Physician assistants find their voice in the union
The physician assistants working within the walls of Michigan Medicine at the University of Michigan in Ann Arbor never really had much of a say in the way patient care was performed. The lack of a voice was one of the biggest reasons behind the plan to organize a union that started two years ago. But it was the coronavirus pandemic that kicked the organizing effort into high gear and pushed the physician assistants to the finish line. Over this past summer, the United Physician Assistants at Michigan Medicine/AFT was officially recognized by the University of Michigan Board of Regents as the representative of the nearly 350 physician assistants employed at Michigan Medicine.
Historically, physician assistants have not had much of a voice when it comes to patient care, says Megan Williams-Morad. She has been a physician assistant since 2009 and started at Michigan Medicine in 2012. Although the nature of their job requires physician assistants work in collaboration with doctors and nurse practitioners, those workers have had more of a role in decision-making, says Williams-Morad. “Our opinions haven’t mattered.”
Thanks to the board of regents’ agreement to their union’s representation, “I believe we will have a more open and amicable relationship with the hospital,” says Williams-Morad, who was on the organizing committee.
Williams-Morad’s biggest concern is patient safety. “We are often put in a position where we have no control over decisions about how we practice are made, and we are not given adequate resources. Now, our union will be able to bargain for the resources we need to produce policies that lead to safe patient care, especially during this pandemic.”
Jill Hasen started working at Michigan Medicine in 1990. At the time, Hasen was one of a handful of physician assistants and currently works in orthopedic oncology and inpatient/outpatient surgery. She started thinking about unionizing two years ago, after the university set up mandatory meetings to address the results from a survey of physician assistants that revealed they were not satisfied with their work. “At that point, we were all thinking about it,” says Hasen. It was during one of those meetings that she picked up a piece of paper, wrote the word “union” on it, and held it up, just like in the movie Norma Rae. And so it began.
Hasen did some research, and read up on all of the unions that work with health professionals; the physician assistants decided to work with the AFT.
“In the beginning, there were typical fears that arise in an organizing effort. People were terrified to rock the boat, but our organizing committee did a lot of educating,” says Hasen.
“Now that we have a platform for our voice through our union, I want to see us with a seat at the table — and to play a part in how the university is run and patients are seen and how we are compensated,” says Williams-Morad. “Right now, the university system is facing big financial burdens because of the pandemic. They have chosen to address those burdens with a reduction of the workforce — physician assistants and support staff in particular,” she says, referring to the university’s decision to suspend their retirement match as well as cost-of-living adjustments during the pandemic.
When the physician assistants objected, they were told hey were spoiled. However, they feel the university is being unfair with its cuts. The physician assistants are also working with other unions at the university to persuade it to use some of its multi-million-dollar endowment to address this burden. Michigan Medicine has also proposed cutting call shifts as a cost-saving measure. The physician assistants say such a move would affect patient care. “Many of us are concerned that our patients won’t be safely seen,” says Williams-Morad. “We want a role in making these decisions.”
David Dumais agrees; he’s been a physician assistant in the ER at Michigan Medicine for five years. “Having someone on call to cover shifts is like a safety net. Without it, patient wait times will increase, and that hurts patient safety and patient satisfaction. It also decreases morale.”
Unilateral decisions by management concerning workflow like this are one of the reasons Dumais wanted a union. In the beginning of their organizing effort, Dumais squeezed 34 physician assistants in his living room, so they could talk about unionizing.
“It’s nice to see it come to fruition; it’s also nice to know that there is a body representing us to have our voices heard and empowering people to provide the best patient care,” says Dumais. “I never thought I would be doing this, but I hope our victory will inspire others to get active in their communities and empower people to make change.”
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