Emergency room physicians, nurse practitioners, and physician assistants at Ascension St. John Hospital in Detroit initiated a strike on Thursday, protesting what they describe as unfair labor practices endangering patient care. These Ascension Doctors and medical professionals, members of the Greater Detroit Association of Physicians union, walked out citing understaffing and deteriorating working conditions as primary reasons for their action.
The union, representing 43 healthcare workers employed by TeamHealth — a staffing firm contracted by Ascension St. John and owned by Blackstone, a private equity firm — has been in operation without a contract since filing their intent to organize in May with the National Labor Relations Board. Their central grievance revolves around the assertion that inadequate staffing levels within the emergency department are causing unacceptably long patient wait times and compromising the quality of care provided.
Demonstrating their concerns, striking workers held signs proclaiming, “No more profits over patients,” highlighting their belief that financial considerations are being prioritized over patient well-being.
In response to the strike, TeamHealth issued a statement assuring that they collaborated with Ascension St. John to maintain full emergency department staffing and prevent any disruption to patient care.
“Patients needing critical emergency care during this time should continue to come to the emergency department at Ascension St. John Hospital,” TeamHealth stated. They further asserted their commitment to quality patient care and clinician support, even amidst financial pressures from insurers and Medicare. TeamHealth also refuted the union’s claims of unfair negotiation practices, stating, “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.”
However, Dr. Shaun Gray, an emergency room physician with 17 years of experience at St. John, paints a starkly different picture. He reported to the Detroit Free Press that on Wednesday night, patient wait times in the emergency department stretched up to 13 hours. Adding to the strain, Dr. Gray stated that approximately 20 emergency room beds were taken out of service due to insufficient staffing, despite a waiting room filled with 60 patients. This situation, he explained, forced some individuals in need of medical attention to leave without receiving care.
Emergency room doctors and nurses on strike holding signs, indicating labor dispute and patient care concerns
Dr. Gray emphasized the resource limitations faced by the ascension doctors and staff: “We have 50 people that need to be seen, but we don’t have anywhere to put them or any staff to support them,” he said. He detailed how a physician’s ability to treat patients effectively is severely hampered when essential resources like patient monitors, IV supplies, and imaging transport are unavailable due to understaffing. Dr. Gray expressed his frustration, noting that these challenging conditions are becoming increasingly common.
TeamHealth countered these claims by stating that the median emergency room wait time at Ascension St. John in 2023 was 25 minutes, and had decreased to an average of 15 minutes in 2024, which they presented as “far less than the 10 to 15 hours the union claims.”
The union, however, disputes TeamHealth’s method of calculating wait times. They argue that TeamHealth’s clock stops when a patient’s vital signs are initially assessed after ER check-in. Patients are then often returned to the waiting room, where they may wait for many additional hours for an available bed, physician consultation, and treatment.
Dr. Gray elaborated on this discrepancy: “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,” he 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.” This distinction is critical in understanding the ascension doctors‘ concerns about reported wait times versus actual patient experience.
TeamHealth defended their methodology, asserting that “door-to-doctor time” is a standard metric across emergency departments nationwide. They referenced the American College of Emergency Physicians’ definition, which considers it the time until a face-to-face evaluation by a provider, including medical doctors, physician assistants, or advanced practice nurses.
Further, TeamHealth cited data from the Centers for Medicare and Medicaid Services, stating the average Ascension St. John emergency room visit duration before discharge is 210 minutes, which they argue is “much less than the claims the union is making.”
The strike by these ascension doctors and medical professionals underscores a growing tension between hospital management, staffing firms, and frontline healthcare providers regarding patient safety and working conditions. The differing accounts of wait times and staffing adequacy highlight the complexities of this labor dispute and the urgent need for resolution to ensure optimal patient care at Ascension St. John Hospital in Detroit.
Contact Kristen Shamus: [email protected]. Subscribe to the Free Press.
