Roy Exum: "You're 'Briefly Fired'"

Thursday, April 2, 2020 - by Roy Exum
Roy Exum
Roy Exum

It is inconceivable to me how any hospital in America has the audacity to tuck-tail and run when the worst epidemic in our world’s history is banging at the door. ‘Shock’ is the only word to describe Erlanger Hospital’s “furlough” earlier this week and now comes word that some medical staffing companies around the country are actually cutting doctors’ and nurses’ salaries as they actually care and treat coronavirus patients. I never knew cash could get this cold. Oh, my goodness, this is hardly the America that Mr. Norman Rockwell once loved to paint.

A non-profit news agency, ProPublica, presented a glaring story on this April Fool’s Day that a large staffing provider, Alteon Health, is losing revenue as hospitals postpone elective procedures and non-corona patients are avoiding emergency rooms like the plague.

Alteon Health is owned by the private equity firms Frazier Healthcare Partners and New Mountain Capital, whose principles only go to the hospital when their grandchildren are born, or a politician is laid up.

Most hospitals in America use such staffing companies to supply emergency room physicians, for example, and Alteon sent out a memo Monday that announced it was reducing salaried clinicians, turning them into hourly employees and cutting their hours. Administrative officials would get a 20-percent reduction in pay, and 401(k) matches, bonuses, and paid time off would be suspended. The memo also asked employees to accept the changes or else contact the Alteon Human Resources Department within five days “to discuss alternatives.” I am talking “cold.”

In the meanwhile, New York state has confirmed 83,712 cases of coronavirus, marking an increase of 7,917 since Monday and the virus has claimed 1,941 lives in the state, up from 1,550 yesterday. Of those, about 1,000 deaths were in New York City alone. At 6 p.m. yesterday, the United States had 25,495 more cases than the day before, meaning the 211,698 totals will get heavier with each and every hour. Yet, here’s a staffing company cutting back emergency room doctors’ salaries as though there was nothing for them to do.

“It’s completely demoralizing,” said an Alteon clinician who spoke to ProPublica on the condition of anonymity. “At this time, of all times, we’re putting ourselves at risk but also putting our families at risk … A lot of sacrifices are being made on the front line that the administration is not seeing because they’re not stepping foot in a hospital,” the doctor said. “I’ve completely lost trust with this company.”

TeamHealth, a major staffing company headquartered in Knoxville, took an entirely different approach, saying its employees would not be affected. “We are not instituting any reduction in pay or benefits,” TeamHealth said in a statement to ProPublica. “This is despite incurring significant cost for staffing in anticipation of surging volumes, costs related to quarantined and sick physicians, and costs for PPE as we work hard to protect our clinicians from the virus.”

On Monday Erlanger announced its “briefly-fired program” because a furlough it most assuredly is not. What is perplexing is how the hospital’s Board of Trustees ever went along with something so distasteful. It is absolutely absurd. Sure, they knew Erlanger was losing cash before they could pronounce COVID-19. They also had to know while it appears we are all in for a two- to three-month whipping, to put any employee out on the street amidst such pandemonium is a direct reflection on their leadership.

What is being allowed to happen is best said by three of the doctors in the ProPublica report about Alteon:

* -- “This decision is being made not by physicians but by people who are not on the front lines, who do not have to worry about whether I’m infecting my family or myself,” one said. “If a company cannot support physicians during the toughest times, to me there’s a significant question of integrity.”

* -- “We all feel pretty crestfallen,” another ER doctor employed by Alteon said in a text message. “I did expect support from our administrators, and this certainly doesn’t feel like that.”

* -- “I have a huge loan payment. I have rent. I have groceries. I’m not going to sacrifice my life for when I get sick and they’re going to say, ‘You were replaceable,’” the physician said. “I cannot believe they did that to us."

There were 624 new coronavirus cases in Tennessee yesterday, scooting the workload up to 2,863, and today there will be even more. Erlanger will get the great majority of all of the cases in our region. This is because the Level One trauma center, for all practical purposes, is the lone provider of indigent care in our region. Our “region,” just so you’ll know, is halfway to Atlanta, halfway to Birmingham, halfway to Nashville and halfway to Knoxville. Last year Erlanger had nearly $140 million in indigent care and, aside from a pithy $1.5 million “donation” from Hamilton County and ‘zero’ ($0.00) from the city of Chattanooga, the local support is far and away the worst in the Southeast, if not the nation. Incidentally, each time a person is shot the cost is more than $25,000 with little, if any, compensation. No, the gangs have no health insurance plans “at this time.”

Further, the coronavirus is deadliest among those 65 and up, who we are told at least half live from week to week. In the stimulus package just approved, $200 billion was set aside for hospitals because every single one in America is hemorrhaging. The least Erlanger could have done before its “briefly-fired panic” was to wait, assuring its employees that the Trustees and the management cared about them. That’s brash, but that’s candidly the lack of empathy most of them now feel, as well as the Erlanger “family” itself. Believe this: our fearful community finds such callousness abominable.

While it is obvious new CEO Will Jackson has never run a hospital before, and that his concern for the hospital’s finances are genuine, the raw truth is that there have been no raises, nothing to boost morale, and inept middle management at the hospital since before former CEO Kevin Spiegel fell from grace. Erlanger’s greatest strength has been its people; doctors will be doctors, but the nurse beside the bed, the housekeeper’s giggle, the floor nurses working together like one well-oiled machine – it’s the whole package, and to let anyone put a chink into its side is akin to sacrilege.

Now the entire country faces monumental changes that will evolve into a completely different world than we have ever known.

In as much as we are in the fire, let’s use the forge and hammer our misfortune into something that’s better and exhibit a world where a knee-jerk reaction will never include being “briefly fired” any time and forever in our future.

* * *

Last week 47,000 stores were closed in the United States, meaning those employees are eligible for unemployment compensation. If a person is furloughed, they are still by definition ‘employed,’ and are therefore ineligible for unemployment benefits or help with the mortgage, their daughter’s car payment, their church tithe, or a jug of Clorox to wipe the door knob on the backdoor. If I was a member of the Erlanger Hospital’s Board of Trustees, that would bother me during my prayer time. A lot.

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