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.

Arbitrator Mandates Alameda Health System Employ UAPD Psychiatrists

January 9, 2019

In July 2018, UAPD decisively won at arbitration against Alameda Health System (AHS). Two years prior to that time, AHS contracted out psychiatrists’ jobs in the psychiatric emergency services/triage services to Traditions Behavioral Health (TBH), flagrantly violating both UAPD’s MOU and a California statute, sponsored by UAPD, which protects those jobs. The arbitrator ruled AHS was clearly in violation of the MOU and the statute. The arbitrator then ruled that all of those positions MUST be returned to us! In September 2018, the arbitrator handed down his remedy (see below), outlining that by May 1, 2019, TBH’s contract for staffing PES (milieu and triage) must end, if not sooner (see paragraph #7 of the remedy). Currently, AHS is in violation of this remedy as they have failed to advertise the new psychiatric rates in violation of paragraph #3 of the remedy as the rates have been approved by AHS’ Board of Trustees. Our attorneys are now demanding that AHS abide by this remedy. The arbitrator retains jurisdiction to ensure that AHS does not drag its feet.

The remedy below represents a huge collective effort and victory for UAPD against the contractor, Traditions Behavioral Health.

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Multicare Urgent Care – Legacy Bargaining Team Agrees to Historic Contract

February 25, 2019

Facing an increasing media campaign and an imminent picketing demonstration by UAPD, Multicare Health Systems blinked. After 20 months at the bargaining table, one issue became the sticking point—the urgent care closing policy. Urgent Care doctors and providers wanted to maintain their ability to leave the clinic near the posted closing time. Our tentative agreement essentially preserves this right and will go a long way to prevent burnout and fatigue. In addition to the closing policy there are many other advancements in this first contract—just cause, salary increases with a reduction in total shifts, a new grievance system, to name a few. Legacy bargaining unit members will be voting on this new contract in the coming weeks.

This tentative agreement with Multicare represents the first collective bargaining between a physician and provider union and a private corporate health care organization in the state of Washington and one of the first in the western United States. It will undoubtedly give hope to other doctors and providers who are working as employees without a voice. UAPD has another potential agreement close at hand with Multicare/Auburn Medical center. The next session will be on March 13. We will keep you posted.

MultiCare Providers Stand Together for Patient Safety

January 22, 2019

Hundreds of physicians, physician assistants, and nurse practitioners at the Legacy and Indigo urgent care centers and Auburn Medical Center (AMC) in Tacoma, Washington are standing together to protect the health and wellbeing of Tacoma residents, and improve deteriorating working conditions for healthcare providers.

The three units, all members of the Union of American Physicians and Dentists (UAPD), have been bargaining with MultiCare, the $2.4 billion-a-year healthcare corporation that owns Legacy, Indigo and AMC, since June 2017, but the company has yet to address the providers’ serious concerns regarding patient care and staff safety. After coming to the table multiple times it’s become clear that MultiCare has not been bargaining in good faith on these issues.

Citing practices that “put profit before patient care,” UAPD members are demanding that the healthcare giant address policies that impact patient care such as staff retention, inadequate staffing levels and consistently overworked staff. These issues have led to astronomical turnover rates, unpredictable facility closures and chronic short staffing. All are contributing factors to what providers see as a declining standard of care in MultiCare facilities.

Providers will be holding MultiCare accountable both at the facilities and in a growing social media campaign.

UAPD’s Fifteenth Triennial Convention A Lively Success

November 16, 2018

Last month’s Triennial convention in San Francisco proved to be thought-provoking. Well over a hundred of our members and staff attended the two-day event at the SFO Westin hotel. On Friday morning we were treated to an illuminating documentary on physician suicide entitled Do No Harm. Emmy award-winning filmmaker and director Robyn Symon presented her piece and later answered questions. What followed was a fascinating CME on practitioner burnout. Etiologies and strategies to prevent and reduce burnout were presented and discussed by the panel and audience. We then heard from incoming State Treasurer Fiona Ma about the upcoming California budget and her own philosophy. She pledged to work with UAPD to help fill hundreds of our state vacancies.

During lunch, a panel of three of our reps led a discussion about the roles of stewards in UAPD. Stewards are the backbone of our union. After lunch, we broke out into several working groups in order to brainstorm issues specific to our sectors. Lots of great ideas and best practices were discussed. We later reassembled in the main hall to hear a financial planner talk about the current and future economy and strategies to save and grow money. After a break, we were treated to a rollicking evening reception in the main ballroom with refreshments, music, DJ, and dancing. Lots of fun and camaraderie followed.

The next morning we started the business portion of the convention. We reviewed the minutes of our last Triennial and the current Treasurers report. Despite the negative financial impact of the Janus decision, UAPD remains in positive cash flow. Our Vice Presidents, Drs. Lewis and Farooqi, introduced the newly elected UAPD Board and then we went around the room to introduce each individual attendee. It was a very representative turnout. I then gave the State of the Union address “DBA UAPD”. The gist of the speech is that while pledging our union to excellent service to our members ultimately UAPD must adhere to strict business principles. We must preserve and develop our membership in both older (State, LA)and newer markets (Washington). We must eliminate financial waste in several areas—payroll, legal, meeting and office expenses. We recently consolidated the Oakland and Sacramento office. We are looking to purchase a small permanent office space in LA. To read the entire speech, check out the post here on the UAPD website.

