Thursday, September 27, 2007

More SEIU letters to doctors

I have discussed below the tactical use of letters from the SEIU to doctors at our hospital. Here is another type of letter. This one was an email sent to the doctor's business address.

This is clever approach to appeal to doctors' sense of concern about patients and to try ultimately to create a divide between physicians and hospital administration. Let's deconstruct this a bit -- first on elements of style (which, admittedly, are very well done!) First, the writer gives the impression that she has actually talked with other doctors in the hospital, who recommended that she contact this one. But, none of those doctors' names are provided. Second, while for privacy reasons I have deleted some personal items relative to the author's family, she made use of a familial connection to medicine to generate a sense of camaraderie and appearance of some technical knowledge of the field. Finally, there is an element of informality in the closing, i.e., use of first name and "Cheers", as a way to present a sense of intimacy, along with the offer to hold conversations confidential.

On the substantive side, notice the choice of topic, as though there is something special or unusual about the issue of patient bed delays at this hospital. Every hospital in Boston has delays in patients passing through the Emergency Departments. This has been well documented. Ultimately has to do with how much bed capacity you choose to build on the medical/surgical floors and in the ICUs. Each hospital tries its best to manage bed capacity and avoid the need for expensive new construction. (I wonder if the SEIU has written letters like this to all of the Boston hospitals.)

From: Sara Rothstein
To: Dr **
Subject: Patient Bed Delays @ BIDMC

Dr ** -

A number of physicians across BIDMC have suggested that I talk to you about the hospital’s challenges with patient bed delays.

By way of introduction, I am working with SEIU 1199/United Healthcare Workers East and leading its new physician outreach project in Boston. The outreach project is being done in conjunction with the union's efforts to organize healthcare workers at hospitals across Boston. . . .

SEIU 1199/United Healthcare Workers East has a strong history of partnership with healthcare providers and we would like to have similar partnerships in Boston, with the hospitals and with the physicians. As such, I am meeting with physicians to better understand the concerns and priorities in their departments. A number of people have expressed frustrations with delays in moving patients from the ED to inpatient units, moving patients between inpatient units and moving patients out of the hospital. Everyone I’ve spoken to has recommended that I speak with you for more information.

Would you have some time to talk more about this? The conversation would absolutely be confidential. I’d be happy to meet with you at the hospital or elsewhere if you prefer.

I look forward to hearing from you.


Sara Rothstein
Physician Relations

p.s. I want to apologize that you didn’t receive a letter we sent to BIDMC physicians last month. The letter to you was just returned to the union for being sent to the wrong address. I am attaching a copy of the letter and related attachments to this email. The letter was sent to physicians to explain our position on Free and Fair union elections. There has been a lot of back and forth on this topic between Paul Levy and the union and I’d be happy to answer any questions you may have.


Rob said...

Well this is just a dumb marketing tactic. Once the reader figures out it's a con, do you really think s/he is going to have a good impression of you? This is about generating numbers, and hoping that a few will nibble.

It's really amateurish.

Which just proves that, if they really DO have patients' interests at heart, do a clean job of it and prove just that. Don't con people. Conning people into listening just proves you're not serious.

This is just poor poor poor and no wonder you're annoyed, Paul. I hate liars too, especially cheap ones who insult our intelligence.

I support workers' right to organize. I don't support bad con jobs.

Anonymous said...

I really like your blog but I think this time you are a little defensive and nitpicky on the letter. I do not think it was intended to create a divide between administration and the medical staff. Rather, I think it is a way to dig up information that will be used against the hospital. Bed availablity many times has as much to do with adequate staff as it does with actual beds, I suspect that is where they are heading with this. I also sincerely doubt that the SEIU has any brilliant ideas about how to solve this issue. Holds in the ED are the end product of many issues: RN shortages, the number of uninsured in this country, lifestyle choices, aging of our population, the way we have set our health system up in this country etc...

Anonymous said...

Dear Mr. Levy,
Where is the fun loving guy that I used to read? You are becoming a bit cranky with this union talk. Don't let them get to you. They will be gone soon enough as long as you are honest and fair with your employees and treat them with respect.
Yours truly...

Anonymous said...

As someone who is fundamentally supportive of worker's rights and issues - a good liveable wage, workplace safety, career ladders, and true, meaningful employee empowerment - I am incredibly saddened and stunned by the type of slur campaign against public charities that SEIU has run in jurisdictions throughout the country. I am astonished by the financial and other resources directed to these very sophisticated tactics (and indeed, to the political campaigns as cited in news reports). Why aren't union dues devoted to improve the lives of union members? Why not reinsure catastrophic health care costs? Why not subsidize transportation costs for workers (as most Boston hospitals do)? Why not join with health care providers and consumers on common safety, quality and health care access goals? Their current tactics are repugnant to observers who would otherwise call themselves true and historic friends of labor. The quest for more members at any cost -- and the money that brings to the union -- has blinded them to the good they could be doing right now in every state in the country.

Anonymous said...

I agree with anon 5:14; the bed issue is a convenient red herring, although it may prove useful to them also. This is really an effort to solicit gripes from physicians about the hospital, to give the union more ammunition about issues they are currently unaware of.

I have some procedural questions - was this email sent to just one physician, or many? (The p.s. about the previously sent letter was confusing). If one, would he/she happen to be serving on the medical executive committee or anywhere else where he/she would have knowledge of problematic internal issues? If so, how coincidental!

Last, I can vouch that the bed problem is decidedly a NATIONAL issue, and that is no secret at all. That's why I think it's a red herring.

Anonymous said...

And p.s.; I repeat my earlier advice to the medical staff to stay the heck out of this one. It will be bloody and if you take sides the medical staff will make enemies no matter who wins.

Anonymous said...

Dear anon 6:36,

Thanks very much for the supportive words. Don't worry, I'm not cranky! Stay tuned for lighter moments!

But you are probably wrong about these folks being gone very soon, even though we do as you say and have the highest regard for our workers. Just look at the experience in other cities across the country.

Anon 7:30. Some great points. Isn't it interesting, for example, that there is nothing in any of these letters or elsewhere supporting what BIDMC has done to provide public access to clinical results on infections and other issues in our hospital, especially compared to every other academic medical center (unionized or not) in Boston?

Anonymous said...

This is an interesting glimpse into the scale and force of the union organization. I think it's amazing that they are able to track which doctors have or haven't received sent letters, and then follow-up. That takes a tremendous amount of resources. How are these being paid for? Probably workers' dues. Frankly, I think its a little disingenuous for the union to insist on your not using "patient care funds" for activities related to organizing when they are doing the same thing with worker dues that derive from and could otherwise be spent on the same. What makes one more right than the other?

Anon 7.30 - you're right on.

Toni Brayer, MD said...

Same tactics are used on the West Coast by SEIU. If I were a union member, I would hate that my dues are being spent this way. I support workers rights but SEIU is hurting health care for patients and driving up costs.

Paul, you can erase this part. Check out my latest blog and let me know what you think. Best. TB

Anonymous said...

Well written, yes. But it still reminds me of one of those prolific foreign e-mail solicitations I receive from time to time offering me my share of a windfall of money if I only provide my bank account number.

I guess if you really think about it for a moment that's pretty close to what it actually is isn't it?

Stay strong Paul!

Anonymous said...

Anonymous 11:20, I don't think the union keeps track of mailings that have bounced back because, as you say, that would be an incredible amount of work. I suspect that this is the first mailing to this physician, and the concerned letter about bed problems is just a cover to get the physician to read the real letter about union elections. But then, I may simply be a highly suspicious person.