Doctors Criticize Conditions at the Santa Cruz County Health Services Agency

Jun 13, 2013, 10:00 ET from Union of American Physicians and Dentists

SANTA CRUZ, Calif., June 13, 2013 /PRNewswire-USNewswire/ -- Doctors working for the Santa Cruz County Health Services Agency (HSA) don't believe that County administrators are doing enough to fill vacancies in their unit, particularly in the Child Mental Health and Adult Mental Health Services.  As a result of the County's doctor shortage, children and adults with severe psychiatric issues are often required to wait weeks or months to begin treatment.  Many of those patients are then passed between multiple doctors as the County relies heavily on outside contractors, most of whom stop working after a few months.  County doctors are concerned that the chronic short-staffing and constant turnover of contractors have left severely mentally ill patients without proper care, creating problems that affect the whole community.   In negotiations with the County this year, doctors have asked the County to do what it takes to hire more permanent staff members.    

To attract new hires, UAPD, the union that represents Santa Cruz County doctors, has been seeking modest cost of living increases for doctors starting next year.  However,  the County has insisted on two more years without a pay increase.  In addition, the County wants further cuts to doctors' health care and retirement benefits, which are already less generous than what other County workers have.  Negotiations reached an impasse in late May.  Both sides will attempt to resolve the disagreement during in mediation in July.

"After all the concessions we've made in recent years, our salaries and benefits aren't enough to attract new doctors, or keep the ones we have," says Patrick Teverbaugh, M.D., who has worked as a psychiatrist for Santa Cruz County for twenty-one years.  Since 2011 nine doctors have left County service, out of a bargaining unit of fewer than twenty.    The County has posted the vacancies, but most doctors who are offered positions with the County do not accept them.   

County doctors do not accept management's claims that the County cannot afford to make improvements.  Using outside contractors to provide mandated care is far more expensive than hiring County doctors.  To temporarily fill psychiatrist vacancies during the last year, the County has relied on nine different contract doctors, who each cost up to $225 per hour (or $468,000/year).  Moreover, in the last two years, County doctors voluntarily contributed more than $400,000 in additional revenue to the county budget, by handing their portion of federal Electronic Health Record (EHR) incentive money over to the County.  That extra revenue could be used to help recruit and retain doctors.  

"We have tried to settle this at the bargaining table, but no one on their side seems willing to do what it takes to fix this problem.  We are starting to suspect that the County does not want to have any doctors on staff, that they would prefer that we all take other jobs and that our positions sit vacant forever.  Which would be a disaster for the health of this community," says Joann Moschella, D.O., a family practice physician who works with children and adults in the County's Watsonville clinic. 

The County's recruitment and retention problem will worsen as competition for doctors increases with the implementation of the Affordable Care Act.   In its 2012 Report to the Community, the Health Improvement Partnership (HIP) of Santa Cruz County warned,  "According to the American Association of Medical Colleges, the United States will be short some 45,000 primary care physicians by 2020.  Locally, this predicament is even worse...With health care reform this gap in primary care will only multiply." 

SOURCE Union of American Physicians and Dentists