Pickets this week at MultiCare Indigo clinics over surge of patients vs. quality of care

Eight Indigo Urgent Care clinics operated by Tacoma-based MultiCare will see informational pickets this week organized by a union representing some of the medical staff.

The pickets are the result of ongoing bargaining talks that started last fall between workers represented by Union of American Physicians and Dentists and MultiCare.

The union represents about 85 Indigo providers.

UAPD, in a release this week, contended, “The demands for speed have caused many providers to quit, creating a 27 percent turnover rate at Indigo Urgent Care within the last 12 months.”

The first pickets in King and Pierce counties were launched Tuesday at clinics in Federal Way and Puyallup. Future pickets are planned at clinics in Marysville, Kirkland, Tukwila, Tacoma and two clinics in Seattle.

UAPD president Dr. Stuart Bussey spoke to The News Tribune on Tuesday via phone during the group’s Federal Way picket.

He described staff “often working beyond 12-hour limits, putting patient safety at risk.”

“So, you’re seeing burnout,” Bussey said. “Doctors making decisions at 8:30 or 9 o’clock at night … You have this corporate mentality translating into a sweatshop.”

Hours posted online show Indigo clinics open 8 a.m. to 8 p.m. with virtual-care appointments starting before 8 a.m. UAPD contends the rate and pace of appointments push providers to see as many as “six or seven patients per hour,” according to a union news release.

“That is not enough time to fully evaluate each patient’s needs, update their medical history, and perform charting functions before the patients leave,” the union added.

MultiCare said in a statement provided to The News Tribune that it “remains committed to bargaining in good faith with UAPD with the goal of reaching a fair contract that supports a safe, equitable and economically sustainable workplace.”

The health system added, “Our top priority is a fair contract that supports staff as well as patients and the communities we serve.”

UAPD, in its release, noted, “Urgent care clinics are becoming mini ‘emergency rooms’ across the region as wait times at hospital emergency rooms continue to grow.”

A provider who attended Tuesday’s Federal Way picket told The News Tribune that the staff turnover at the clinics was “a huge issue,” with senior physicians leaving and being replaced with less-experienced providers.

The provider declined to give his name for fear of retaliation. He added that a major frustration was having to take on more serious cases that previously would’ve been sent directly to a local emergency room.

For example, someone with chest pain or dizziness, “they want us now to check the patient’s urgent care, EKG or something on them and then send them to the emergency room,” he said. “Time is oxygen for tissues. If you have somebody who’s coming in and they’re actually having a true heart attack or a true pulmonary embolism, the time they’ve wasted coming in … getting an EKG and such,” he argued, did not benefit the patient.

Part of the problem, he added, was a backlog stemming from overburdened primary care providers, where patients are opting for urgent care rather than waiting months to get in to see a primary care provider.

The end result is more complex cases hitting the clinic’s front-line providers in a line of work initially established for quick turnarounds, a complaint voiced by other Indigo workers in past disputes.

A nationwide physician shortage was highlighted in a recent MedPage Today column written by Dr. David Nash, founding dean emeritus and a professor of Health Policy at the Jefferson College of Population Health in Philadelphia.

Nash’s report stated, “Unfortunately, the long-predicted physician shortage is the current reality and, since it takes a minimum of 7 years (4 years of medical school and 3 years of residency) to adequately educate and train a physician, we are well behind the eight ball.”

MultiCare did not answer questions from The News Tribune regarding EKG protocol at the clinics, any staff shortages or what it was doing to address provider burnout.

The health system, in its statement, said, “We believe the best way to come to an agreement that satisfies both parties is at the bargaining table. MultiCare has proposed a competitive wage and incentive package, including agreeing to several UAPD proposals.”

This isn’t the first time MultiCare and UAPD have faced off over issues regarding Indigo staff.

In May 2021, the two sides reached an agreement after more than a year of talks, including a two-day strike, focused on COVID safety and PPE supplies, staffing, breaks and general operations.

Indigo also has been in the news for a recent Tacoma closure and opening.

In April, the health system closed its longtime James Center Indigo clinic, 1812 S. Mildred St., to make way for a MultiCare Obstetrics Access Clinic. A MultiCare representative told The News Tribune that staff from the Indigo clinic would be transferred to other nearby sites.

At the same time, a new Indigo was set to open in the Stadium District at the Merrill Gardens at Wright Park complex.

MultiCare operates more than 30 Indigo clinics in the Puget Sound region. UAPD noted in its release that “a lack of progress in negotiations may force a strike vote and a work stoppage in the coming weeks.”