This story has been updated to include a response from Santa Clara County.
Physicians working in Santa Clara County’s Health and Hospital System today 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 Valley Physicians Group (VPG), which represents approximately 450 physicians is in negotiations with the county on a new contract.
“Despite being hailed by county leaders as among the ‘frontline heroes of the pandemic’ for their dedicated service during the two-years of the COVID-19 pandemic, VPG physicians have worked without a contract for more than a year.” the union said in a statement.
“The county’s proposals dramatically harm patient care and safety by reducing the time they receive with their doctors and treating them as units of time rather than real people with valid healthcare needs,” the physicians’ group said in a statement.
The county responded with its own statement: “The county is currently engaged in contract negotiations and an associated fact-finding process with Valley Physicians Group, which we expect will result in a new contract between the County and the doctors who work in our health system."
"The county is committed to reaching an agreement with Valley Physicians Group that will enable the county to maintain a fiscally sustainable, top-notch healthcare system for the hundreds of thousands of patients we serve every year.”
“We are proud to serve some of Santa Clara County’s most vulnerable community members,” said VPG Chairman Dr. Stephen J. Harris. “Our patients should not be denied time with their doctor and the quality healthcare experience just because they are using a public hospital. Santa Clara County’s Health and Hospital System should be setting the standard for quality care, not lowering the bar.”
Valley Medical (SCVMC) has clearly outperformed the for-profit and non-profit hospitals in serving community needs during the COVID-19 pandemic (https://sanjosespotlight.com/santa-clara-county-residents-swamp-hospital-emergency-rooms-for-covid-tests/#comment-80502). With a swift and outsized response, SCVMC immediately took the lead in community outreach, dominated community coronavirus testing, provided significant treatment services, became the most important provider of vaccinations and have led the county in public health research (https://www.youtube.com/watch?v=ujJeH66tyB8; https://data.sccgov.org/COVID-19/COVID-19-testing-by-healthcare-system/vzxr-ymut; https://data.rgj.com/covid-19-hospital-capacity/facility/santa-clara-valley-medical-center/050038/; https://www.sccgov.org/sites/covid19/Pages/dashboard-vaccine.aspx).
At the same time, the County authorities have had to persistently cajole, mandate and, at times, fine for-profit hospitals to scale up their coronavirus testing and vaccination efforts to meet community needs throughout the pandemic. The for-profit hospitals resisted undertaking what they saw as “public health” interventions, as if their patient pools are not also part of the “public.” They lobbied to get back to their mainly elective surgery-driven profit models and some even furloughed staff, reduced staff salaries, closed a maternity ward in East San Jose and opted out of providing vaccinations to the public–all in the middle of an unprecedented pandemic. One was even caught giving preferential access to vaccines to patients in wealthier zip codes (https://sanjosespotlight.com/are-south-bay-hospitals-ready-to-perform-elective-surgeries-amid-covid-19/; https://sanjosespotlight.com/markowitz-hca-jeopardizing-mothers-babies-with-planned-closure-at-regional-medical-center/; https://sanjosespotlight.com/ following-covid-19-vaccine-scandal-good-samaritan-permanently-closes-vaccine-clinic/; https://sanjosespotlight.com/good-samaritan-hospital-ceo-resigns-following-covid-19-vaccine-scandal/#comment-43814). Thus, while the community was confronting the most serious public health emergency in 100 years, private hospitals were ditching the Hippocratic Oath in favor of the bottom line on their balance sheets (https://www.nlm.nih.gov/hmd/greek/greek_oath.html).
The insertion of for-profit services into the healthcare sector, as our recent history clearly illustrates, creates incentives that are hazardous to human health. The drive for return on investment collides with, and pushes against, the delivery of adequate–not to mention compassionate–care. Skimping, cutting corners, while circumscribing and limiting caregiver-patient interactions, boosts the bottom line as it chips away at patient health, as well as the health of healthcare providers themselves, as we have seen.
The case of overworked nurses all over the country, recently highlighted by the New York Times, highlights the dangers of for-profit ways of providing health care (https://www.youtube.com/watch?v=PrDyii0P4DU). The profit imperative–as SCVMC physicians point out, will produce unnecessary mental and physical fatigue and potential attrition in the ranks of valuable and essential healthcare professionals while endangering the quality of care received by patients.
Like education, healthcare is best produced in the public sector with well-paid professionals who are provided the support required to practice their professions to the best of their abilities and to the highest standards. Mission-driven, publicly-operated healthcare facilities like the Veterans Health Administration (https://www.va.gov/health/); the Military Health System that includes the Walter Reed National Military Medical Center (https://health.mil/About-MHS; https://walterreed.tricare.mil/About-Us/Pre-Eminence-in-Patient-Care ); the Indian Health Service (https://www.ihs.gov/ aboutihs/); and public university health centers such as U.C. San Francisco (https://www.ucsfhealth.org/about) and U.C. Los Angeles (https://www.uclahealth.org/why-choose-us/) provide the highest quality care as attested by their patients.
For more than a century, SCVMC has been an exemplary foundation of public health in the county (https://www.scvmc.org/about-us/go-public). Like its public sector counterparts enumerated above, SCVMC provides excellent service for those most in need of such care and for those least able to afford such care. Let’s be sure that the County’s physicians and all health care personnel are well-paid and fully supported. Let’s not allow the County’s permanent management bureaucracy to adopt the logic and metrics of for-profit providers that will subvert the public sector’s mission to equitably provide quality care.