Once a sought-after workplace, Mercy Medical Center in Springfield faces a potential mass exodus of doctors, physician assistants and nurses in the emergency department, as they claim the non-profit hospital focuses on “their bottom line.”
MassLive spoke with multiple medical staff members close to the situation who all agreed to talk with anonymity due to fear of retaliation.
One staff member said when they joined the hospital, it was all about patient care.
Now, “patients are just numbers and you need to see more numbers.”
Others stated the emergency department has become “chaotic,” and another said the changes have made it “really unsafe for patient care.”
The turmoil began earlier this year when changes to the emergency department’s operations added stress that led to burnout. Now, tensions have reached a breaking point for many staff members as Trinity Health moves to outsource staff to Vituity — a for-profit, physician-owned group from California whose arrival previously caused staff departures at hospitals in Connecticut.
The collaboration, Mercy Medical Center and Vituity said in a joint statement, “strengthens our commitment to improving access and delivering high-quality, patient-centered care while ensuring the long-term sustainability of these essential services.”
The statement highlighted Vituity’s “long history of success in improving patient care, emergency department efficiency, and provider support in many states across the country, including now at Trinity Health Of New England hospitals in Connecticut.”
But those MassLive spoke to in the medical field and lawmakers in Connecticut aren’t convinced — pointing to Vituity’s troubled track record, including departures when the company recently moved into Connecticut.
Massachusetts Nurses Association (MNA) feared the Connecticut departures would bleed over into Massachusetts. But Trinity Health told the union just a couple of months ago the same thing wouldn’t happen in Massachusetts. Now, that promise has already unraveled, the union says.
Medical staff agreed there were improvements that could’ve been made to Mercy Medical Center’s emergency department, including hiring techs or fixing delivery system to the lab that has been broken for more than a year. But staff who spoke to MassLive said those changes still aren’t being addressed.
Instead, a new system was created at the beginning of the year in hopes of seeing more people with less resources and staff, multiple staff members told MassLive. This included putting people in emergency room hallways and asking staff to sign on to patients they hadn’t yet had the chance to evaluate. If there is an empty space, a patient is being put there regardless of what else is going on, staff said.
Recently, emergency department waits have been 18 hours, although, it’s more common to wait about eight hours. And patients can wait five hours before being seen after being put in a bed. Just getting them to a bed is considered enough, staff said.
“We were already feeling that stress,” one staff member said.
About a month ago, people started giving their resignation notices, including some staff members who never thought to leave before. The notices are often made 120 days in advance. Those made more and more of the physicians reexamine “what our future is.” As the number of physicians and physician assistants agreeing to stay dwindled, the staff left behind fear for their community.
“It’s really unsafe for patient care,” one person said.
It could also affect physician assistants’ licenses, as there is a legal requirement for physician assistants to register a specific supervising physician with the state. But with so much uncertainty, it has some fearing for more than just this job.
The nurses’ union said it has been meeting with the hospital monthly to try to improve conditions for its staff with little success. But physician assistants don’t have a union to support them.
Despite these conditions, staff told MassLive they’re doing their best for their patients.
Instead of addressing what staff concerns were, including from the MNA, Mercy Medical Center told emergency room staff they could either sign on with Vituity or find a new job.
As staff began asking questions, there weren’t many answers, staff members said.
At one point, staff were told the partnership would begin in July, while they were later told it will start June 1. None of the people MassLive spoke with have been allowed to see contracts or know if their pay will be the same.
A press release provided to MassLive confirmed the partnership begins in June. It only affects emergency department staff.
“Our patients will benefit from Vituity’s experience in delivering high-performing emergency care across diverse communities nationwide,” said Robert Roose, president of community hospitals, Trinity Health Of New England. “This collaboration will also enable Mercy Medical Center to advance our Mission in the communities we serve and to uphold the highest standards of care.”
All emergency medicine providers will be offered the opportunity to continue working through Vituity, Mercy Medical Center’s statement said. Mercy administrators will also work with Vituity to continue any visa and loan forgiveness programs that may already be in place for current emergency medicine providers.
But contracts might not be available for weeks, nearing the June 1 start — a similar tactic used in Connecticut, said Connecticut state Sen. Dr. Saud Anwar, Democratic co-chair of Connecticut’s public health committee.
Some staff have turned to Reddit for answers.
One staff member read on Reddit that other people’s pay didn’t change at first but it did later. It was tied to profits.
“Springfield is no Beverly Hills,” one person said, adding that profits shouldn’t be the point of helping a community like Springfield, where people might not have insurance or have Medicaid.
Some doctors are looking elsewhere, as they feel they have options. But some staff consider Springfield their home and don’t want to — or can’t — leave.
“It’s not good for Springfield,” one staff member said.
Nurses are also bracing for the change.
Although their jobs are not directly being affected by the new company, their day-to-day will drastically change.
