Strike Looms as NYC Turns its Back on Doctors Working at Public Hospitals
“They won’t come back to the table. They won’t talk to us.” Doctors at four New York City hospitals are prepared to strike after the city and its affiliates refused to come back to the bargaining table. Physicians at another city hospital will hold a strike vote on January 3.
By Steve Wishnia
Doctors at four of New York’s 11 public hospitals have overwhelmingly voted to authorize a strike after more than a year of futile contract talks.
The vote at Jacobi Medical Center and North Central Bronx Hospital in the Bronx, Queens Hospital Center, and South Brooklyn Health, announced Dec. 19, was 97% in favor of a possible walkout, the Doctors Council SEIU said. The union represents more than 2,500 doctors at the ten hospitals where New York City Health + Hospitals has contracts with affiliates to hire them.
Jacobi, North Central Bronx, and South Brooklyn are among the seven hospitals affiliated with Physician Affiliate Group of New York (PAGNY), which declared an impasse and imposed its contract terms in October. Queens Hospital is affiliated with Mount Sinai.
Doctors at Elmhurst Hospital, the other Mount Sinai affiliate, are scheduled to hold a strike-authorization vote on Friday, Jan. 3.
“As of now, we have no scheduled bargaining sessions with the city or any of its affiliates,” Dr. Michael P. Jones,” head of the residency program for emergency-room doctors at Jacobi, told Work-Bites. “They won’t come back to the table. They won’t talk to us.”
The main issues, he says, are “very simply: recruitment, retention, and respect.”
In the aftermath of city hospitals bearing the brunt of the first wave of COVID, the system has been “struggling with understaffing and filling positions,” Dr. Jones explains, and doctors are “overbooked.”
But negotiators for the affiliates and NYC H+H have repeatedly told the union they are “not budging,” he says. The pay increases they have offered, he adds, are below market rate and not enough to keep up with inflation, and they want to reduce time off and health benefits. He says he doesn’t know whether his two children will still have dental coverage.
“Providers are vital to the high-quality care that NYC Health + Hospitals delivers to New Yorkers,” a spokesperson for NYC H+H told Work-Bites. The “affiliates, which employ the doctors, have made fair offers to the Doctors Council that we believe will make a difference in recruiting and retention at our facilities. We believe the offers are good for the providers and fair to the NYC taxpayers.”
The tentative five-year contract deal NYC H+H announced Dec. 16 for the about 500 Doctors Council members employed directly by the city followed the usual recent pattern for city unions: wage increases of 3% for each of the first four years, retroactive to 2021, and 3.25% in the fifth year. The deal imposed by PAGNY gives raises, but they are not retroactive to August 2023, when the affiliates’ previous contracts first expired.
‘It’s a real crisis’
At Jacobi, Jones says, so many doctors are leaving that the emergency department has a “chronic revolving door,” with the staffing shortage covered by overtime and “locums,” doctors hired temporarily on three-to-six-month contracts. (“Locum” comes from the Latin phrase “to hold the place of.”) Like travel nurses, they are paid much more than staff, he adds. Other departments, such as urology and the psychiatric clinic, are largely staffed by a mixture of part-time doctors and locums. “And the hospital lost its rheumatology division because we couldn’t retain a wonderful physician.”
“It’s a real crisis,” he adds.
For Dr. Gray Ballinger, a primary-care physician at Queens Hospital, NYC H+H’s move to cut patients’ first visit from the standard 40 minutes to 20 minutes was a “watershed moment” of “moral outrage” about care being taken away.
She estimates that 30% to 50% of her patients need a translator to speak with a doctor. The 269-bed hospital, in Hillcrest in eastern Queens, stands amid neighborhoods filled with immigrants from Guatemala, Bangladesh, Uzbekistan, and more.
“It is not a 20-minute visit even if the patient comes in with one chief health complaint,” she says. Many, she adds, have had little medical care in the past, so she finds herself doing “forensic medicine” for undiagnosed conditions such as diabetes and heart problems.
With good and regular medical care, Dr. Ballinger continues, a 45-year-old can stay healthy enough to keep working, even if they’re doing two or three jobs. Without it, they could end up having a stroke at 50 and become permanently dependent.
“Every day, I take 20 lives in my hands. This is not work where you can cut costs and get the same outcome.”
The strike votes “reflect the exasperation” of doctors in the system, says a Queens physician who asked to be identified as Dr. Y out of fear of retaliation. But at some hospitals, he says, immigration lawyers hired by PAGNY and Mount Sinai have advised doctors with employer-sponsored work visas not to sign strike-pledge cards, because it might jeopardize renewing their visas.
PAGNY did not respond to messages from Work-Bites. A Mount Sinai spokesperson said it would not be able to comment until after the holidays. NYU-Langone, the affiliate for Woodhull Hospital in Brooklyn, declined to comment.
A turning point?
The contract dispute, says Jones, is a crucial moment for the direction of NYC H+H, the largest publicly owned hospital system in the U.S.: Will the Adams administration upgrade the system, or will it abandon the poor and middle-class people it serves?
“I believe that health care is a human right. Unfortunately, the city is not funding it,” says Jones, who recalls that he was inspired to go to medical school by working in an ambulance after the 9/11 attacks. “This is the moment for the city to commit.”
If it doesn’t, he says the odds are not good that the system could handle another pandemic.
Ballinger describes doctors in the system as “true believers in treating the people who need us the most,” calling it a rare example of “socialized medicine in America.”
She hopes a contract deal can be reached. “We would much rather continue to work with and see our patients,” she says. But if not, “we’re ready and prepared to act.”
The affiliate system means the doctors they employ don’t get the benefits that city employees have, and the union has to negotiate with both NYC H+H and three separate affiliates. But it has a hidden advantage for labor, Ballinger says: Because doctors are employed by contractors, they’re allowed to strike.
“We’re asking for something that will keep our system viable,” she adds.