Cuts put patient care in jeopardy

MORE THAN 250 doctors, nurses, staff members and community members rallied across the street from Harlem Hospital on October 13 to draw attention to the fact that New York City's Health and Hospitals Corporation (HHC) is waging an attack on workers--and quality patient care is in danger as a result.

Doctors Council SEIU mobilized doctors, the New York State Nurses Association turned out its members, and other staff members--from environmental services to fellows studying at Columbia Medical Center to social workers--came out to show solidarity and support.

The economic crisis that's hitting Harlem especially hard was the backdrop to this rally. More than a year ago, HHC announced that it had a $1 billion "structural deficit" and would therefore be "restructuring" to cut costs. And what HHC means by "restructuring" is increasingly clear.

A few months ago, HHC collaborated with a sensationalized media frenzy in order to help smear Columbia University doctors at Harlem Hospital. A huge backlog of unread echocardiograms was found, and stories about lazy, overpaid doctors hit local and national news media. Around the same time, staff members were forced to go to numerous mandatory hospital-wide meetings about "personal responsibility" and "working together to fix our compromised image."

For years, HHC has denied doctors' requests to fill vacant positions in the Division of Cardiology--which is what's needed to get the staffing to read the echocardiograms, doctors say. Soon after the scandal, HHC announced the termination of the long-time affiliation with Columbia, starting on December 31, 2010.

Clearly, the doctors were thrown under the bus, and HHC used a media campaign to justify the changes. And if a few patients were put in danger in the process, it was worthwhile in HHC management's eyes.

SINCE THEN, the picture of HHC's "restructuring" plan has become clearer and clearer.

Columbia affiliates--including doctors, resident doctors, fellows, administrative staff and workers from many other programs--were mailed termination letters through FedEx a month ago. Supposedly, an unnamed, unknown "non-academic" entity will take over and make these workers new offers (the ones that aren't laid off, that is). To this day, there is no concrete offer, and no information on this unnamed entity.

Both the neurosurgery and rehabilitation medicine departments are closing. There are also rumors that more departments could be cut. HHC says that these departments don't serve enough patients to justify their existence. Apparently people with disabling conditions and diseases don't deserve to exist at Harlem Hospital if they don't bring in enough money.

So even though 10 percent of positions are currently unfilled, administrators plan to lay off another 10 percent of the doctors. And as many as another 15 percent or more doctors may leave due to "layoffs, removal of services and fear of declining patient care standards," according to an open letter from the Medical/Dental Board to Mayor Michael Bloomberg. It should also be noted that the average doctor at Harlem Hospital makes half of what doctors in private practice take home.

There were numerous speakers at the rally, and their tone was appropriately militant and angry. Democratic politicians assured the crowd that the party--from the bottom to the top--will "bring HHC to the table this week to find out what is going on."

The president of the Harlem Chapter of the NAACP said, "Doctors will not be cut. And that's not a threat. That's a fact!" The crowd responded with cheers and shouts, "That's right!"

When one of the politician said, "You know why I'm not going to let doctors be cut?" and then pointed to his doctor saying, "Because that's my doctor!" the doctor raised his fist and people chanted, "Whose hospital? Our hospital!"

Rev. Jesse Jackson of the Rainbow Coalition spoke about the insanity of letting profits dictate health care decisions. He pointed to the renovation at Harlem Hospital and said, "How are they going to prioritize all that money on a new hospital and then not have any doctors to fill it?"

While there was no next step put forward, and while the politicians fired people up only to assure them that they "would take care of it," the show of support was nevertheless a real morale booster for anxious workers who have been under relentless attack.

Keep an eye out in the coming months. Some workers at Harlem Hospital will be ringing in the New Year newly jobless. Union members will be entering negotiations for a new contract with the "unknown entity." And some workers may be signing new offer letters for who-knows-what wages and benefits.

That perhaps is the worst part of all of this. No one knows what their lives will look like, and how and if they will be able to make ends meet in 2011.