Doctors picket in Tacoma as dispute with health system over COVID safety gear heats up
Doctors and other health care workers who say there is not enough COVID-19 safety gear at Indigo Urgent Care centers in Washington have a point, state officials say, but the problem is not unique to Indigo.
The pandemic has stretched thin supplies of personal protective equipment used by health care workers, according to the state Department of Labor & Industries, which has received 17 complaints about working conditions at Indigo clinics since March.
Inspectors have investigated five of the largest Indigo clinics, finding a number of issues that normally could result in citations, according to a letter sent to one of the facilities in Olympia.
“Under non-emergency circumstances, potential hazards that could have been cited include: Reusing single-use PPE such as respiratory protection, surgical masks and gowns. Once PPE shortages have subsided, you will be required to adhere applicable (Division of Occupational Safety and Health) codes regarding the reuse of PPE,” the letter states.
Indigo doctors are embroiled in a labor dispute with Tacoma-based MultiCare over working conditions.
Physicians and advanced practice providers represented by the Union of American Physicians and Dentists organized an informational picket Thursday at the James Center MultiCare Indigo site at 1812 S. Mildred St. in Tacoma.
The action follows a strike authorization vote, passed last month.
The Indigo sites are designed to treat non-emergency medical issues, promoting convenience and short amount of time required by patients to spend at the sites from intake to treatment.
There are more than 20 MultiCare Indigo clinics in the Puget Sound region, including Tacoma and Olympia, and five clinics in Spokane and the greater Inland Northwest.
In September, the union cited “assembly-line” working conditions at the clinics, with a heavy workload, inadequate supplies of personal protective equipment, few breaks and extended operating hours to accommodate more patients amid the pandemic, among other issues.
“Despite their extensive training and knowledge of what constitutes safe PPE and care, MultiCare has refused physician requests for N95 masks as providers test hundreds of COVID-19 patients each day,” said the union in its announcement of Thursday’s picket.
“MultiCare does not provide N95 masks and the company bans providers from bringing their own. Physicians and providers have unionized with UAPD to combat MultiCare’s profit-driven, fast paced care, and to restore the autonomy once held by their profession,” it added.
Marce Edwards, MultiCare media representative, told The News Tribune via email: “Throughout the pandemic, MultiCare has rigorously protected staff and worked hard to deploy the appropriate PPE to the appropriate care setting. To ensure the efficacy of PPE, we require our employees to use MultiCare-provided PPE that’s passed our inspection and meets our high standards. We’ve vetted our use of masks and PPE with infectious disease and infection control physicians and specialists internally and compared our PPE guidelines to other similar organizations. We’re completely confident our staff is safe, and we have no clinical evidence to the contrary.”
Complaints filed with state
Tim Church, communications representative for L&I, told The News Tribune this week that 17 complaints had been filed regarding Indigo sites in Western Washington, and the complaints generally were “all the same about each location.”
According to a summary provided by Church, the complaints cited providers reusing PPE, being furnished “unapproved” wipes and told to use only certain amount, and not enough supplies on hand since the supply manager was on furlough.
L&I “performed inspections in the largest Indigo outlets in each region — five inspections total,” Church told The News Tribune via email in response to questions.
Four of the inspections, at clinics in Olympia, Puyallup, Tacoma and Marysville, have been closed, according to Church. The fifth, in Federal Way, remains in progress.
“Because most of the complaints were virtually the same for each location, and because of the large workload involving COVID complaints, we looked into most situations but did not check in to every location individually,” Church wrote.
“So far none have been cited for violations,” he added.
The lack of citation appears to say more about the state’s current PPE supply than the complaints.
“A number of those (cases) that were closed were sent a letter noting that in normal times, they could have been cited for some of the practices, but, because PPE is in short supply, they are not being cited,” Church wrote.
A copy of the letter sent to the Olympia Indigo clinic dated Sept. 8 was provided to The News Tribune by Church, who indicated it was similar to the other letters issued.
The letter noted the CDC had issued guidelines for “limited use and reuse of PPE. Under normal circumstances, following these guidelines would not be allowable occupational health practices.”
On Sept. 18, L&I and the state Department of Health sent out a joint hazard alert that clarified and updated guidelines regarding hospital workers’ safety.
In its introduction, it notes: “Employers that do not consider their PPE or respiratory protection supplies adequate to meet these expectations must contact their suppliers and local county emergency management to resolve supply issues.”
Among other items under the guidance for hospitals, it says: “Disposable respirators and procedural masks must be replaced daily at the beginning of each shift for every employee and immediately upon employee request when soiled or damaged during the shift. Multiple shift use of disposable respirators/masks is NOT allowed.”
It also noted that hospitals should ensure they are adequately staffed with qualified infection prevention staff and resources.
Church on Thursday told The News Tribune that “The hazard alert applies to clinics as well, but it depends on several variables, including the size of the clinic, the types of patients a clinic sees, the hazard level of the cases the clinic handles, and other details.”
“It’s important to understand that the hazard alert did not change requirements and is not an enforcement document itself. It is meant to clarify requirements and guidance about coronavirus hazards for hospitals and other health care facilities,” Church said via email Thursday.
Talks continue
The two sides, UAPD and MultiCare, have been in bargaining talks since 2019.
Physicians and advanced practice providers at Indigo Urgent Care centers voted in 2018 to join the UAPD, which represents represents over 200 physicians, advanced nurse practitioners and physician assistants in Washington state.
“We are currently in bargaining right now but the union and MultiCare are still far apart on many issues,” Joe Crane, regional administrator for UAPD, told The News Tribune via email Wednesday.
In response to questions about Thursday’s informational picket, MultiCare’s Edwards said: “While we support our providers’ right to negotiate a fair labor contract, we’re surprised by this tactic as we’ve tentatively agreed to many contract details, including a tentative agreement about safety and a formal process to resolve disputes.”
UAPD President Dr. Stuart Bussey said in Tuesday’s picket announcement: “Indigo providers are tired of working long shifts and not being able to go home after 12 hours. UAPD’s bargaining team offered to bargain with MultiCare any day leading up to the action, as members prefer negotiations over pickets and strikes. MultiCare has yet to take the Union up on this offer.”
Edwards on Wednesday wrote: “MultiCare participated in several bargaining sessions in September and is also bargaining with the union (Wednesday), our second session in October. We are hopeful that we can reach a speedy resolution.”
This story was originally published October 8, 2020 at 1:08 PM.
