Dozens of providers at PeaceHealth in Whatcom County could vote to unionize, citing inadequate pay, fears over job security and burnout.
Physician assistants, nurse practitioners and certified nurse midwives have been in behind-the-scenes discussions with the Union of American Physicians and Dentists for about 10 months, clinicians and union officials say.
In interviews, caregivers in this group, called advanced practice clinicians or APCs, said they work up to 60 hours a week with no additional compensation, to meet administrators’ demands to see more patients and make more money for the not-for-profit health care system. Certified nurse midwives, who deliver babies and provide other reproductive health care, can work 70 or more hours per week, representatives of the group said.
Those who spoke to Cascadia Daily News requested anonymity because they feared retaliation for union organizing.
Advanced practice clinicians perform many of the same functions as medical doctors at a fraction of the pay. In some cases, they make only a few thousand dollars more a year than nurses, caregivers said.
“Providers are being asked to work harder,” said Ray Quintanilla, the union’s Washington state director, speaking about the PeaceHealth workers in Bellingham. “They’re being asked to work longer, and they’re being asked to work while spending less time with their patients,” which can cause quality of care to decline.
When asked to comment on advanced practice clinicians’ unionization efforts, PeaceHealth spokesperson Bev Mayhew provided the following statement:
“PeaceHealth is committed to providing a fair and just workplace for all of our caregivers, and endeavors to offer wages, benefits and working conditions consistent with standards across the region and industry.”
PeaceHealth has been chronically understaffed since losing employees due to the COVID-19 vaccine mandate, the providers said.
Short-staffing has resulted in patients being unable to see their primary care physician and going to the ER instead, providers said. Some clinics have wait times of three or four months.
Turnover is high, the PeaceHealth staffers said, due to burnout and pay rates that aren’t keeping up with the area’s rising cost of living. They also said decisions about patient care are made by administrators with no input from providers.
The organizing effort among physician assistants, nurse practitioners and certified nurse midwives comes amid financial struggles at PeaceHealth that have led Whatcom County’s dominant health care provider to cut staff, and reduce or eliminate services.
PeaceHealth in Bellingham announced the closure of its allergy and immunology clinic. The provider also closed its overnight sleep lab and reduced palliative care services.
“They’ve shown the community by closing down the clinics they can’t be trusted to do the right thing unless it’s in their financial interests,” a physician assistant said. “So we’re not sure they would provide fair conditions for our employment.”
“We’re just feeling we’re at our breaking point,” the physician assistant added. “The only way forward is to come together and bargain together, so we can have some guarantees.”
Nurses at PeaceHealth are represented by the Washington State Nurses Association, and a wide range of health care workers, including housekeeping staff, MRI technicians and certified nursing aides, are members of SEIU Healthcare 1199NW. Both groups received significant cost-of-living raises in negotiations last year.
Nurses received some of the same benefits advanced practice clinicians say they want, including a guaranteed grievance process and pay incentives that increase staffing levels.
It’s not clear the APCs’ union effort will succeed. Staff leading the effort say they have support among some clinicians, but others don’t want to “rock the boat.” Still other providers are opposed, organizers said.
Currently, clinicians are signing confidential support cards online. Union representative Nathaniel Huff declined to say how many signatures he has received.
“Support figures are sensitive,” Huff said. “If management learns about the numbers, it gives them information they could use against APCs and their efforts to organize.”
In the next couple months, if union officials are confident they have the support, they will file the workers’ intent to unionize with the National Labor Relations Board, which would protect workers against retaliation. A vote among clinicians on whether to join the union would come next.
While the clinicians are clear about wanting better work conditions and pay, Quintanilla, the union director, said they also are concerned about their patients.
“They’re worried about the future of [PeaceHealth], the viability of it, and what it means to the thousands of patients that rely on this health care system, particularly those on Medicare and Medicaid — retirees, the elderly, and low-income people,” Quintanilla said. “These are the folks who really rely on this health care network.”
