Doctors on Strike?
LifeLong Medical Care was founded in 1976 to fill a gap in healthcare services for marginalized community members in Berkeley. Since then, it has grown to over 20 locations offering medical, dental and behavioral health services in the East Bay and Marin County to underserved populations, including low-wealth, unhoused, undocumented and elderly patients.
In 2018, Dr. Angelina Shigeura was hired by LifeLong Medical Care as a family medicine physician. Growing up in East Oakland, Dr. Shigeura’s dream was always to serve the community where she was raised.
Dr. Shigeura’s work day provides insight into the challenges many of our community’s healthcare providers face. Beginning at 8am, Dr. Shigeura meets briefly with her medical assistant before seeing her first of 22 patients. Dr. Shigeura is allotted 15-minutes per patient consultation. In that time, she connects with each patient, provides a diagnosis and treatment plan and then must “close the visit” in the patient’s electronic medical record. Closing the visit is critical as that’s how the clinic gets reimbursed for services by Medicare/Medicaid and other insurers. Dr. Shigeura has time to close about 2/3 of her patients during the day; the rest are completed after 5pm, when she’s off the clock.
Her work day doesn’t end there. Then, Dr. Shigeura checks the filing cabinet where there are notes from patients, physical therapy referrals, home health orders and the like that need her signature. Finally, she addresses the urgent items in her electronic medical records inbox that include medication refills, patient calls and x-ray results. Dr. Shigeura leaves the clinic around 6:30pm, and spends another hour or two at home working.
Even with the extra hours she works each evening, Dr. Shigeura can’t complete all of the necessary tasks. Dr. Shigeura gets paid for working 33 hours per week, even though most weeks she works 50. She laments, “I’d like to spend 40 hours of patient-facing time, but that would require me to spend all weekend catching up on the additional work needed to be done. It’s demoralizing because we’re constantly told it’s our own inefficiencies, instead of a systems failure. We lose a lot of people because this doesn’t feel sustainable.”
In fact, the medical provider attrition rate at LifeLong has increased dramatically over the past few years. LifeLong providers are dedicated to serving the most marginalized in our community. They take the job knowing they will get paid less and work more hours than their colleagues at HMOs and private practices.
As LifeLong expanded to more locations, the needs of their providers fell to the wayside. Two years ago, approximately 140 LifeLong providers unionized with the Union of American Physicians and Dentists (UAPD). UADP was formed as a response to the extractive, for-profit model of the current healthcare industry, which has rendered the human aspect of healthcare almost invisible. UADP’s mission is to ensure providers are involved in decision-making at all levels of healthcare — and most importantly that healthcare itself is a human right!
In early 2022, the workers began to negotiate their first contract with LifeLong management. Dr. Shigeura is a member of the bargaining team. Over 15 months later and with an impending strike, management finally agreed to mediation.
The one-day strike took place on Tuesday June 27 outside the West Berkeley Health Center on Sixth Street, where dozens of workers rallied. Coffee, treats and sandwiches from local eateries were plentiful. Occupella performed to lend their support. The mediation will continue the first week of July.
Dr. Shigeura would love to spend her career at LifeLong, but that will only happen if an agreement is reached. “We’re not trying to tear LifeLong down. We’re elevating these issues primarily for the good of our patients.”
This article was first published in the Berkeley Times on July 6, 2023.
