It’s a term you often hear when speaking with the medical providers who care for and treat many of the region’s most economically vulnerable patients at Piedmont Health Services (PHS), which employs 600 people and operates eight health centers. communities in Alamance, Caswell, Chatham, Lee, Orange, Nobody and Randolph Counties.
“As medical providers, we don’t focus on salaries. We are happy with our salaries,” said Rupal Yu, a family doctor who has worked with PHS since 2012. INDIA Last week. “The kind of people who work at Piedmont Health will not work for Duke Health. We care for patients who have very little, and we are trained to meet their needs, to fill those gaps in a powerful and meaningful way.
Notwithstanding accepting relatively modest salaries, Yu, along with nearly 50 other doctors and medical providers at PHS, are focused on getting a seat at the table.
On Nov. 23, PHS doctors and medical providers petitioned the National Labor Relations Board to form Piedmont Health Services Providers United and submitted a petition to PHS CEO Brian Toomey outlining why they felt he was important to form a union.
The petition stated that the petitioners are “a diverse and united group of physicians, nurse practitioners, physician assistants and nurse midwives who have chosen to work in this organization because of our alignment with the mission of the PHS : ‘To improve the health and well-being of communities by providing high quality, affordable and comprehensive primary health care.
Their main concern is not having a voice in organizational decisions that affect how they provide patient care.
“We see how our patients must overcome multiple barriers to access our care,” the group said in the petition. “They suffer when basic clinic functions are neglected and staff burn out. We are tired of not having the time, tools and support we need to do our job. Each time we fail to meet the needs of our patients, we feel the pulse of our beloved PHS weaken.
The group stressed the importance of collective bargaining and called on Toomey to “recognize our union”.
Toomey could not be reached for comment.
But the same day the petition was filed with the National Labor Relations Board, PHS responded by hiring Ogletree, Deakins, Nash, Smoak & Stewart, a powerful law firm with a national reputation for union busting.
This spring, Duke University officials hired the law firm after Duke University Press (DUP) employees announced plans to form a union.
Ogletree Deakins was a formidable opponent, but the DUP workers prevailed.
“[This fall] the National Labor Council ruled in our favour,” Sandra Korn, deputy editor of the DUP, told the INDIA this week. “Workers won the vote, but Duke hasn’t recognized us yet. So, for the moment, we are without legal recognition. It’s as if their anti-union law firm is going to do a legal feat to delay as long as possible. It’s like [Ogletree Deakins’s] business model is to intimidate workers and prevent people from having the power they deserve in the workplace.
Members of the PHS Providers Union await the outcome of a pre-election hearing on Tuesday with attorneys for Ogletree Deakins at the NLRB’s offices in Winston-Salem, Michaela McCuddy, a family physician at the PHS Center in Siler City, told the INDIA.
“It happens because [PHS CEO] Mr. Toomey refuses to recognize our supermajority outright, and the goal is to work out the details of our election,” McCuddy said.
“We find it reprehensible that our leadership is wasting our precious resources to delay our election,” Yu said of this week’s hearing. “We are ready to organize a union election. We are ready to vote, and it must be done. We have work to do with patients who need our care and it is an unnecessary distraction and delay.
Ogletree Deakins officials were not available for comment.
PHS’ seemingly anti-union stance seems counterintuitive to its origins just over half a century ago as a federally qualified health center eligible for Medicare and Medicaid reimbursement. . Agencies like PHS operate as a medical safety net that provides high-quality primary care regardless of the patient’s ability to pay, according to ruralhealthinfo.org.
Company officials on the PHS website note that the healthcare provider was established in 1970 by UNC-Chapel Hill healthcare professionals and community members who were concerned about the access to primary health care in their communities. Then known as Orange-Chatham Comprehensive Health Services, the organization gave “special attention to those who did not receive appropriate health care and did not have access to services,” according to its website.
The Piedmont mission is why Yu, a family physician and UNC-Chapel Hill Medical School graduate, started working at PHS after completing her residency with UNC Family Medicine.
Yu was drawn to PHS because of its reputation as one of the nation’s largest community health service providers and its inclusiveness mission that results in treating 50,000 people each year.
“The majority are either uninsured or on Medicaid,” Yu said. worked, all of whom are brilliant and dedicated. So I knew I wanted to come here after my training. It was a no-brainer because I’m mission-oriented.
McCuddy echoed Yu’s sentiment about PHS.
“I always wanted to be here and work in this specific community of Siler City,” she said.
McCuddy said she decided to work in rural Latinx, Spanish-speaking communities while attending UNC medical school. It was also at this time that she became aware of the PHS.
“I wanted to bring care where it was needed most,” she explained. “I love rural medicine. As a doctor, I feel like family in some ways. You can be a pillar of the community in so many different areas, inside and outside the clinic.
McCuddy said a close friend told him about an opening at PHS’s Siler City clinic.
“Siler City is close to me. I felt obligated,” she said. “I was like, ‘Yeah. This is where I want to be.
Krishna Kothary is a family nurse practitioner who earned her graduate degree in nursing from Johns Hopkins University. In 2018, she began working at PHS’s Burlington and Carrboro clinics. In addition to being a senior nurse practitioner, her expertise is in addictions, gender affirming care, and HIV care.
For her, PHS was a natural choice.
“Community health is where my heart and soul have been, for my entire career,” Kothary told the INDIA Last week. “It is a mission in which I wanted to participate. I am passionate about caring for underserved communities.
Kothary says the job involves treating high-risk patients who face a complexity of barriers, including economic and language barriers. She treats a large number of Spanish-speaking patients.
“These barriers can affect their health and also affect their ability to get health care,” Kothary said. “There are these social determinants of health: unsafe neighborhoods with poor air quality, intergenerational trauma, poverty, a child living in poverty whose asthma worsens due to poor housing or a relative who smokes…. This is what I deal with every day.
But the medical providers who spoke with the INDIA say PHS has strayed from its roots. They cite workplaces where they have no say in decisions that affect their patients’ lives and their own, where they feel intimidated when asking for change, and where there is high staff turnover due to frustration, increased workloads and reductions in their own health coverage.
McCuddy said that while the Siler City Clinic is exactly where it wants to be because people bring so much passion to their work, she’s starting to see issues with PHS’s ability to retain employees.
“People want to be there,” she says. “They feel supported by other suppliers, but they don’t have a voice in the organization. Every two weeks, or every three weeks, someone leaves, and people are sad to leave. They want to be here.
Yu said frustration had been “building up for quite some time” among her colleagues. She added that those frustrations have been exacerbated by the pandemic. In addition to high staff turnover, she decried patterns of mismanagement by managers who lack the expertise or support to do their jobs.
“We need to put in place a mechanism to raise issues,” Yu said. “There are many issues at stake. The problem is that we have no mechanism. We must have a place at the table.
Kothary said the PHS system is “one more hurdle to the hurdles our patients already have.”
“One of the main reasons I want a union is to have a say in the system,” Kothary said. “A lot of medical providers apologize [to their patients] for the system. Not a day goes by that I don’t apologize for the system.
Kothary added that it’s one thing to apologize to your patients for the challenges they have to endure and another to apologize for a system that is supposed to help them but feels more like exploitation. .
“My heart breaks at this point of how the system represents itself and has become an obstacle,” she said.
Yu said that as agents of nonprofit healthcare centers, PHS medical providers “have an obligation to serve our vulnerable population with dignity and respect.”
“And we believe a strong voice from medical providers will create stability, strengthen our mission, and make Piedmont Health a better place for everyone.”
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