Who we are
• PDOCC is a locally run, independent union representing the physicians and dentists who work for Contra Costa Health Services. Our members work in the county hospital in Martinez as well as in 11 outpatient clinics spread throughout the county
•We provide high quality healthcare to low-income patients in our county. Our clinics and hospital primarily serve people with Medi-Cal insurance.
Our contract dispute
•Our last contract with the county expired in 2016. We have been in negotiations with the county ever since, and declared impasse in the negotiations earlier this year. Multiple mediation sessions failed to result in a settlement, and we are now in the middle of a lengthy fact-finding process
•If fact-finding also fails to lead to a negotiated settlement, the county may simply impose its “last best final offer”, which contains several items that are unacceptable to our members. In this case, we will likely vote to go on strike
•We would prefer not to have to go on strike, and we are launching a campaign to encourage the county Board of Supervisors to agree to a fair contract.
It’s not about the money
• Salaries have largely been agreed upon.
• Most classes of doctors and dentists will receive salary increases that are approximately cost-of-living increases
It’s about the working conditions
• The county is demanding that our primary care doctors see 20% more patients per clinic session
• The county is also insisting on a significant reduction in scheduled administrative time for our emergency medicine and primary care doctors
Why? More patients seen = more revenue for the county.
What’s wrong with seeing 20% more patients?
• Patients will have even less time to talk with their doctor
• Patients will spend more time waiting in the waiting room because their doctor is running behind • Patient safety will be at risk as doctors are forced to work faster than is safely possible
• Quality of care will decrease as shorter visits leave less time to address preventive measures like cancer screenings
• Doctors will burn out, leading some docs to leave the system
What is administrative time?
• Administrative time (or admin time) is time build into a doctor’s schedule to complete tasks like finishing notes, reviewing test results, refilling medications, calling patients on the phone, responding to emails from patients, filling out disability forms, completing prior authorizations for insurance companies, etc.
• Currently, doctors in the emergency medicine and primary care receive up to 8 hours a week of administrative time in their schedules
• The county wants to reduce this to a maximum of 4 hours per week
• This will lead to more hours spend doing administrative tasks outside of work hours (evenings and weekends), leading to burnout.
What is physician burnout?
• Burnout is a clinical syndrome consisting of emotional exhaustion, depersonalization and lack of self worth
• Burnout is an epidemic among US physicians – over 50% of doctors experience at least 1 symptom of burnout. Rates are highest among front-line physicians like Primary Care Providers and Emergency Medicine doctors
• Causes include emotional demanding work, time pressures, and long hours.
• Consequences include worse medical care, medical errors, and high turnover.
Are we a good healthcare system? YES!!!
• We run a 176 bed full-service hospital including emergency and L&D, which serves a vital role within our community
• Our outpatient clinics provide strong primary and specialty care. We outperform the majority of safety net systems in California on quality metrics like PRIME, QIP and HEDIS
• We operate a nationally-renowned family medicine residency program that ensures an ongoing supply of good doctors to serve in our county
• We run innovative programs for people with opioid addiction, mental health disorders and people returning from incarceration
• We are actively working to reduce health disparities through programs such as the African American Health Conductors and the Promotores.
Are we a drain on county resources?
• According to the county’s own numbers, CCHS is 93% self-sustaining, with only 7% of our expenses covered by the county general fund
• Also according to the county’s own numbers, our clinics and hospital require less money from the general fund than they did 10 years ago, despite providing significantly more services to more patients
Is our county too poor to pay for healthcare?
• Contra Costa County is in the top 2% of counties nationwide for median income (https://en.wikipedia.org/wiki/List_of_United_States_counties_by_per_capita_income)
• Contra Costa County is in the top 0.5% nationwide for home prices (https://www.nar.realtor/research-and-statistics/housing-statistics/county-median-home-prices-and-monthly-mortgage-payment)
• Our county received a AAA bond rating from S&P (the highest possible rating) (http://www.co.contra-costa.ca.us/DocumentCenter/View/46190/Capital-Construction-Bonds-6517)
• Our county supervisors just voted themselves a 14.5% raise over the next 3 years (https://eastcountytoday.net/contra-costa-county-board-of-supervisors-get-pay-raises-after-3-2-vote/)
What do we want?
• We want a new contract that provides fair salaries that keep up with the cost of living, while leaving our clinic schedules and administrative time the way they are now.
• We believe that this is the only way to ensure that our clinics and hospitals remain strong and able to provide top quality care for our most vulnerable residents.
How can you help?
• Call, write or email your county supervisor, tell them that you value the high quality healthcare that PDOCC members provide for low-income people in our county, and ask them to settle our contract without insisting on increased patient loads or decreased administrative time (http://www.co.contra-costa.ca.us/5715/Supervisor-Who-Represents -Me)
•Distribute this letter to the other members of your organization and ask them to contact their county supervisor as well
• Follow us on social media: @Doccupy Contra Costa on Facebook and @DoccupyCC on Twitter