WILMINGTON — ChristianaCare doctors started to vote last Thursday on whether or not to form the first union in the health care system’s history. Results are expected to be in on June 27.
“Any time you try and make a change, you can expect some concern. But we believe at ChristianaCare we want to do what’s best for our patients, and the voices of close to 500 physicians who work in the hospital to make those decisions should be heard,” said Dr. Bryan Haimes, an internist and pediatric doctor who is also working to lead the unionization effort.
“The goal is to gain some measure of control so we can take better care of our patients,” he added.
Back in May, two-thirds of the more than 400 physicians that work at ChristianaCare’s Christiana and Wilmington hospitals, its cancer center and its Middletown emergency center, signed cards that sought to authorize a union election to join the Doctors Council Service Employees International Union. The petition for the vote was filed with the National Labor Relations Board.
Haimes told the Delaware Business Times that while the requirement was to seek 30% of staff members, those working on the union effort thought working to get 70% would send a clear message of majority support.
Haimes said that he and fellow doctors have long been concerned about the level of burnout seen at ChristianaCare, notably with the health care system shifting some of the work to outsourced private practices to internal labs and employees that have made for a higher, and sometimes, untenable, work load.
For years, Delaware’s health care systems and hospitals across the country have been leaving the bedside. Many nurses have opted to let their licenses lapse in the past couple of years, and there were about 1,660 physicians — ranging from family medicine, internal medicine and other — according to a 2022 Department of Labor Report.
“During COVID, we were extremely busy, but we knew that was an emergency and everyone was willing to work a little harder and take on those extra patients. But it seemed once they realized we could take those on, they continued to make us do so. Lots of doctors are spending several hours outside their paid day to do things to make the workload more bearable,” Haimes said.
One of the major sticking points was back in December 2023, ChristianaCare had announced to physicians that it would be rolling out time away practice in July 2024. This model would reportedly pay out the paid time off for physicians up to 145 hours over the next months.
But it would also create a system where physicians would have time away from practice banks that could be used for time off. Under the new model, pay is based on working 40 hours a week throughout the year, with time off unpaid — and taking on additional shifts would recoup that loss.
Haimes said that ChristianaCare has since adjusted the total hours scheduled for physicians after pushback, but he still said that would push more burnout.
“I was worried about the trends that I saw about frontline health workers leaving, and worried that caused more health professionals to leave the practice in Delaware. Twenty-three of my fellow colleagues have left the practice over the last two and a half years,” Haimes said. “Over time, we’ve seen the hourly rate and overtime lowered, despite the fact there’s not enough staff to fill the gaps.”
A ChristianaCare spokesman told the Delaware Business Times that the compensation model and benefits were developed as part of a three-year process. The goals were to “improve equity and fairness across our organization” as well as increasing competitiveness to recruit top talent to support staff. It also represents $21 million in investment in physician salaries and benefits.
“It’s important to note that time away from practice is paid time off—in fact, the design of our time-away-from-practice benefit encourages and supports our physicians’ ability to use their available time off for vacations and personal needs. The time-away-from-practice model is consistent with contemporary best practices among employed medical groups,” the ChristianaCare spokesman wrote in a prepared statement.
The health care system also noted that it hired 360 physicians over the last three years, including 25 physicians for the emergency department in the last nine months.
“We respect the right of our physicians to determine whether or not they want a union to represent them, and we are working with the National Labor Relations Board to ensure all procedures are followed to ensure a free and fair voting process. We believe that continuing to have a direct relationship with physicians is an essential component of our continued shared success,” ChristianaCare Senior Communications Manager Bill Schmitt added.
There has been no union for hospital systems in Delaware, and across the country it has been a relatively new movement. The American Medical Association recently adopted a resolution that noted that as corporate entities have grown in the health care space since 2014, so have unionization efforts.
Physicians now employed by hospitals, health systems or corporate entities have jumped from 47% in 2018 to 73.9% as of January 2022. Physicians who are union members have grown 26% between 2014 and 2019. The Doctors Council has worked to help about 4,000 doctors unionize in Minnesota, Wisconsin, New York City and other locations.
“You’re seeing more and more of these health care systems turn into monopolies. Yes we could work in New Jersey or Philadelphia, but we want to continue to work where we raise our families,” Haimes said. “I do have a feeling that in the next 10 years, we’re going to see more physicians who are unionized, because there’s a drive to improve patient care and maintain our integrity.”
Editor’s Note: A previous version of this article misquoted Dr. Bryan Haimes about the number of colleagues that have left ChristianaCare, We regret the error.
