite—Celebrate Interdependence Day!

June 27, 2018

By Stuart A. Bussey, MD, JD, UAPD President

Today, in the shadow of the Independence Day weekend, the US Supreme Court declared by a 5-4 vote that public union “fair share” agency fees are unconstitutional and not mandatory. They chose fuzzy borders of free speech and association over the gritty reality of free ridership to justify this potential financial blow to labor unions. The Janus vs AFSCME decision marks the final chapter of the 75-year-old “Right to Work” anti-labor law playbook which has progressed through 26 state legislatures. Now the rule is federalized.

Many of the fair share members who did not join UAPD as full members were unaware of the important differences between these two categories. Now after the Janus decision there won’t be any more fair share members, only non-members. There are big advantages to being a full member. Most importantly, when UAPD has a robust roster of full members, committed to the principles of unionism, the employer takes notice. There is strength in numbers. We have greater staff resources. This power leads to more favorable contracts, grievance outcomes, better representation and greater respect for the bargaining unit. Higher membership leads to greater member involvement, optimism, community, and synergy of ideas to improve the workplace. Only full members can participate in contract surveys and bargaining sessions, be on committees, participate in legislation, attend free CME, and enjoy our legal defense fund. There are monetary union perks as well–reduced mortgage payments, rental and insurance discounts, etc.

Corporate and billionaire interests will continue their efforts to deconstruct unions in the US because they see them as one of the last roadblocks to a plantation economy–where there is little resistance to unreasonable and self-serving policies. Where they can pay less and expect more from their employees. Let’s fight back! The words “doctors and union” have been an oxymoron. We traditionally are individualists and have been likened to herds of cats. Following today’s Janus decision, however, we must unite to survive. Stay or become a full member… but don’t turn into a non-member! Seek out a fair and a satisfying workplace by working together.  Please consider this over the long weekend. It is good to be independent, but it is crucial to interdependent.  

Are You in or You Out? Top 10 Reasons to Be a Full UAPD Member

May 24, 2018

By Stuart A. Bussey, MD, JD, UAPD President

With the Janus v. AFSCME Supreme Court decision expected in days or weeks, we UAPD full and fair share members face an important decision. The Court will likely decide that public union fair share fees are not legal or collectible and that there will be only two possibilities-full membership and non-membership–Do you fair share fee payors really want to stop paying your fair share fees and become nonmembers, jump ship, free ride? Many of our fair share payors incorrectly believe that because they pay fair share fees of 0.86% of their salary, for union services, that they are full members. They are not. For only .04% more of your salary, you may enjoy UAPD full membership benefits- participating in bargaining, voting for the contract, being on union committees, running for office, free CME and legal consultation. to name a few. Over the last year UAPD stewards, staff, and representatives have been asking you to become full members. It’s not too late to convert over to full membership. Just click on the link at the bottom and fill out the appropriate membership form.

To our doctors and providers who are already full members, you have our unwavering gratitude for your loyalty and service. We need you to recommit your full membership by clicking the link at the bottom of this article and fill out the appropriate membership form. If the Janus decision is adverse to public unions, we anticipate that big money and union busting organizations like the Freedom Foundation will try to contact you. They will argue that you should drop your full membership and not pay any dues money for your union services. That makes no sense.  Don’t listen to them. Would a patient not pay anything for medical services? A patron not pay a shopkeeper for a product? A citizen not pay taxes for government services? New York State has already passed legislation that would make certain benefits applicable only to full union members. California lawmakers are also considering similar legislation. Your membership is critical to our union’s survival! Without your full membership and dues, we cannot provide you with a good contract and representation services. It’s time for us all to acknowledge the value of UAPD.

The TOP TEN REASONS we must remain or become full UAPD members

  1. A Good Union Contract is Your Best Return on Investment- where else can 0.9% dues yield several percent annual salary and other monetary increases? We need a robust staff to bargain for good contracts
  2. Grievances Matter- without adequate resources our representatives cannot comprehensively address and correct contract violations.
  3. Pension and Benefits – We need strong political alliances and resources to maintain good pensions, defined contributions, and health benefits.
  4. Just Cause and Just Culture– The best defenses against capricious discipline and system dysfunction have been negotiated and maintained by UAPD
  5. Time off- Vacation, leave and flexible work hours become as important as money as you age. Ensure UAPD has adequate staff to fight for them.
  6. Relevant Legislation- Whether union, health care, or socially conscious UAPD’s political arm needs membership muscle and resources to advocate
  7. Legal Defense- To supply our members with top legal advice, defense and advocacy we must maintain a superior legal program and consultants
  8. CME and other free perks- only members may enjoy free CME, legal consultation, union plus insurance, discounts on mortgages and more
  9. Leadership and Involvement- only as a member can you become a steward, vote for contracts, serve on union committees, or run for union office
  10. Fighting for Equity in health care- For half a century UAPD has stood for fair treatment of our patients, doctors, and providers. Let’s keep it up!


Colleagues, sisters, and brothers, please click on the link below and choose the appropriate Docusign form to commit to full membership. Don’t go it alone and miss out on UAPD benefits.


