Observation from NES' choice not to pay its doctors
Observation from NES Health's choice not to pay its doctors: we employed (non-practice-owning) emergency physicians need a way to work together to protect each other's workplace-related interests. In the extreme, that means a coordinated response to the threat of non-payment. In more stable times, it means negotiating as a group over improvements in working conditions, staffing, scheduling, salaries, and benefits. In other words, it means forming a union.
For context, within NES, each of its hundreds of physicians appears to be deciding individually whether to work for free or face the backlash of "patient abandonment." 1099s are being played off against W2s. ACEP and AAEM are trying to coordinate among physicians, but neither organization has a direct role on the inside of NES or its EDs.
A unified voice of NES' frontline physicians would be able to address the situation in a coordinated fashion. Hospital CEOs have the duty to staff their EDs; NES is a subcontractor (a subcontractor no longer paying its workers). With a united voice, NES could work out a coordinated transition to another contract holder - or a to new EM group composed of the ED physicians who work at that ED - without lost compensation. The CEO's alternative would be to close/divert their ED, an option they are unlikely to take.
Similar example from 2023: American Physician Partners took advantage of the lack of employee organization (no union) to not pay the physicians for their last month of work and to not cover malpractice tail - without declaring bankruptcy. Meanwhile, APP took the money that kept coming in for the next 7 weeks, as bills from pre-shutdown visits were collected. The physicians could have sued over violation of the WARN Act, but largely due to the lack of internal employee coordination, this was not done. ("The Worker Adjustment and Retraining Notification (WARN) Act requires employers with 100 or more employees to give at least 60 days' written notice of a mass layoff or plant closing. The notice must be provided to affected employees, their representatives, the local chief elected official, and the state dislocated worker unit.") And APP's co-founder & CMO left with a $1.7 million severance package.
Non-practice-owning emergency physicians: it's time to stand up for ourselves and organize.
PS: For inspiration, see this ACEPNow article about Detroit's emergency physician union -https://www.acepnow.com/article/the-er-docs-strike-back/