➡ A significant shift is happening within the medical profession where doctors, frustrated with administrative work and questioning their work-life balance, are beginning to unionize to collectively address their concerns. This change has been prompted by a growing trend of doctors no longer owning private practices, but becoming employees of larger healthcare systems, which they claim is leading to diminished patient care quality.
➡ The text delves into the ethical and financial complexities surrounding healthcare coverage and the responsibilities of hospital systems, providers, and patients. It brings into focus issues like the ongoing unionization of healthcare providers who are seeking better support and lesser administrative tasks, and the high cost of members are passed onto consumers or insurance companies. It ends with a pointed personal experience on prioritizing healthcare coverage during childbirth to avoid crippling debt.

Doctors. We gotta get to the money aspect of the show, y’all. Doctors are starting to unionize. I never thought I would see this a day in my life. Did y’all know that doctors are starting to unionize? Yeah, they are. Let me bring y’all up to speed of what’s happening. As recently as the early 1980s, roughly 75% of doctors in the US worked for themselves, owning small clinics. Today, that same percentage of physicians are employees of hospital systems or large corporate groups.

Some physicians worry that trend is taking a heavy personal toll and leading to diminished quality of care. As Fred Desam Lazaro reports, doctors at one large midwestern health provider decided to unionize. Go, girls. Hours before sunrise, Kate Martin shepherds her daughter to the ice rink. While her daughter perfects her balance on the ice, Martin uses the time to seek her own work life balance. Currently, I have about 86 things in my in basket.

For family practitioner Leah Devore, the best time to catch up with backlogged work is after her small children are in bed. It all depends on my kids, whether or not they wake up and come down or cry or the baby needs a bottle. For many primary care clinicians, work stretches far beyond clinic hours. Notes from appointments, lab results, medication orders, messages from specialists. For some, it’s reaching a breaking point.

Hello, everyone. On this recent morning, Martin, a nurse practitioner, and colleagues, doctors and physician assistants, all employed by the Alina health system, gathered in an unfamiliar setting. The Minneapolis offices of the National Labor Relations Board. How in the world are you guys pulling this off? Here to witness the ballot count in a historic vote to form a union. He can’t. So basically, doctors are saying we don’t want to live and die by the harsh realities of what it takes in order to really fulfill the duties of my job requirements.

We tied it along hours. We may make a lot of money, but we willing to unionize. We’re willing to unionize, and we’re not going to be in our own private practices as much as we say that we used to be, because we want to have a work life balance. Yep. Connie, you are absolutely right about health insurance. They want work life balance. I always believed when I was growing up that they just worked abnormal hours.

They was always on call. I never believed, or I would never even think that doctors as a whole, or anybody for that matter, private care, physicians, surgeons, people that work in hospitals. I just never thought that I would ever see the day that a doctor would be. That a doctor literally would want to unionize. I never thought that I would ever see this day rely on a lot of y’all may not be familiar with PBS videos, but they all look like this corporations.

We can’t rely on healthcare executives to do the right thing for our patients. Dr. Matt Hoffman, a leading organizer of the drive, says primary care providers have borne the brunt of a relentless drive to squeeze profits by increasingly large corporate owners, all at the expense of patient care. His employer, Alina, is a $5 billion a year. This video was released one day ago, literally one day ago. So yes, this is very recent health system.

With 60 primary and urgent care clinics across the twin Cities area and nearby Wisconsin communities, Hoffman says that the problems here are hardly unique. You could go to any city, you could find a health system. The same issues exist. The main problem is we have so much paperwork, so much administrative work that really isn’t about delivering care to patients. The victims of that are really the patients we see.

So basically what the doctors are saying is that they no longer want to have the same level of work life balance that they’ve experienced in the past because they don’t want to do the dandy work. They don’t want to do the paperwork. They don’t want to do all of the stuff that it takes in order to be a doctor. They just want to go in, see the patients and come back home.

They want to go in, see patients and go home. They want to go home, and they want to pass that off. Part of being in a union is passing off responsibilities or balancing out life by allowing for yourself to not have to be subjected to the same things that you was in yesteryear. So if they could fight for as a group, the fact that they don’t have to do the menial tasks in the name of saying, well, this actually doesn’t help us or this doesn’t help patient care.