Doctors: Independent Professionals or Government Agents?

April 2, 2018

By Stuart A. Bussey, MD, JD, UAPD President

The sad look in my patient’s eyes reached down to the pit of my stomach “I only want to drive a couple of miles to my friend’s house” he lamented. But Carl’s progressive dementia and arthritis couldn’t allow me to sign his DMV driver’s license form.  Increasingly, we physicians have been placed in the often uncomfortable position of being both the investigator and enforcer of privileges involving health issues. Driving, adoption, school and sports participation, employment, disability, competence, and conservatorship are only some of them.  Institutions, especially our governments, look to us for guidance and assign liability to our decisions.

This holds special relevance for our UAPD doctors who are employed in various levels of government. What happens when our professional judgment and scientific reasoning collide with the protocols of an agency or a supervisor with a personal agenda? We have all experienced conflicts regarding patient care or disposition with our supervisors and administrators. Debates about appropriate medications at CDCR, discharge decisions at County hospitals or claimant disability at DSS often make us feel that we are mere tools of government, not independent practitioners.
Read more …

UAPD Pulse: Looking Back and Ahead… UAPD 2018

December 26, 2017

By Stuart A. Bussey, MD, JD, UAPD President

We can all agree that 2017 was a memorable year-both outside and inside of our union. Donald Trump was sworn in as our 45th president and has used an executive style from his TV show “The Apprentice”. This year global warming became all too real.   Drought, fire and hurricanes spread around the world. Senseless mass shootings continued. Sexual harassment cases abounded.  But…there were also bright spots in 2017.  Unemployment reached an all time low and our economy is booming. Scientific and technology breakthroughs surprise us daily.  A high school senior in Texas bought his special needs classmates new shoes.   A customer in Washington left a $3000 tip for his $39 dinner.  A 5 year old from Mississippi called 911 to arrest the Grinch.  An ophthalmologist in Michigan carried his elderly patient through the snow to his office. The human spirit continues to amaze.

2017 also saw lots of changes and successes at UAPD. In February, after 35 bargaining sessions, UAPD reached an agreement with the State of California and ratified a new MOU.  While the general salary increases were moderate, we scored significant pensionable salary adjustments for hundreds of our members.  This was due in no small part to the strike ratification vote we took in January.  There were many other developments in the state sector which UAPD met with skill and tenacity—“lift and shift” of our DSH psychiatrists to CDCR, telehealth policy changes, ensuring laptops are optional on call, creating research to support the legal case for higher physician salaries, protecting Medical Consultant scope of practice, fighting timekeeping and retaliation issues, and, of course, member grievances.  We also fought against gender discrimination at CSU, contracting out and bullying at our UC clinics.

Read more …

California’s Climate Change: Single-Payer

June 7, 2017

By Stuart A. Bussey, MD, JD, UAPD President

Two seemingly unconnected events last Thursday remind us that we live in a progressive, independent-minded state. First, the California Senate passed SB 562 (Lara/D), the Healthy California single-payer bill. This bill purports to solve our state’s health care access problem, which has been partially relieved by the ACA and is now threatened by the new AHCA bill. The California Assembly is preparing for the weighty debate on how exactly to pay for SB 562’s universal coverage. Cost estimates range from $330 billion/year (UMass study) to $400 billion/year (legislative analysis). These figures are comparable to the 2016 estimate of California’s health care cost of $370 billion. Much of this money would be available as repurposed Medicare and Medi-Cal money — and the Feds would have to agree. The State, under Healthy California, would take on the role of single insurer. The plan would be governed by a nine member board of experts who would authorize payments to hospitals, doctors, ancillaries and pharmaceutical firms in a hybridized and collectively bargained fee-for-service paradigm. The collective bargaining part of the bill could elevate UAPD as a preeminent representative of many of California’s providers. Physicians probably would be working at discounted rates of reimbursements, but they would at least be paid promptly and by one entity (the State). They would not have to play tiresome reimbursement and authorization games with dozens of profit-motivated insurance companies. Doctors should spend less time billing and more time with their patients.
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Good Things Come to Those Who Wait…

March 14, 2017

By Stuart A. Bussey, MD, JD, UAPD President
Believe it or not, this phrase was coined by a British advertising agency to emphasize the virtue of  patience in waiting for Guinness ale to be correctly poured into a mug.  But it also applies to our UAPD members who wait patiently while their bargaining teams negotiate contracts for them.

Late last month the UAPD State Bargaining Team reached a Tentative Agreement with the State of California.  While the team strongly recommended ratification of the agreement, we all knew that not everyone would be completely satisfied by what the contract contains.
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State Negotiations: Chess or Chicken?

November 30, 2016

By Stuart A. Bussey, M.D., J.D., UAPD President

First things first. I hope that you enjoyed a well-deserved Thanksgiving holiday.

The game of chess requires clarity of mind, the ability to think ahead and effectively guess what moves your opponent will make. The same cannot be said for the game of chicken. Less reason, more nerve and resolve. Which player will blink and give in first? With over half of the twenty-one State bargaining unit negotiations stalemated, both of these games are being played by the State and by its employees right now.

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