TACOMA, Wash. -- Doctors at MultiCare Indigo Urgent Care clinics say their union has authorized a strike, citing unsafe working conditions, lack of Personal Protective Equipment and concerns over how patients are scheduled and seen.

There are 22 MultiCare Indigo Urgent Care locations in the Puget Sound region, plus five clinics in Spokane and the inland Northwest. MultiCare physician Brian Fox said the company's 12-hour work shift policy and mandate that all patients who enter a clinic's door must be seen have exhausted doctors, with an uptick in volume during the pandemic.

"If a dozen patients walk in at 7:55 p.m., according to our policy, we're obligated to stay until all of those patients are seen," Fox said. "You know, after an exceptionally long day of seeing 40 or 45 patients in a shift, we wanted to have the option for patients that weren't as ill to say, 'Can we please reschedule you for tomorrow morning?'"

In a written statement, a spokesperson for MultiCare said they remain committed to the negotiation process and are working hard to negotiate a fair labor contract, and said its urgent-care clinics offer a number of shift options.

President of the Union of American Physicians and Dentists Dr. Stuart Bussey said doctors have reached a breaking point after a year of contract bargaining. He argued MultiCare's management hasn't taken its providers' concerns seriously enough.

"Doctors need a voice, an unimpeded voice, to advocate for the patient," Bussey said. "We still have the duty to take care of the patients as much as we can, without the interference of a profit-minded entity, called 'the employer.'"

Bussey added large healthcare corporations often are determined to see as many patients as quickly as possible, to increase revenue. He contends this makes for stressful and unsafe working conditions for staff, and less quality care for patients.

"It's now behind the military, the expenditure of this government - 19% of our gross product - is for health care, over $3 trillion," he said.

According to a Medscape survey, two-thirds of U.S. physicians report worsening levels of burnout and loneliness in the pandemic. The American Medical Association has developed some new resources to help physicians handle the increased stress and anxiety.


get more stories like this via email

Until the pandemic, telehealth and telemedicine were still outliers in health care but they have gone mainstream, especially benefiting underserved and rural New Mexico communities.

Heather Dimeris, director of the Office for the Advancement of Telehealth at the Health Resources and Services Administration, the primary federal agency tasked with improving access to health care services for people who are uninsured, isolated or medically vulnerable, said a national conference being held today will bring public- and private-sector leaders together to discuss topics related to best practices.

"Telehealth licensure, agreements between states to help practitioners practice across state lines, as well as access to broadband," Dimeris outlined. "This is free and virtual and it's open for the public."

Dimeris explained government data show patients who get telehealth services have the same, and in some cases better, outcomes as in-person visits.

Dimeris noted underserved communities often see benefits and improvements in their quality of life through behavioral-health services via telehealth. And those who qualify can leverage the federal Lifeline program, a free government phone service through the Federal Communications Commission.

"Internet is really a foundation of good telehealth services and we can do audio-only appointments, or appointments over the phone, but it's always nice to at least have the video chat," Dimeris pointed out. "That connectivity can be really hard in remote areas of New Mexico."

She added expanding virtual visits could cut down lengthy waitlists for urgent appointments. And she acknowledged many people seeking mental health services prefer to talk with a doctor in order to bypass stigma sometimes experienced with office visits in small communities.

A new analysis from Washington state shows passing an initiative making a long-term care benefit program optional could cost taxpayers millions.

Initiative 2124 would make optional the WA Cares program, in which workers contribute a little more than 0.5% of their paychecks for access to long-term care benefits. The Office of Financial Management estimates passage of the initiative would cost the state between $12 million and $31 million within three years.

Kristin Hyde, press secretary for the group No on 2124, said other analyses have found even greater consequences.

"This initiative would effectively actually end the program, it would shutter it, it would bankrupt the program," Hyde contended. "By 2027, in effect benefits would not be able to be paid out for the nearly 4 million workers who have been vesting in the program."

Supporters of the initiative, including Rep. Jim Walsh, R-Aberdeen, said the program provides little practical effect and people should have choice on whether to contribute to the program. Under the program, Washingtonians will have access to up to $36,500 in benefits from the WA Cares Fund starting in 2026.

Hyde noted the program can be used to pay home aides, for instance, which could help more than 800,000 family caregivers in the state. She added many caregivers are women who sometimes have to choose between work and taking care of family members.

"Long-term care is not covered by regular health insurance and it's also not covered by Medicare," Hyde pointed out. "It's this gap and so we're really in a rock and a hard place here. We don't have anywhere to turn."

Hyde explained it is why state lawmakers approved the WA Cares Fund. She stressed the benefits are flexible and available for use on expenses like home modifications as well.


get more stories like this via email

Kentucky has made some changes to expand access to free transportation for people who need help getting to medical, dental and mental health appointments, picking up prescriptions and more.

Medicaid's nonemergency medical transportation benefit will now include individuals who own a working vehicle but cannot drive due to a medical condition.

Emily Beauregard, executive director of Kentucky Voices for Health, noted it also applies when using the vehicle conflicts with another household member's need to drive to work, school or their own health care appointment.

"It's going to mean that a lot more Medicaid members will be able to schedule these appointments, make it to the doctor, and not have to schedule everything around when a car or a ride is available to them," Beauregard explained.

If the vehicle is unusable or is unsafe, Medicaid members will need a note from a clinician, employer, school, mechanic, or transportation authority stating the vehicle isn't operable. Nearly 60% of Kentucky Medicaid beneficiaries report lack of reliable and affordable transportation as a barrier to receiving health care services, according to data from the University of Kentucky.

Amber Sparks, a Corbin resident, said she relied on nonemergency medical transportation when her son experienced a mental health crisis requiring hospitalization. She recalled not until she needed nonemergency medical transportation did she realize it was available.

"Another instance that I had to deal with it is that my dad was diabetic, and he wasn't homebound, but he did need daily care and daily back-and-forth to appointments," Sparks recounted.

Beauregard outlined how Kentuckians can find out if they quality for transportation assistance.

"They can call the regional broker in their area," Beauregard pointed out. "If they don't have a car in their name -- or if there is a car, but it's in use for work or for school by another adult in the household -- they should be able to get approved for nonemergency medical transportation."

She added rides can be scheduled with those regional brokers by appointment, Monday through Friday, 8 a.m. to 4:30 p.m., or Saturday from 8 a.m. to 1 p.m., at least three business days before their trip. A list of brokers is online at kyloop.org or by calling Kentucky Medicaid at 800-635-2570. For medical emergencies, call 911.