Contracted emergency workers at Ascension St. John 'inching' toward strike

Unionized, contracted emergency department workers at Ascension St. John Hospital, which sits on the border of Grosse Pointe and Detroit, said in a release Wednesday they are "inching toward" a strike.

Members of the Greater Detroit Association of Emergency Physicians have been negotiating with St. John Emergency Services for the last six months, according to the release. They are attempting to negotiate the union's first-ever contract and considering a strike vote "within the next month" if no progress is made.

"While we are trying to stay optimistic that an agreement can be reached, negotiations have failed so far to address any substantial issues regarding patient care and physician safety," said Dr. Michelle Wiener, a physician in the ER.

"We are negotiating in good faith, and we are very disappointed that this is not being reciprocated by the other side. It is getting hard to envision a scenario that doesn't involve a strike without our employer making drastic changes to their negotiating tactics."

The emergency medicine physicians and mid-level providers in the union are not employed by the Ascension St. John Hospital, spokeswoman Airielle Taylor said in an email.

"Emergency medicine physician and mid-level provider services are furnished to St. John Hospital through a contract with TeamHealth," Taylor said. "Should a strike be called against TeamHealth, TeamHealth has shared a comprehensive contingency plan with the hospital that will ensure these contracted provider services will be uninterrupted. St. John Hospital’s emergency room will remain open and operational for anyone seeking care. Patient care will not be disrupted."

TeamHealth is a private, Tennessee-based physicians and hospital management company. While the union's contract is with St. John Emergency Services, TeamHealth representatives have been present during the contract negotiations, Wiener said.

The health care workers voted to unionize last summer. The union includes contracted doctors, advanced practice clinicians, physician assistants and nurse practitioners in the Emergency Department.

TeamHealth has negotiated in good faith with the union, and any statements saying otherwise are misleading, spokesman Josh Hopson said in an email.

“We are committed to keeping this dialogue open to ensure clinicians are valued, and patients at St. John Hospital receive the critical emergency care they require," Hopson said.

The union claimed that since TeamHealth and St. John Emergency Services took over management and staffing of the Emergency Department in 2015, wages, benefits, staffing levels and investment in medical equipment have declined. Patient wait times can reach 10-15 hours, with dozens of patients in the waiting room, according to the release.

"Our goal has been clear since Day 1: We will no longer accept 10-15 hour wait times and 50 people sitting in the Emergency Room waiting area looking for medical care," Wiener said in the release. "It's really sad that it has come to this."

TeamHealth disputed their claim and said the median "door to doctor" wait time in 2023 was 25 minutes. That time has dropped to 17 minutes so far in 2024, Hopson said in an email.

The union is hoping to get "basic benefits," including sick pay as well as recommended safe staffing ratios, security commitments to keep employees safe, pay parity compared with other Metro Detroit hospitals and more transparency on billing for services in the contract, Weiner said.

"It's just got into kind of like a critical inflection point where we just decided we would rather take the heat and the consequences of doing something like this than have to deal with managing patients in an unsafe manner," Weiner said.

TeamHealth also disagreed with the union's claims that employees are under-compensated and staffing levels hurt patient care.

"TeamHealth offers competitive compensation and comprehensive benefits to all of our clinicians, including a robust well-being program to support physicians physical, mental, and emotional health," Hopson said. "Physician staffing levels at the hospital have always ensured high-quality care and patient satisfaction, and the staffing levels are higher than published medians for comparable emergency rooms across the country."

Medicare officials track how well hospitals perform across five areas of quality: mortality, safety of care, readmission, patient experience, and timely and effective care. The federal government classifies the Ascension St. John Emergency Department volume as "very high," with over 60,000 patients every year. On average, patients spend 210 minutes in the department before leaving.

The advanced practice provider pay offered at Ascension St. John is also significantly lower than state and national averages, according to the release. The pay makes it difficult to hire experienced providers, said Casey Kolp, a physician assistant in the Emergency Department. Weiner said several nurses have left due to staffing conditions.

hmackay@detroitnews.com