You Called Me "Greedy?" - $2.2 Million/Year CEO of Catholic Health Care Whose Mission is to Bring "God’s Mercy to the Poor and Under-served" Sues Union for Defamation

From the annals of cognitive dissonance....

Background

Here is the background.  Mercy Health, formerly Catholic Health Partners, claims to be the largest health system in Ohio, and one of the largest in the US (look here).  It's mission is:

to extend the healing ministry of Jesus by improving the health of our communities with emphasis on people who are poor and underserved.  In all that we do, we strive to demonstrate our core values of compassion, excellence, human dignity, justice, sacredness of life and service.

Its current CEO is Michael D Connelly, MA, JD.  In his latest CEO's message, he stated,

our commitments to the Catholic Church, its ethical and religious directives and our Mission are unwavering. Our name change reinforces our fidelity to our powerful message – of compassionate, quality healthcare – bringing God’s mercy to the poor and under-served. As Pope Francis shares 'the Lord’s most powerful message (is) mercy.' 

However, as reported in Becker's Hospital Review in 2011, Mr Connelly's total compensation in 2009 was $1,570,451.   In a December, 2012 Journal-News article, the update was

Michael Connelly, president and chief executive officer of Cincinnati-based Catholic Health Partners, received total compensation last year of $2.2 million for his position over a $3.6 billion organization with more than 32,500 employees. James May, president and chief executive of Mercy Health, a division of Catholic Health, received total compensation in 2011 of $1.2 million.

Mr Connelly Sues for Defamation

This now is relevant to a story reported briefly in Cincinnatti.com,

Michael Connelly, president and CEO of Mercy Healthy, has filed a lawsuit against Service Employees International Union No. 1199 alleging invasion of privacy and defamation.

The reason? A van displaying a large image of Connelly featuring the words 'GREED! GREED! GREED!' and his personal telephone number was circling his Hyde Park neighborhood Monday.

The billboard on wheels featured the following text: 'Mercy Health CEO Michael Connelly is getting rich off the sick, disabled and indigent!'

The article included a picture of the van, emblazoned with a picture of Mr Connelly labeled "Mercy Health - $2,000,000 - CEO."  Further text included the assertion that "Mr Connelly is getting rich off the sick, disabled and indigent."

However,

''This is personal and not a 'labor dispute,'' stated the lawsuit filed by Connelly Wednesday in the Hamilton County Court of Common Pleas. The lawsuit has been filed against the union and its president, Becky Williams.

'Defendants acted with malice in the way they structured and published their radio ad and the mobile billboard by accusing Connelly of disregarding the medical needs of Mercy Health's most vulnerable and sympathetic patients in a way to excite and offend public sensibilities to achieve maximum destruction of Connelly's personal and professional reputation,' according to court documents.

Actually, as reported by the Cincinnati Business Courier, the van that so offended Mr Connelly "listed his work phone number," not his personal phone number  A brief look on Google revealed that it is the main number of the hospital system, not his personal line.  That article also included,

But Anthony Caldwell, spokesperson for the union, said the radio ad and billboard are actually bringing the truth to the public.

'I don't see why they see this as defamation … we are merely representing the opinion of the workers and of the union,' he said. 'The issue, I believe, is that they are not used to being held accountable by people in the community. Sometimes the truth is hard to handle.'

Comment

This little contretemps certainly was the product of a labor dispute, and I do not want to take a side in that dispute.  There are some things to be learned from the kerfuffle, however.

First, the huge disconnect between the pay now frequently given to top hired managers of non-profit hospitals and hospital systems and the stated mission and/or track records of these organizations is now less anechoic.  It is becoming a topic of public discussion, and becoming relevant to such things as labor negotiations.

The obvious non sequitur in this case is a hospital system ostensibly devoted to needs of the poor and under-served but that pays enough to make its CEO a millionaire many times over.  At best this appears unseemly, and certainly seems specifically worthy of public discussion. 

The need for such discussion appears all the more acute because of current concerns about health care costs and access, and reasonable questions about how much the public money that provides a great deal of hospital revenue (e.g., in the US through Medicare and Medicaid programs) ought to go to make top managers rich.  Trying to impede such discussion by bringing litigation against those who participate in it in some states might be regarded as a SLAPP, strategic litigation against public participation.  (Ohio, however, is not one of the states with specific laws meant to discourage SLAPPs.)      