After Executive Director Zegory Williams introduced our staff to membership we heard from AFSCME organizing director Walter Blair and our political director Doug Chiappetta. At our formal luncheon, we presented the Marcus service award to outgoing Treasurer Peter Statti for over 40 years of service. A job well done, Peter! Dr. Victoria Behrman will take over the Treasurer duties going forward. Staff Patricia Hernandez and Doug Chiappetta presented gifts and a declaration by the California Senate to our retiring Executive Director Zegory Williams. Zeg has done a great job for nearly 17 years at UAPD. He will be missed. We finished the convention business by reading, amending and passing several resolutions on state vacancies, hiring practices, pensions, a UAPD app, and single payer. We debated various constitutional amendments for over an hour. The most controversial was the question of a name change for our union. Traditionalists felt that we should keep UAPD as is, while others felt that we should recognize and advertise that we have become more of a health care melting pot of practitioners. We are establishing a committee to explore and finalize all the amendments by years end. All in all the Triennial was a great way to look back at the last term and commit ourselves to grow stronger in the next three years.

The Votes Are In: A New UAPD Board Has Been Elected

September 7, 2018

Your votes have been tallied from last month’s UAPD Board elections and here are the results:

Vice Presidents: Ronald H. Lewis, MD, FACP, and Mubashir A.Farooqi, MD

County Board Members: Rex L. Cheng, MD, Victoria A. Behrman, MD, Sandhya Radhakrishnan, Pharm.D, Gary Pedneault, MD, and John A. Uyanne, MD

Those Board seats uncontested include: Stuart A. Bussey, MD, JD, PresidentShakalpi Pendurkar, DDS, MPH, Secretary, Peter A. Statti, MD, Treasurer, Milton L. Lorig, MD, JD, Private Practice Sector, State Sector Jeff Nelson, MD, Alex Spinoso, MD and Robert A. Bitonte, MD, JD.

Thanks to all who participated in this triennial democratic exercise of our Union, to those who ran, to those who voted, and to those who have previously served on our Boards. We are a better union for it. I look forward to working with the new Board in the challenges of growing stronger during the post-Janus era. Hope to see you at our upcoming Triennial Convention in San Francisco on October 26th and 27th.

Stuart A. Bussey, MD, JD

Victory for AHS Doctors! Arbitrator Rules in Favor of UAPD

July 6, 2018

UAPD decisively won at arbitration against Alameda Health System (AHS). Two years ago, AHS contracted out psychiatrists’ jobs in the psychiatric emergency services/triage services to Traditions Behavioral Health (TBH), flagrantly violating both UAPD’s MOU and a California statute, sponsored by UAPD, which protects those jobs. The arbitrator ruled AHS was clearly in violation of the MOU and the statute. The arbitrator then ruled that all of those positions MUST be returned to us! AHS and UAPD need to quickly work out the way to rid PES/Triage of TBH. The arbitrator will retain jurisdiction should AHS drag its feet. Our next task is to bring PES/Triage wages to market, which has been on the table since May 2017, with absolutely no response to date from AHS. Now, AHS will have to respond or face the wrath of the arbitrator.

Special thanks go to all of our bargaining team members, especially Dr. Milton Lorig, MD, JD and Senior Representative Patricia Hernandez, JD. Kudos as well to our legal team and those who testified. Lastly, thanks to out UAPD Lobbyist, Doug Chiappetta, who guided the legislation that helped achieve this victory.

Mad As Hell And Not Going To Take It Anymore: AHS Physicians Walk Out

June 29, 2018

Physicians of UAPD working in ambulatory at Alameda Health System (AHS) walked out of a meeting at the Hayward Wellness Center on Wednesday, June 27, 2018 in protest of AHS’ intransigence. Those physicians have been out of contract for a year. AHS, rather than bargain in good faith over conditions at AHS, propose disrespectful and unethical mandates that would harm our most vulnerable patient population by demanding a “factory style” approach to patient care, treating our patients as “widgets” with physician pay linked to the number of “widgets” seen. Our physicians confronted AHS’ Chief Medical, Ghassan Jamaleddine, M.D., and made clear to him that AHS’ position is unacceptable. The group overwhelmingly voted to strike if AHS continued in its present course at negotiations. Our physicians are unwilling to sacrifice the doctor/patient relationship by delivering substandard care under an “assembly line” approach to the delivery of healthcare.

More Doctors and Advanced Providers Unionize in Washington State

August 1, 2018

We would like to congratulate the physicians and advanced practice providers at Multicare’s Indigo Urgent Care centers who voted Monday to join the Union of American Physicians and Dentists (UAPD). Indigo providers sent a message that they want collective bargaining rights and a voice in providing care to patients. “I am excited that we have formed a union because, as a collective voice, we can work cooperatively with Multicare to create an organization that excels at providing high-quality patient care and provider satisfaction”, said Sara Pederson, an Indigo Physician Assistant.

Indigo providers now join UAPD bargaining units previously formed at Legacy Urgent Care Centers and Auburn Medical Center. The drive to unionize Indigo centers came about because providers perceived that they were having too little impact on patient care decisions. Many of these decisions appear to have been cost driven by Multicare. Profits have been placed before patient care and employee welfare.

Now begins the process of better understanding the specific priorities of Indigo providers. We want to start contract negotiations as soon as possible. In the next several days Indigo providers will receive a bargaining survey that will help evaluate their concerns on compensation, working hours, benefits, and other issues. One of the most important issues concerns an effective and reasonable urgent care closing policy. “In the past Multicare has forced many of its providers to work late into the night, seeing patients after an already long shift. This presents a real safety issue for both providers and patients”, stated Stuart Bussey, M.D., UAPD President. Our union is excited to begin negotiating a contract for Indigo providers.

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 15^th 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.

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