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.


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Law enforcement officers and drug prevention advocates in Missouri are joining forces to tackle prescription drug misuse.

As part of the Drug Enforcement Administration's "National Prescription Drug Take Back Day," five collection sites will be set up across Taney and Stone counties on April 26.

Data from two years ago showed around 190,000 Missourians misused opioids, including 180,000 who misused prescription pain relievers.

Marietta Hagan, project coordinator at Cox Health, warned prescription drug misuse contributes heavily to opioid use disorder.

"People would get prescription medication that didn't belong to them as easy as walking into their parent's medicine cabinet and pulling it out of there, or pulling it out of the side night table at bedtime," Hagan explained.

Volunteers will be at the sites offering free safety tips and disposal kits, making it easy for families to clear out their medicine cabinets.

Hagan emphasized "Drug Take Back Day" is about more than just safe disposal. It is also a reminder to store medications properly to prevent misuse. She shared guidance on how to safely get rid of unwanted medications.

"Previously government agencies had encouraged actually the flushing of medications," Hagan noted. "But we now know thanks to environmental science, that is not recommended. Those medications end up in our water supply, in our lakes and our streams."

Most prescription and over-the-counter medications will be accepted, including pills, patches, and vapes without batteries. National Prescription Drug Take Back Day is held twice a year, typically in April and October.


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A Tennessee nonprofit is warning that potential Medicaid cuts could threaten crucial support for the state's nearly 1 million family caregivers.

Medicaid supports 4.5 million individuals through home health-care services nationwide.

Megan Schwalm, president and CEO of the Tennessee Caregiver Coalition, said more than half of its funding comes from the now-dismantled Administration for Community Living - which has been folded into the Department of Health and Human Services.

Schwalm said federal funding cuts have affected the coalition, which provides respite services for people caring for loved ones with dementia or other serious conditions.

"Our state typically reimburses at $23.44 an hour for respite, and so us being able to provide at about $5 an hour is a huge cost savings," said Schwalm. "But with those cuts to Medicaid and the Administration for Community Living, we won't be able to provide those services any longer."

She said the funding cuts have already forced the loss of a staff position and nearly all outreach efforts for respite services across Tennessee.

Medicaid is jointly funded by states and the federal government, but Congress is proposing cutting Medicaid spending by $880 billion over 10 years.

According to AARP, Tennessee already ranks poorly among states for its lack of supports and services for caregivers and people with disabilities.

Schwalm acknowledged that Medicaid could benefit from reform, but she said dismantling it without a clear, comprehensive plan would be detrimental to the people of Tennessee.

"These cuts to Medicaid are coming, but there is no safety net in place," said Schwalm. "There is no alternative. And so it is very unclear what will happen to these folks in these programs."

She emphasized the importance of Tennesseans letting their elected officials know how they feel about safeguarding these safety net programs.




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A bill in the Tennessee General Assembly is reigniting debate over how rural hospitals can staff anesthesia providers. House Bill 979 would address the shortage of anesthesiologists in rural Tennessee by allowing hospitals in counties with fewer than 105,000 residents to directly employ physician anesthesiologists.

Hospitals now have to use third-party anesthesiology services.

Dr. Louis Chemin III, anesthesiologist and physician with Tennessee Anesthesiology Consultants Exchange, supports physician supervision in what's known as the "Anesthesia Care Team" model. He said anyone hired as an anesthesiologist would be required to follow strict medical guidelines.

"Currently under state law, a hospital cannot employ an anesthesiologist, a radiologist, a pathologist or an emergency medicine physician. If this bill were to pass, it would allow hospitals in these rural communities the option to hire an anesthesiologist," he contended.

Chemin said the bill would allow a hospital anesthesiologist to perform anesthesia in one operating room, or to supervise the process in up to four operating rooms.

On Wednesday, the bill passed the House with a vote of 72 to 5, with 11 members "present but not voting." It now heads to the state Senate.

When a physician anesthesiologist provides medical direction to Certified Registered Nurse Anesthetists or Anesthesiologist Assistants, Chemin explained, they must comply with seven steps outlined by the Centers for Medicare and Medicaid Services to qualify for reimbursement under Medicare.

"This law means that if a hospital employs an anesthesiologist, that they must allow the anesthesiologist to practice in a way that is safe and is in agreement with these seven steps," he continued.

Chemin added that these requirements would ensure the anesthesiologist's active involvement in the patient's care and safety.


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