Second, this incident demonstrates at a minimum the overdeveloped sense of entitlement of hired managers who are able to amass such fortunes.  It is understandable that Mr Connelly was annoyed by the attention his inflated pay was receiving.  However, he chose not to merely verbally express his argument with the sponsors of the "greed" van.  Instead, he chose to use his organization's resources to launch a defamation lawsuit.  In Ohio, as in many states, to defend against defamation one must simply prove the truth of the matter (look here).   The text on the van announced he was a $2,000,000 CEO."  In fact, in 2011, according to public records, his total compensation exceeded $2 million.  The text also stated he is getting rich off the sick, disabled, and indigent.  Earning more than $1 million a year seems to fit the common definition of getting rich.  By definition, the hospital's patients include the sick and disabled.  The hospital's stated mission is to serve the poor.  Whether or not by taking such a salary he demonstrated greediness is a matter of opinion, but it does not seem unreasonable to characterized someone getting over $2 million a year supposedly to serve the poor and under-served as "greedy."  There might be worse adjectives one could use to describe these circumstances.  Furthermore, how Mr Connelly's privacy was invaded by publicizing the main phone number of his organization escapes me.  Thus the claims that Mr Connelly's organization is making on his behalf seem a bit fabulous, and possibly frivolous.

Mr Connelly runs a 501(c)3 organization whose tax returns, which include his total compensation, are by law public.  If he is afraid that thus revealing his total compensation makes him subject to ridicule, maybe he should consider asking for his compensation to be reduced. 

As we have noted many times before, top leaders of big health care organizations are now often paid enough to make them instant multimillionaires.  Their supporters, often cronies, other managers of other big organizations, or their paid employees or vendors, often trumpet the same tired talking points to try to justify this pay (look here).  One frequently used talking point is that to be the CEO one must be "brilliant."  It may be that many of those leaders are starting to believe their own public relations, and really think they are so brilliant as to be worth millions of dollars, and so worthy that no plebeian ought to question them.

Are such entitled people the right people to run health care organizations, particularly those claiming to be in virtuous service to the poor and under-served? 

So to repeat, true health care reform would put in place leadership that understands the health care context, upholds health care professionals' values, and puts patients' and the public's health ahead of extraneous, particularly short-term financial concerns. We need health care governance that holds health care leaders accountable, and ensures their transparency, integrity and honesty.

But this sort of reform would challenge the interests of managers who are getting very rich off the current system. 

As Robert Monks also said in a 2014 interview,

People with power are very reluctant to give it up. While all of us recognize the problem, those with the power to change it like things the way they are.

So if challenged a little, they may sue the challengers.  If challenged a lot, who knows what might happen. 


 So I am afraid the US may end up going far down this final common pathway before enough people manifest enough strength to make real changes. 

 

2:57 PM

Time to "Look for the Union Label?" - "First US Doctors' Strike in Decades," at University of California Student Health

The First US Doctors' Strike in Decades

A few news media outlets in California have reported on what has been up to now a very rare event - a strike by physicians.  An initial summary was in an article in the San Diego Union - Tribune, whose title was

First U.S. Doctors' Strike in Decades

A handful of doctors providing medical services to students at UC San Diego — and their colleagues at nine other University of California campuses — went on strike Tuesday.

It's the first time in 25 years that fully licensed doctors are picketing a U.S. employer, according to the Union of American Physicians and Dentists, which represents the physicians at the UC schools.

The work stoppage began at 7:30 a.m. and is scheduled to last one day. It involves 150 health center doctors who manage the primary care and mental health needs of students.

A second article in the Union-Tribune suggested that the point of contention between the union and the University of California administration was not primarily wages,

Collective bargaining has not gone smoothly for UC student services doctors who voted to join the Union of American Physicians and Dentists in November 2013. The two sides have not been able to agree on a contract. Union members voted for the one-day strike after accusing the university system of refusing to provide key financial information that would aid their negotiations.

An article in the East Bay Express clarified that, 

The central unfair labor practice complaint centers on the university's refusal to disclose basic financial data to doctors as part of the negotiations, according to Dr. Jeff Nelson, a UC Berkeley physician and a member of the bargaining team.

'We have asked UC for financial information as to where their funding sources are and what kind of finding they have, and they're not giving that, even though as a public institution, they're required to,' Nelson told me this morning at a rally outside the Tang Center where UC Berkeley students receive health services. Citing the $3.1 billion fundraising campaign UC Berkeley completed last year, he added: 'They have an awful lot of money.'

Without the financial statistics the union has requested, UAPD can't fairly negotiate and settle a contract, said Sue Wilson, a UAPD spokesperson. 'We have a right to certain information that we need in order to bargain a contract.' For example, she said, the union has sought information about the recently approved 20 percent salary increases for chancellors, but hasn't had any luck getting the details it requested. Wilson said the union has also filed an unfair labor practice charge regarding UC's recent decision to require UAPD doctors to contribute more money to their pensions, despite the fact that university officials originally said they would make those changes through the contract negotiations. 'It shows a lack of respect,' she said.

Apparently, the striking doctors want more money not for salaries, but to improve services to patients, as discussed in the second Union-Tribune article,

Dr. Amol Doshi, one of the staff physicians who didn’t report to work Tuesday, said his decision to join the union and to strike came down to disagreements with management over how student health services is run. 

