County Physicians Say Working Conditions Are Causing ‘Moral Injuries’

The labor dispute between Santa Clara County and physicians at its public health facilities are heating up this week, with continued complaints from doctors that they are being “pushed beyond health limits” by “a broken healthcare system.”

In a statement, Valley Physicians Group (VPG), which represents approximately 450 physicians in negotiations with the county on a new contract, cited a county doctor suicide in May and another attempted suicide by a county doctor on July 12 as examples of the impact of high-stress working conditions.

Physicians working in the Santa Clara County Health and Hospital System on June 29 delivered boxes containing more than 3,500 petitions urging Santa Clara County supervisors to support a fair contract with Santa Clara County’s publicly employed doctors.

The county physicians pointed to what they claim are chronic short staffing, unsafe patient workloads and other systemic barriers at the county that prevent them from providing the best possible care to their patients while maintaining physician well being.

They scheduled  a press conference today at 12:15pm at Valley Medical Center Main Hospital to press their grievances with the county.

“Distinct from burnout or exhaustion, what physicians are experiencing is called ‘moral injury’ by experts who define the condition as occurring ‘when clinicians are repeatedly expected, in the course of providing care, to make choices that transgress their long standing, deeply held commitment to healing’,” the union said in a statement. “[This] often leads to physician mental health being minimized by employers.”

With a surging COVID variant expected to put more strain on the county’s healthcare system, doctors are calling on county leaders to implement immediate steps to address physician well being.

Their recommendations include:

  •  no longer pressuring county doctors to rectify the county’s failure to recruit adequate staff to operate clinics on weekends and holidays
  • immediately allocating resources to mental health services
  • resetting county expectations relating to physician workloads and well-being thresholds
  • collaborating with doctors to address ongoing working condition issues and needs

“VPG physicians are dedicated to serving some of the most vulnerable members of our community, but we need the support of county leaders and hospital management to deliver the best care possible,” said VPG chairman Dr. Stephen J. Harris. “Instead, the county tries to squeeze as much as it can out of its publicly employed physicians while giving back as little as possible. Doctors are resilient, and no strangers to hard work and long hours. We are COVID-strong and COVID-tested, but there is a limit to how far we can be pushed, and we are being pushed too far right now.”

VPG physicians have worked without a contract for more than a year. The union said a proposal advanced in negotiations by county leaders “would make things worse by establishing a patients-per-hour standard that reduces the amount of time patients spend with their doctors and further stretches doctor workloads.”



  1. This is what all the forelock tugging is about: “VPG physicians have worked without a contract for more than a year.”

    So, how much more money do you want. Let’s just get to the economics. There is plenty of room for discussion in this area without bringing in the class and racial animus.

  2. Forcing people to work without a contract is not legal. The facts are if you want to talk economics, the reality is chronic shortages of staffing has resulted in less situational awareness regarding Covid or any other public health issue.

    In my HRM education, my understanding is that these people are justified to actually stop working at this time unless ordered by a court to resume. And if the court sees that there is such a lag between contracts and work, that is likely going to make a impact. Especially also if these contracts are written to comport to at-will standards. In effect if the contract is written with at-will as a condition, these workers should just leave and find better working conditions.

  3. CA PAtriot,

    Your comments do not appear to address te actual topic here, instead you are going on a tangent. In any event, if these workers do in fact leave, then the shortages of medical care in the area will get so bad, that it may FORCE more lockdowns regarding Covid, especially when the new variant 2.75 is showing it is starting to grow in CA and so far no research is showing good news regarding current treatments and vaccines on it. Centaurus is likely going to be one of the straws that breaks the public health back. In fact we still have not taken any steps to do what is called:

    “In addition to vaccines, longer-term plans should include variant-agnostic measures to prevent infections and reinfections. “This includes creating infection-resilient environments through improved ventilation, filtration, or sterilisation of indoor air, sensible reprovision of lateral flow tests, and appropriate and supported isolation periods that will actually reduce ongoing transmission,” he said.”

    So we cannot appear to ever stop this problem, and if these worlkers simply leave you are going to be stuck with Covid lockdowns UNTIL it is destroyed.

  4. Juan,

    Please understand that there is no legal requirement for a physician to be responsible for maintaining care. In fact there was a case recently where a hospital tried that to force at-will employees to not change jobs from their hospital to another and the court rejected it. The facts are if any worker finds their workplace intolerable, they have the legal right to take another one. It is the responsibility of the health care company to deal with case management. I understand that this will likely make our medical system so short it will potentially break down. But that is not the responsibility of the care workers, it is the responsibility of the community for not practicing safety and the administration to ensure their workers are justly compensated

  5. I wish someone would call the Santa Clara County Supervisors and ask what is there take on all of this(doesn’t matter which one). They should try and solve the issues here since VMC treats everyone in our county and we are a large county.

  6. SCC’s health system consumes about 45% of our budget and its largest percentage. The 22-23 total budget is $11.6 billion – a 17.5% increase and almost double inflation.

    About 25% (estimates vary) of health invoices are deemed uncollectible for public hospitals. Doing the math gives a first level approximation of $1.3 billion / year in uncollectible receivables.

    Customarily these would be sold to collect ~ $0.10 / dollar owed – e.g., over $130 million. Some revenue is better than none.

    Two separate attempts by Public Records Requests to get an accurate figure resulted in ‘we have no records responsive to your request’. Escalation to SCC Finance Chair & Vice Chair Cindy Chavez & Otto Lee resulted in no response, nor action.

    Presumably HHS problems could be solved if Chavez and Lee properly did their jobs.

  7. Please checkout Transparent California website and look at the salaries we’re paying for these physicians who still want more! The highest paid employee in the County in 2021 was a physician. This physician made a whooping $931k! The highest paid nurse made $657k! How much more do they need? A lot of people suffered job losses during the pandemic. The Healthcare providers in Santa Clara County flourished! Too bad the Supervisors didn’t have a response for the outrageous wages. Let’s talk about where our public funds are going.

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