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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Florida's new law banning fluoride in public water systems has drawn sharp criticism from dental professionals, who cite decades of evidence supporting its safety and effectiveness in preventing tooth decay.

Dr. Jeff Ottley, president of the Florida Dental Association, warned that the change will lead to a rise in cavities, particularly among children and underserved populations.

"Over the next two to three years, we will see an increase in the number of cavities, particularly in children and older adults who take multiple medications, which cause dry mouth," he said. "Those older adults will start getting cavities along the roof surfaces of their teeth and under existing restorations, like crowns and fillings."

Backers of the ban, including libertarian groups and some GOP legislators, have argued that "fluoride is a choice" and have recommended topical treatments, such as toothpaste, over what they claimed to be "mass medication."

Ottley stressed that fluoride occurs naturally in water, and the ban eliminates adjustments that allow cities to reach optimal levels for dental health.

He also predicted severe consequences, especially for Florida's Medicaid system and rural communities.

"The Medicaid system in Florida already has the lowest reimbursement rate across the country," he said, "and so you're going to have an influx in the number of kids looking, and parents looking to treat their kids who are on Medicaid, and the providers just aren't going to be there."

Ottley warned that higher Medicaid payments will be needed to attract dental-care providers, which he said could lead to ballooning costs.

His interim advice for parents: Seek prescription fluoride vitamins, and everyone should maintain rigorous brushing and flossing routines, cut their sugar intake and avoid post-brushing snacks before bed.


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California lawmakers are considering a bill to ease regulations on birth centers at a time when maternity wards are closing in many counties. Assembly Bill 55 would streamline the licensure process, which allows a birth center to accept Medi-Cal, making midwifery care available to low-income families.

Sandra Poole, health policy advocate with the Western Center on Law and Poverty, said the bill would also no longer require a birthing center to be within 30 minutes of a hospital but instead rely on a transfer plan to address potential emergencies.

"Of course, if you're in an area where the labor and delivery has closed, that's going to be impossible," she explained. "There are 12 counties in the State of California that have absolutely no labor and delivery wards at all in the county."

Birth centers are non-hospital, homelike facilities for low-risk pregnancies. At least 40% of California's birth centers have closed since 2020, and just four of the 37 remaining centers are licensed, because the current licensing process is unnecessarily burdensome, according to a study published today by the Western Center on Law and Poverty, in partnership with the California Black Women's Health Project and the Black Women for Wellness Action Project.

The study also surveyed patients on the merits of birth centers. Holly Drayton is a mother and former doula from the Santa Barbara area.

"For people to have that option would really give them the opportunity to choose the birth that they want in an environment where they do feel comfortable to labor in the way that they're supported, to make it the best possible outcome," Drayton said.

Sarah Archer, a mother who supports birth centers, said they are an important part of the state's health care system, and are proved to reduce pre-term births.

"People deserve choices in the way they want to give birth, not just in a sterile hospital," she explained. "It's a very safe, very quiet, beautiful, serene environment versus a medical setting."

The bill has passed the State Assembly and is now before the Senate Health Committee.

The Illinois Department of Public Health said the first positive test for West Nile virus in 2025 has been detected in Winnebago County near Rockford.

Health officials warned people in the infected area and elsewhere to take precautions to avoid the mosquito-borne disease, which is expected to spread across the state. Last year, Illinois reported 69 cases of West Nile, with 13 reported human deaths.

Sameer Vohra, director of the Illinois Department of Public Health, said evidence of the disease usually emerges this time of year.

"In Illinois, we typically see the first environmental positive test for West Nile in mid- to late May," Vohra explained. "Mosquitoes typically emerge in the spring and are active until the first hard frost of the year."

Vohra noted West Nile virus is an endemic disease in Illinois, meaning it is commonly found in the state. Public health officials are highlighting the importance of taking action to "Fight the Bite" during National Mosquito Control Awareness Week, which runs from June 18-24.

Vohra pointed out most people who are bitten by infected mosquitoes do not contract the disease but one in five will show symptoms ranging from mild discomfort to a serious and possibly fatal illness.

"Right now, there's no treatment for West Nile virus," Vohra emphasized. "But supportive care is really important, especially if you're developing symptoms or you're that one of 150 people that can develop severe illness."

Public health officials have advised Illinoisians to wear long sleeves and pants outdoors, use Environmental Protection Agency-approved insect repellent and stay indoors during peak mosquito hours at dawn and dusk. They also recommend trying to keep mosquitoes from breeding.

"One way to do that is to dump any standing water," Vohra advised. "Examples of that include flowerpots, children's toys, pet bowls, bird baths, buckets, used tires, abandoned swimming pools, any place where you can get standing water."


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