If we were to free ourselves to actually have more regular schedules and to spend more time with the patients instead of doing all of the paperwork that comes along with being a doctor, we could be a lot more effective and we can have more work life balance, Yakar says the staff does that paperwork. Well, that’s not what they saying in this documentary that’s waiting on hold. It’s not getting to see your normal doctor.

It’s having to see someone that doesn’t know about you. This is kind of going to be our waiting area. Pediatrician Jennifer Mamel said she’d had enough and took an early retirement from Alina to strike out on her own with a psychotherapist colleague. She was just settling into a new small clinic above a St. Paul’s strip mall targeted at adolescent patients. I have the luxury of controlling my own schedule.

I can spend the amount of time I need, she began. So all they are, she got that old fro. All they are are overglorified entrepreneurs that have a specialty in one line of business, and that’s healthcare and whatever it is that they do. And so that’s the way that they justify being able to have their own time. They don’t want to work at the times or based off of what the system is telling them to work.

They don’t want to be a part of the hospital system, or if they are a part of the hospital system, they want to join a union and have a different type of way that they operate in there now. They could say, well, I want to see patients from this time and this time. And then that allows for me to have work life balance. They don’t have to deal with the same stuff that they’re dealing with before.

But again, I’ve always looked at doctors like Dr. Strange. Dr. Strange come in with his luxury car, come in and save a patient. He’s the king. He drives out. He’s rich, he’s balling. He may spend a lot of hours. He takes a lot of risks, but he get a lot of rewards as a result of it. That’s changing now. Everything is going over into structure. Everything is going into, oh, I want to have work life balance.

That’s like a theme of today right now. And her career in a provider owned group, which was later bought by Alina. With the merger came centralized scheduling and standardization in everything, from how much time is spent with each patient, even to hand sanitizers, she says. They were putting them all at kind of waist level, right? So you came in the room and I went up to the fellow doing it and know, this is a pediatrics department.

How about if we put them up a little bit higher? Because I could see kids really enjoying these. He said, no, I’ve been told they have to all be at this level. A week later, of course, they had to come and move them all. Dr. Hoffman was among those who protested an even graver policy at Alina, one they took to the New York Times. The policy instructed staff to stop providing care to patients with more than $4,500 in overdue bills, going beyond the more common practice of turning over such deaths to collection agencies, did you have personal experiences with patients that you could no longer see? Yes, absolutely.

These are the patients that really need the care the most. People that can’t. Okay, so let me ask you a question. This is just to be objective. This is just to be objective. So they didn’t like the fact that the healthcare system, and I’m not saying right or wrong, I’m in no position. I’ve never been a doctor. I’ve never had to deal with patients, right? And they’re basically saying, we don’t like the idea that the healthcare system that we work for stopped seeing patients once they had bills and they weren’t paying us, even though we have to pay you.

I’m looking at it as a capitalist, okay. And I’m asking this question as a capitalist. Would they, as an independent doctor with their own practice, by themselves, not a part of the healthcare system at all, would they still see patients even though they knew that that patient wasn’t going to pay them? Because most doctors that have their own private practices, and I’m open to the possibility that I’m wrong, usually get the majority of their money from the healthcare system, meaning Medicaid, medi cal, blue cross blue shield.

And so if that patient then said, hey, doc, I know that you used to see me all the time, and I need you to continue to see me. I don’t have no more health care coverage, though, and I’m not going to be able to pay you. Would you still see them in your private practice? Because if not, if the answer is no, then it means that it’s hypocritical because you’re requiring for a larger employer and you’re removing the responsibility from yourself to continue to pay you a guaranteed salary even though that person or that organization is not being paid also.

And so it’s a catch 22. And the reason that it’s a catch 22 is because they want to get paid and they want to put stipulations and they want to put requirements on these employers that then have to bear the responsibility of taking care of people that don’t pay and have to abide by all of these government regulations and paperwork and is governed by the federal government and then its governing bodies, but they are requiring them to do something for them that they wouldn’t do they self.

And then the other side of it is, and this is one of the reasons that they’re unionizing. The other side of it is this, though a lot of people believe that everybody deserve health care coverage in the United States of America. And so that cost is now passed on to you. The cost is passed on to you. If everybody believes that they deserve it, somebody has to pay for it.

