Doctors, nurses walk out on strike at Ascension St. John in Detroit

Kristen Jordan Shamus, Detroit Free Press
Updated ·4 min read
16

Editor's note: This story has been updated to include new comments from TeamHealth, which manages the emergency room at Ascension St. John Hospital.

Wearing their white coats and blue scrubs, some with stethoscopes still draped around their necks, emergency physicians, nurse practitioners and physician assistants at Ascension St. John Hospital in Detroit walked off the job Thursday, striking against what they say are unfair labor practices that put patients at risk.

The union, the Greater Detroit Association of Physicians, filed an intent to organize with the National Labor Relations Board in May, and has been working without a contract since they organized.

The group of 43 doctors, physician assistants and nurse practitioners are employed by a Knoxville, Tennessee-based TeamHealth, which is contracted to manage emergency department at the east-side hospital.  TeamHealth is owned by the private equity firm Blackstone.

Ascension St. John Detroit emergency room physicians pour out of an emergency room door to hit the streets outside of the hospital to join the picket line on Thursday, April 18, 2024.
Ascension St. John Detroit emergency room physicians pour out of an emergency room door to hit the streets outside of the hospital to join the picket line on Thursday, April 18, 2024.

The union alleges that understaffing and poor working conditions have created an unsafe staffing situation in the emergency department, which has led to excessively long wait times for patients in need of care.

Some workers carried signs that said: "No more profits over patients."

TeamHealth said it worked with Ascension St. John to ensure the emergency department was fully staffed during the strike so patient care wouldn't be interrupted.

"Patients needing critical emergency care during this time should continue to come to the emergency department at Ascension St. John Hospital," TeamHealth said in a statement.

"TeamHealth’s top priorities are delivering high-quality patient care and supporting our frontline clinicians, as they care for our communities 24 hours a day, 365 days a year. TeamHealth has provided clinicians with support and resources for over 40 years, even in the face of material reimbursement pressure from private insurers and Medicare.

"We have negotiated in good faith with the union, and any statement to the contrary is false. We invite the union’s leadership to return to the bargaining table and secure a resolution on reasonable and sustainable terms.”

Dr. Shaun Gray, an emergency room physician who has worked the last 17 years at St. John, told the Free Press that the staffing situation has gotten so bad, patients waited as long as 13 hours to be seen by a doctor Wednesday night in the emergency department.

And despite having 60 patients in the waiting room, managers shut down about 20 ER beds because there weren't enough doctors and nurses to staff them, he said. The long wait time forced some people in need of care to leave without being treated.

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The group of 43 doctors, physician assistants and nurse practitioners are employed by a Knoxville, Tenn.-based TeamHealth, which is contracted to manage emergency department at the east-side hospital.
The group of 43 doctors, physician assistants and nurse practitioners are employed by a Knoxville, Tenn.-based TeamHealth, which is contracted to manage emergency department at the east-side hospital.

"We have 50 people that need to be seen, but we don't have anywhere to put them or any staff to support them," Gray said Wednesday night. "A single physician alone can't treat a patient when there are no resources to get them on a monitor, get the IV started, get them transported to imaging. ... This has started to become the norm, and it's just so frustrating."

TeamHealth said Friday that the median wait time at Ascension St. John was 25 minutes in 2023, and dropped to an average of 15 minutes in 2024 — "far less than the 10 to 15 hours the union claims."

However, the union said TeamHealth counts emergency department wait times differently than many patients would. TeamHealth's wait-time clock stops, the union said, when patients have their vital signs assessed after checking in at the ER. Most patients are then asked to return to the waiting room afterward, where they typically have to sit for hours for an open bed, to talk with a doctor and receive treatment.

"When the public hears that the door-to-doctor time is 20 minutes, it's implying that they're being seen by a doctor in 20 minutes," Gray said. "But they're really just being eyeballed in that first 20 minutes by a PA (physician assistant), if we have one, and then they're waiting 10 hours."

TeamHealth said door-to-doctor time is "a common metric used in all emergency departments across the country. The American College of Emergency Physicians defines it as the time from when the patient arrives to the Emergency Department until a 'face-to-face evaluation of the patient by the provider,'" which it said could be a medical doctor, doctor of osteopathy physician assistant or advanced practice nurse.

The Centers for Medicare and Medicaid Services reports that the average patient spends 210 minutes in the ER at Ascension St. John before they are discharged, which TeamHealth added, "is much less than the claims the union is making."

Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Free Press.

This article originally appeared on Detroit Free Press: Doctors, nurses walk out on strike at Ascension St. John