Ann Marie Paquette has been a nurse for 45 years, including 16 years in the emergency department at Mercy. She knows the doctors she works with and they know her. It helps them both work faster and better as a team.
She said the current doctors also help out newer nursing staff, which is incredibly important. It leaves her wondering, will the new people brought in by the for-profit company be willing to take the time to help others?
But Mercy said staffing needs might change, including being hopeful that people may reconsider their earlier decision to leave Mercy.
Lawmakers and healthcare workers tried to put a stop to Trinity Health of New England partnering with Vituity for four of its Connecticut hospitals, saying it would adversely affect hospital employees and patients, Connecticut Public Radio reported in January.
“On Jan. 6, we all received emails that we have 90 days to either leave the communities that we have served for decades or sign up for a for profit company without any details,” Dr. Gagan Singh, regional director for hospital medicine at Saint Francis Hospital in Hartford, Connecticut, told the news outlet.
Anwar said lawmakers tried to tell Trinity to “stop this right now. Reverse your decision right now.”
But the not-for-profit health system continued with the decision to outsource some of its employees.
About 120 physicians, some of whom had been working in the area for more than 15 years, had until April 7 to agree to work for Vituity or lose their jobs.
“They did not have enough time to seek a job,” Anwar told MassLive. “It was done in a very poor taste and very poor communication and unprofessional manner.”
Additionally, Anwar said the physicians “were not given the details of the contract” and not given the chance to make informed decisions before signing or losing their jobs.
About 30 physicians did not return to Trinity Health of New England, leaving Connecticut for work elsewhere, Anwar said.
For those who stayed, quality of life has diminished, as they are expected to see more patients than they should, Anwar said.
“The quality of life for the physician is not as good,” he said, adding the quality of patient care, therefore, also goes down.
Now, he’s working to try to pass several bills in Connecticut to stop this sort of thing in the future.
“We’re trying to work on some bills here to have a large change like this go through the Attorney General’s Office and the Office of Health Strategies,” he said.
These changes would include if a private equity company is going to be involved in healthcare, if the value of the buying entity is more than $10 million or it includes more than five physicians. It also encourages transparency and a due process to allow physicians to look over their contracts.
“We’d never thought people would be that unprofessional and also so profit driven that they would use these kind of mechanisms, but they did,” he said.
The senator encourages Massachusetts to do the same.
“There’s a shortage of physicians in the country, and there’s a shortage of physicians in New England. If we do not treat our physicians in a fair manner, we will lose them to other parts of the country. And most of the parts of the country are very welcoming to physicians from our parts of New England,” he said.
This isn’t the first time there have been issues at Mercy Medical Center this year.
The Occupational Safety and Health Administration (OSHA) is investigating the hospital for an effort to reduce injury reports in a way that a national expert, and former OSHA official, sees as “gaming the system.”
Last year, a regional director for Trinity Health sent out an internal training document focused on how to treat worker injuries in ways that — when possible — don’t require a report to OSHA, The Republican reported. It was directed at the emergency department teams and sent to some employees at Mercy Medical Center.
“Can you provide an ACE wrap instead of a splint?” it says. OSHA considers a wrap first-aid, which does not trigger a report, while a splint is categorized as medical treatment, which must be reported to OSHA.
MNA filed a complaint with the state over the document.
“For them to treat their employees in this way is pretty effed up,” Ronald R. Patenaude, associate director of labor action at the MNA who works with nurses at Mercy Medical Center, said.
And nurses said things haven’t improved since picketing outside the hospital’s main entrance to raise concerns about their working conditions last fall.
“Support the frontline not the bottom line,” read one sign. “Trinity has no mercy,” another read.
“Our working conditions are increasingly unsafe and unsustainable, and our wages are falling behind, making it harder to recruit and retain nurses,” Dee Doyle, a nurse and co-chair of the union bargaining committee, said in a statement.
The union told The Republican that staffing is a problem. When nurses are out sick, they struggle to have enough people to cover for them, said Jaime Hyatt, a registered nurse at Mercy and co-chair of the union committee that bargains with the hospital.
State law says that in an intensive care unit, a registered nurse can take care of one or two patients, depending on their condition. But with staffing issues at Mercy, Hyatt said ICU nurses are often caring for two patients. “That’s just not safe,” he said.
Nurses have 30 minutes for lunch, Hyatt said, but many don’t have time to stop working. “You’re just too busy,” he said.
Months later, the issues remain the same, Paquette said, adding that she recently stayed after her shift because there wasn’t enough nursing staff and the waiting room was full.
“It’s not safe for the patients,” she said.
Her shift once took years of experience and skill to earn. Now, they can’t even keep it staffed.
Those who remain, especially new nurses, are often found crying mid-shift, crushed by the chaos, she said.
Previous reporting by Greta Jochem was used in this article.
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