Our lives as physicians and healers are pulled in many directions, mostly by the work we do. I chose to work with an underserved population through a Federally Qualified Health Center. The work we do there is often more difficult than most because our community is so poor. Their poverty is not just about their health but extends throughout the spectrum of their lives. I and my fellow travelers in medicine at all levels support them as best we can. Often they are the effluvia of our society, the throwaways, with multiple and complex disease conditions. Hopefully, our work environment supports the work we do. What do we do when it does not?
My colleagues and I have been faced with that dilemma for some time. With ever-decreasing budgets and animosity toward the poor — as if they made themselves poor — services are ever more difficult to come by. The bean counters are ever more vigilant. The pressure to produce much more with much less is ever present. Indeed, often safety not only of the patient, but of the care providers, is compromised. In an age where primary care providers are as rare as hens’ teeth, we have been steadily bleeding them out our doors. With an administration that isolated us as a staff, ignoring rather than consulting, bullying rather than embracing concerns, tone deaf to our requests, we — the remaining staff — made a choice to unionize our workplace.
Unions, you say? As I thought about this on Martin Luther King Jr. day, I paused to recall his words regarding social justice and human rights, realizing that given the above circumstances, indeed we have taken a path which insures both.
Unions, you say? We chose our union, a union of professionals, the American Federation of Teachers Connecticut Branch, to help us form an association of professionals in our workplace. It is a bottom-up organization and leaves the structure the decisions to us, with guidance as we need it.
Unions, you say? We feel that this is an upward movement not just for the community of practice, the providers of care, but as those who are at the sharp end of the knife, an ability to be involved with decisions about our community and how they shall be treated.
We as physicians have suddenly become the bad guys. I don’t expect the return of Dr.’s Kildare and Welby, but I do expect that a seat at the table will bring the physician view into the equation with equal weight. I do expect that we will see our patients as Maimonides declared: “May I never see in the patient anything but a fellow creature in pain.” As we reflect on the legacy of Dr. King, I hopethat we continue to provide for our patients and our communities the highest levels of medical care available.
“Injustice anywhere is a threat to justice everywhere.”
Dr. Buchbinder is a board-certified Podiatrist practicing within an FQHC (Federally Qualified Health Center) in Hartford, CT. He is director of the FreeMED Software Foundation, a nonprofit dedicated to making accessible and extensible medical records available worldwide. Dr. Buchbinder also blogs at A view from the provinces: A new Yankee’s view of the world.