The hospital system can’t continue to bear the responsibility of it. You still want to get paid as a doctor. Everybody got to get paid within a hospital system itself. Is it hypocritical or is it a human requirement? Is it something that we just automatically should just let be what it is because it’s a human requirement. It is the same thing as breathing air. It’s the same thing as drinking water.

Everybody deserve good health care coverage. That’s the dilemma. That’s the dilemma. Is it moral or is it capitalistic? Do we look at it from a moral perspective or a capitalistic perspective? Because you can’t sit there and then gaslight me by having these softball questions and saying, well, have you ever been put in a position where you couldn’t see a patient that owed over $4,500? Would you personally see somebody and still continue to give them work and give services to somebody that owe you $4,500? Are you willing to work for free for something that you spent a lifetime mastering, going to school, residency? Are you willing to do for free something that you spent a lifetime mastering? And if so, then you got a leg to stand on.

Otherwise, it’s a disingenuous argument that you could no longer see. Yes, absolutely. These are the patients that really need the care the most, people that can’t pay their bills. A lot of these people are children. Alina announced it has since discontinued the policy. The company declined to be interviewed for this story, but in a statement said, quote, while we are disappointed in the decision by some of our providers to be represented by a union, we remain committed to our ongoing work to create a culture where all employees feel supported and valued.

When all the ballots were tallied, the 500 plus providers voted two to one in favor of the union. What do you expect if you get to the bargaining table? We need more staff. We need better paid staff to help support us so that we can spend our time in the exam room with patients. So they basically want to pass over the responsibility of doing paperwork, and they want to hire more people and they want to do less work and they want to spend more time with the patients and then be able to go home, and they don’t want to have that responsibility.

That’s what it comes down to. That’s all he’s saying. Dr. Matt Hoffman is basically saying they don’t want to deal with the things that they have to deal with and all the requirements of them and doing a job effectively. They want to go over and pass that on to somebody else. And the only way that they can do that is to band together in a union in order to get their needs and their demands met.

That’s all. He’s basically saying, we need help with our paperwork, with the administrative tasks, so that we can focus on patient care. That’s really what we’re looking for. Things have to be pretty bad, I would argue, when physicians do try to organize, because this has never remotely been a part of their professional culture. And Paul Clark, a professor of labor and employment relations at Penn State, says the doctor’s vote is hardly the final chapter.

Your guess is that we won’t see a contract between Alina and this group of doctors anytime soon. If there was, it would be highly unusual. And that’s enough. We don’t need to read any more of that. We don’t need to see any more of that. And then a lot of times, these healthcare systems, they have to pass all of these costs over into the patients, and that’s why they charge you so much money.

And you see how much they charge in the insurance company if you try to have a baby today, and this is going to lead us into the next thing that I want to talk about. If you try to have a baby today. And that’s the one thing that I made sure that I held on to. I held on for that. When I was going through the 2007 2008 recession.

My daughter was born in February 2008. Right. And of all of the things that I had to go ahead and sacrifice and make a payment on, I sacrificed. I gave my car back. I sacrificed, I gave the other car back. I moved back into my mother’s basement. I made sure that I had the best health care coverage for when my daughter was born because I did not want to be saddled with that debt.

I just didn’t. I didn’t want to be saddled with that debt. And if you look at the cost and how much they’re charging these insurance companies and how much they dinging them and billing them to death for, you got this pin. Or if you ever get an epidural or patient care and stuff, somebody said, YouTube needs a partner. No, we don’t. No, we don’t. No, you get what you put in.

It’s a dog eat dog world. I don’t want to be a part of no union with no other content creators. You could forget it. No, we don’t. I’m good. I’m good. I come on here and I work and I grind and I hustle, and I don’t want to be a part of nobody’s union, you can keep your little partner union. And so they have to pass over them cost over to the consumers or to the insurance companies, which then is another form of inflation because the cost of things and doing business is going to continue to go up based off of what your needs are as an individual.

5000. That’s it. Yeah, right, bro. I’m sure it’s even worse now. That was in 2008. That was 15 years ago. Boy, the cost of having a child. You all still want to have a kid. I. .