Inside the Split Decision on NYC H+H Doctors’ Contract
The Health Building at 125 Worth St. in New York City.
By Steve Wishnia
Doctors at seven of New York City’s public hospitals have voted to ratify the tentative contract agreement reached Jan. 13, but physicians at three others voted to reject it, the Doctors Council SEIU announced Jan. 27.
The deal was approved at Kings County, Lincoln, Metropolitan, and South Brooklyn hospitals, where New York City Health + Hospitals contracts with Physician Affiliate Group of New York (PAGNY) to employ doctors. It was also ratified at Elmhurst and Queens hospitals, where Mount Sinai is the affiliate, and Woodhull Hospital in Brooklyn and three smaller NYC H+H facilities where NYU is the affiliate.
The three that voted no, Harlem, Jacobi, and North Central Bronx, are all PAGNY facilities. Jacobi and North Central Bronx were among the four hospitals where doctors set a Jan. 13 strike deadline, which pushed Mayor Eric Adams to call for mediation after more than two months without a bargaining session.
There were different reasons why doctors voted no, North Central Bronx Hospital obstetrician Dr. Heather Irobunda told Work-Bites, but perhaps the main one was that the contract offer “didn’t really address problems with staffing,” particularly recruiting and retaining specialists.
NYC H+H patients tend to be working-class, uninsured, or on Medicaid, and have to “struggle to get health care,” she explained. This creates a problem “when they aren’t able to see specialists they need because our institution doesn’t offer it anymore.”
Several NYC H+H doctors have told Work-Bites that the system has been losing specialists and subspecialists in fields such as as cardiology, rheumatology, and maternal fetal medicine (diagnosing and treating high-risk pregnancies), leading to either long waiting times for appointments or some hospitals not providing those services at all.
To have specialists, “you have to be able to pay them appropriately,” with salaries and benefits reasonably competitive with private hospitals, Dr. Irobunda said. “What we were presented doesn’t come close.”
The Doctors Council said the four-year contract includes “salary incentives that take steps to address the crisis of short staffing and physician burnout impacting doctors across the NYC H+H system.”
The agreement was intended to cover the more than 2,500 Doctors Council members who work for the private affiliates at 10 of the 11 municipal hospitals. The union did not release either overall vote totals or the results from individual hospitals, but said the outcome reflected “the varying circumstances and day-to-day realities of doctors at different facilities.”
“At a time when even basic health care is under threat, Doctors Council SEIU is committed to working with members from the facilities that did not approve the proposed contract and continuing our advocacy for the investment necessary for all H+H doctors to truly fulfill the mission we are called to do,” union President Dr. Frances Quee, a pediatrician, said in a statement.
Another reason for the no votes, Dr. Irobunda said, was that the raises in the deal were not retroactive to when the union’s last contract expired in August 2023. The contract that the about 500 Doctors Council members who work directly for NYC H+H agreed to in December included raises retroactive to 2021.
The PAGNY deal promised some doctors raises of up to $25,000 immediately, another $12,000 in August, and 4% in August 2026. Not everyone, however, is getting significant raises, Dr. Irobunda said. Salaries vary widely within the system, so someone doing the same job, such as an internal-medicine doctor, can be paid differently depending on what affiliate and what hospital they work for. The three affiliates each have separate contracts with the union, and there is little transparency.
The proposed PAGNY contract would have also increased health-insurance premiums and copays, and reduced the number of days off doctors get for continuing education—which is important for keeping up with new developments in medicine—Dr. Irobunda said.
A Doctors Council spokesperson said the union’s members would determine what to do next before they announce when they will resume talks with PAGNY.