Banding together in the center of Freedom Plaza, union members of Unity Health Care rallied for change on Saturday, March 15, urging management to reconsider scheduling practices that they allege is “unsafe” and affecting the quality of care.
Spearheaded in partnership with the Union of American Physicians and Dentists (UAPD), care providers, support staff, and patient advocates are continuing ongoing efforts a little over a year after their initial call for management to address regressive working conditions and quality of patient support.
“We’re here today to talk about the working conditions that our colleagues have faced over the past year, both from our providers, to the support staff, to the nurses — all unionized —pointing to mismanagement on Unity’s part,” said George Kerr, representative and organizer at UAPD. “By unionizing [we are showing] that we need more of a say in our workplace so that we can provide the care that D.C. knows. We need to fight for a fair contract.”
The recent protest falls on the heels of Unity Health Care’s President and CEO Dr. Jessica Henderson Boyd announcing her departure from the community health center, effective May 2, after more than five years of service to the organization.
“I’m proud that in 2024, we were able to achieve a positive margin after significant challenges earlier in the year, marking three straight years of a positive bottom line. We’ve done this in many ways including growing our fundraising program and expanding our pharmacies in addition to the important financial stewardship we do every day to ensure we are cost efficient,” said Boyd on the morning of March 5 in a written statement to Unity staff members. “We’ve continued to see momentum in our key quality metrics while also making progress on creating spaces with dignity and respect for our patients to receive the care they need.”
But despite her glowing remarks, under Boyd’s leadership, UAPD members detail that nearly all Unity employees, including providers, support staff, and nurses, have unionized amid rising tension surrounding what they deem as irresponsible scheduling practices encouraging unsafe health outcomes for their patients.
Since their last public meeting in September 2024, members lament that conditions have only gotten worse with no significant improvements on behalf of management.
“A little over the course of the year, [staff has] unionized, because Unity’s business management has caused their staff to go to this point, and it’s also pressuring patients,” Kerr told the Informer. “As of now, their councils relayed that [Boyd’s departure] doesn’t change anything in bargaining. [However], we feel that this is a sign that Unity wants to change from a board’s point of view. We’re hoping that whoever they pick will be connected with the community, the patients, and the staff.”
Healthcare Provider Challenges
Narrowing appointment times in conjunction with an uptick of patient visits per provider, has left staff with unreasonably limited time to address patient concerns and provide continuity of care to long-time patients amid tight scheduling.
Currently, physicians at Unity are scheduled to see up to 24 patients a day, which providers like Dr. Kate Sugarman, a family medicine physician at Unity’s Upper Cardozo campus, says is unreasonable. Providers are requesting a safer schedule of roughly 18-20 patients per day and eight hours a week of paid administrative time to catch up on abnormalities.
She further details the impact of these scheduling practices that have left approximately 40,000 patients without a medical provider, doctor, or a nurse practitioner.
“We care about providing high quality healthcare to people who are poor, people who are underinsured, people who are underserved, and people who have complex medical and psychological needs,” Sugarman said. “We are not here because we are slacking off, but management accuses us of slacking off, and they schedule us a punishing, unsafe schedule of more and more patients.”
Gripes from union members intensified when management’s response to their concerns came in the form of hiring extensive lawyers instructing staff to further enforce the very scheduling practices that have put the health of Unity patients at risk. Simultaneously, the network of community health centers have seen an unprecedented exodus of providers who previously spent ample years pouring into Unity’s patient base, many of whom represent some of the District’s most vulnerable populations.
“All I keep saying is ‘I no longer give going-away parties,’ because so many people have quit. It’s just too many,” Sugarman told the Informer.
While Sugarman has felt the increasing impact of scheduling mismanagement in Northwest D.C., providers practicing east of the Anacostia River, like Dr. Emily Zucker, are also facing challenges.
Zucker, practicing at the East of the River community clinic in Ward 7 for almost seven years, is also scrambling for adequate time to manage the bevy of patients seeking her care. Now, many long-time patients are struggling to find availability in her schedule.
Despite numerous requests, Zucker said that management has not negotiated with Unity’s staff, nor agreed to the need for improved continuity, where medical providers see their same patients. Further, she advocates that providers are given more time with their patients, many of whom often face “complex medical and social issues.”
“I have a lot of patients who I haven’t seen for several years, and [when they] show up on my schedule, they say, every time I call to make an appointment with you, there’s nothing available, so I just keep waiting,” Zucker told The Informer. “These are people with serious medical conditions; diabetes that needs insulin, HIV, pregnancy, those kinds of things, and there’s just not enough providers to take care of the number of patients who need care.”
Contrary to the union member’s account of unmet negotiations on behalf of management, Unity Health Care told The Informer that leadership has been working with UAPD to listen to their demands.
“Our bargaining team (including multiple executive leaders) has been meeting with the UAPD regularly (at least once a month) for more than a year, and we continue to negotiate in good faith,” according to a representative from Unity Health Care. “That said, out of respect for the collective bargaining process, Unity isn’t going to publicly comment on our negotiations or discuss both parties’ proposals. We can assure, however, that what Unity has proposed for patient visits is recognized as within the national standards for FQHCs.”
Expressing gratitude for the entire Unity staff, the statement also noted that union negotiations “cannot jeopardize access to patient care.”
While Unity’s physicians have reached no satisfactory negotiations since their unionization efforts in November 2023, members remain motivated to fight for the future of Unity clinics and the ability to safely provide for the patients that need their care.
“We are all here because we are social justice minded individuals. We are trying to help the people of our communities where we live, and we are not given the conditions where we can do a good job,” said Zucker. “We are just really hoping that Unity will meet us at the bargaining table, listen to our concerns, take them seriously, understand that we are the ones who are doing this work every day so we know what is possible.”