He said only about 15 minutes is provided for each patient, regardless of whether that student has one or several medical issues that need to be addressed.

'We feel like our professional autonomy is being compromised in how we can take care of our patients. We feel that the number of patients that we’re asked to see, many of whom have mental health concerns, require more time and more staffing,' Doshi said.

The East Bay Express noted the UC administration's response did not deal with the substance of these issues,

Reached for comment today, a UC Berkeley spokesperson referred me to the UC Office of the President. Shelly Meron, a spokesperson for that office, dismissed the union's complaints in a phone interview this morning.'"They say this is about unfair labor practice charges. We believe this is simply a negotiation tool.'  Meron said the president's office does not comment on the specifics of unfair labor practice charges and declined to answer questions about the union's claims regarding financial disclosures and the pension policy.

Note that so far this story has been reported nationally only in one small item by Reuters.

Unions as One Method to Address the Plight of the Corporate Physician

So, to summarize, a small group of unionized physicians employed by the student health services of the University of California called a one day strike to protest infringements of their autonomy, particularly requirements that they see patients too quickly for what they believe to be the patients' good, and failure to provide budgetary information relevant to the university's financial capacity to provide better services.  The physicians suspect the university has sufficient money to do so, especially given generous raises given to university managers.

The issues these physicians seem to be facing are familiar aspects of the plight of the American corporate physician.  To recap the background, decades ago, most US physicians worked as solo entrepreneurs, or for small, physician owned groups.  Those few who were employed worked for small non-profits, like the local teaching hospital, or local or US government.  That has all changed.

Now increasing numbers of physicians are employed by increasingly large non-profits, such as hospital systems, or for-profit corporations. A 2013 Medscape article reported that the then current rate of employment was over 50%.

As such these physicians often report ultimately to managers, administrators, bureaucrats, and executives (MABEs).  Many of the people they report do may not be physicians or health care professionals.  Instead, they are likely to be generic managers, trained in business and management schools, with no direct experience in health care, and unclear commitment to its value.  (The 2013 Medscape article cited above included results of survey suggesting the top complaint of employed physicians was being "bossed around by less-educated admins.")

Worse, many generic managers have bought into the primacy of short-term revenue over all other considerations, including patients' and the public's health.  Examples of mission hostile management in health care thus now abound.

In parallel, most top corporate leaders have received increasingly generous compensation, far more generous than non-management employees, including health care professionals get, and that compensation seems to rise regardless of the quality of health care their organizations provide, or even their organizations' financial performance.  (For example, see this post.) 

In the media, and even the medical and health care literature, the rise of the employed, corporate physician has been celebrated, or at least accepted as inevitable. For example, see this post on a Forbes blog by a non-physician pundit with the title, "Physicians want employment, not Marcus Welby MD," implying that choice was completely voluntary.   This attitude may be a product of the long domination of market fundamentalism in the US, in which markets are seen as the solution to all social problems, so neither the outcomes of the "free market" or corporate management are to be questioned. 

However, one would think that contemporary employed physicians are increasingly in a predicament, caught between their professional oaths to put individual patients first, and their generic manager bosses pushing to increase revenue no matter what.  Yet for the corporate physician, protest might jeopardize their livelihood, or worse.  Such physicians may feel captive of the restrictive clauses, such as confidentiality agreements and non-disparagement clauses, in the contracts they signed, possibly often under pressure and without adequate legal counsel.  For example, a 2013 Medscape article was entitled, "Can you speak out without getting fired or being labeled a troublemaker?"  The answer was at best, only sometimes. 

Even in the limited coverage of the California student health doctors' strike, there were references to some of these issues.  These included  what could be mission-hostile management (shrinking visit times regardless of patient needs), and excess compensation to top management (particularly, the Chancellors' pay raises.)   The anechoic nature of the strike, that is, the lack of media coverage so far, seems to reflect the now prevailing market fundamentalist dogma that is generally hostile to workers' rights and organization. 

Nonetheless, the doctors of the University of California student health services did organize, and now they have taken the unheard of step of calling a strike.  That this did not happen sooner is a testament to the enormous power, enforced by billions in public relations and marketing, of the dogma of market fundamentalism.  However, given that most physicians are now employees, and have not been having an easy time of it, this strike may be just the beginning.

In any case, organization of employed workers, collective bargaining, and even strikes, while being anathema to market fundamentalists, may be much better for society than even more radical responses to the ongoing plight of workers.  Remember, it was robber baron capitalism not much different from today's market fundamentalism, that inspired not only the rise of trade unions, but unfortunately, the rise of Marxism and ultimately Communism.

So maybe we should start looking for the "union label" more often in health care.



ADDENDUM (2 February, 2015) - See also post entitled, "Why Physicians Must Unionize" on the On Health Care Technology blog.

11:40 AM