番茄社区

Healthcare workers have long been afraid to speak out for patient and staff safety, but the pandemic "just made this visible to the public and the media."

That's according to Ming Lin, MD, the emergency physician from Washington state who was fired in the early days of the pandemic for speaking out about safety concerns.

Lin spoke during a session of the , a 2-day meeting aimed at calling attention to the increasing influence of large corporations in the practice of medicine and the detrimental effects on physicians and healthcare workers.

"The atmosphere we work in is becoming increasingly corporate," Lin said during his presentation. "Are the companies we work for any different from Amazon or Microsoft, whose primary objective is profit?"

In March 2020, Lin wrote a letter to the chief medical officer of his hospital, St. Joseph Medical Center in Bellingham, Washington, which is owned by PeaceHealth, and . He criticized coronavirus safety procedures, particularly around testing, and continued to lob criticisms for several days. He subsequently lost his shifts at the hospital.

Lin and the American Civil Liberties Union (ACLU) subsequently , the hospital contractor that employed Lin and provided emergency physicians to the hospital.

Lin had worked at the hospital since 2003 and has been an emergency physician for more than 30 years. He said during the summit that corporate influence in medicine has increasingly reared its head in many ways.

Hospitals have set their sights on controlling the medical staff tasked with approving physician privileges for each hospital, Lin said.

"At any point, the medical staff can revoke a physician's privileges," he said. "Hospitals over the last 2 decades are competing to control the medical staff and strip them of their independence. With the medical staff as pawns, hospitals can manipulate physicians to do what they want."

"If you want to keep working and pay off your half-a-million-dollars worth of student loans or your mortgage -- or your yacht, if you're an orthopedic surgeon -- you better listen to the medical staff," Lin said.

When it comes to social media, he noted there's no U.S. law prohibiting corporations from monitoring employees' posts -- even if they're done "from your own home, on your own personal device, and on your own free time."

"Healthcare whistleblowers in this country have been approached by their supervisors in less than 48 hours" of posting, he said.

Lin also said he no longer sees hospitals' human resources (HR) departments as advocates for staffers. He cited polls showing that employees believe HR is a resource for the employer, not the employee, and that workers wouldn't report discrimination to HR over concerns about retaliation.

"Corporations are meant to generate maximum profit," he said. "It's their nature to do so. Unfortunately, there are consequences. It's a bit like throwing a raccoon in a henhouse. If we silence healthcare workers, the outcome would be even more disastrous."

Robert McNamara, MD, chair of emergency medicine at Temple University and a co-founder of TakeEMBack, said during a press briefing that Lin's story shines a light on the problems with the lack of due process written into corporate employment contracts.

"Physicians risk their livelihood to speak up on quality-of-care issues," McNamara said. "The denial of due process enables it. Emergency physicians can be fired on short notice without a chance to contest the claims," because staffing firms risk losing their contracts if they upset the hospital's administration.

Lisa Moreno, MD, president of the American Academy of Emergency Medicine (AAEM), said physicians deserve the right to due process.

"We need the right to be told why we've been fired. We need to face our accuser in that corporation, and we need a jury of our peers, other doctors ... to hear us defend ourselves," she said.

"Corporations don't want to spend money on this," Moreno continued. "They routinely say to doctors, 'If you want to work for us, you must waive your due process rights.'"

She added that AAEM "has a long list going back decades of physicians who were fired solely because they spoke up on behalf of the safety of patients, or admitted too many homeless people, or discharged too many people with good insurance that the hospital wanted to keep."

"This is not the way medicine should be practiced," she said.

Moreno noted that a bill, the was introduced in the House of Representatives last year by former Rep. Roger Marshall, MD (R-Kan.), that gets at this lack of due process. It aims to require hospitals that employ or contract emergency physicians to provide due process protections before taking actions around employment. Hospitals wouldn't be able to terminate or restrict the professional activity or staff privileges of physicians without a fair hearing and review process.

The was organized by Chicago emergency physician Mitchell Li, MD, and other emergency medicine physicians who believe corporate influence in medicine has hit a boiling point where both patient safety and physician autonomy are severely threatened. While TakeEMBack focuses on emergency medicine, the group is also pushing the call to "take medicine back" across specialties.

Comment