Highland’s History of Patient Advocacy

Prior to joining CIR, ACMC residents had an independent housestaff union, the Highland Association of Interns and Residents (HAIR).

This year marks Highland Hospital/Alameda County Medical Center’s 14th anniversary in CIR, but ACMC housestaff have been organizing and taking collective action since long before they voted to join CIR.

Residents at ACMC have been at the forefront of patient care and organization efforts for decades, advocating for the inclusion of resident voices in healthcare policy decisions.

In 1991, as the effects of massive budget cuts and layoffs in California were becoming painfully clear to physicians throughout the state, the housestaff at Highland Hospital educated the public on the consequences of inadequate public health care and lobbied elected officials to stem the tide of hospital layoffs and community clinic closures.

One especially dramatic and evocative action was the staging of a Die-In outside the hospital. Dozens of residents marched outside and then “died,” laying out on the ground with tombstones noting the causes of death related to inadequate hospital care.

“DEAD because of $6 million budget cuts,” read one tombstone. “DEAD because my emergency lab result took hours,” said another. Following the protest, a county poll showed that 83 percent of voters would support raising taxes to help fund public health services.

Residents employed the same tactic one year prior, in the midst of a five-month contract dispute with Alameda County. More than 35 residents marched to the Alameda County Offices and staged their Die-In in order to call attention to their concerns about the quality of care at the hospital and the need for residents to have a voice. Their actions helped settle the dispute, and their new contract was drawn up to include negotiating rights around curriculum, numbers of housestaff and improved working conditions with wage increases, call limitations, an affirmative action fund, and other gains.

New Highland Contract Prioritizes Patients and Residents

ACMC residents settled contract negotiations in October 2012, resulting in gains for all PGY levels and investments and patient care and safety.

The Patient Care Fund was increased to $70,000, a $10,000 increase from the previous contract. An additional $10,000 was set aside to fund QI projects in the hospital.

CIR members also recognized the importance of cultural competence in medicine and negotiated for a $15,000 diversity fund to recruit and retain applicants who are more representative of the patient population in Alameda County, which is primarily Latino and African American— a continued effort since the affirmative action fund negotiated in 1990.

“I was impressed by the congeniality and sense of common purpose found in re-negotiating the resident physician contracts with Alameda County Medical Center,” said Dr. Dominick Maggio, a PGY 2 in emergency medicine. “This helped prove to me that the entire organization is dedicated to the same value of serving the underserved.”

The Alameda County Medical Center Bargaining Committee.

Chiefs at the hospital also benefited from this round of negotiations. While a salary differential was expected for all chiefs, not everyone had received payment. The new contract addressed this with a one-time payment for all chiefs. Equally important was a 12 percent cap on any healthcare premiums that might increase—becoming a direct cost to residents. Residents also received extra funds for attending medical conferences.

Through this latest round of negotiations, housestaff continue the legacy of patient advocacy and strengthening physician community at Highland.

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