A labor union that represents some 7,000 licensed doctors and advanced-practice clinicians nationwide is on the cusp of forming in Colorado Springs.

Leaders of the Union of American Physicians and Dentists announced during a press conference Monday that they had at that minute submitted a filing with the National Labor Relations Board, an independent federal agency, to trigger organized unionization for providers at 20 medical clinics of Peak Vista Community Health Centers in the region.

“We are telling Peak Vista we are not your enemy, we are your colleagues,” said Union President Dr. Stuart Bussey. “This is a community safety net, and these people are warriors of the vanguard of the city. This is not Bethlehem Steel or the coal mills in Pennsylvania, or the sweatshops, or is it?”

Peak Vista has received notification about the intent to unionize, said the organization’s President and CEO Dr. Emily Ptaszek. 

“Peak Vista has been serving the Colorado Springs community for more than 50 years. We are steadfast in our mission to provide exceptional health care to people facing access barriers through clinical programs and education,” she said in a statement. “We stand ready, and have the capacity, to serve this community, from new to existing patients.”

At issue: productivity requirements that began Jan. 1 for providers, whose clients are uninsured, homeless, low-income or have government-subsidized insurance.

The new mandates increased patient loads by more than 25%, limited appointments to 15 minutes, and forced doctors and high-level assistants to complete paperwork and other duties of the job during their lunch period, after hours or on weekends for no additional pay.

“That all affects patient care and quality of care,” said Andrew Guttman, a union representative and organizer.

Employees contacted the Sacramento, Calif.-based workers’ group for assistance, he said, which now has collected affirmation from a percentage of Peak Vista’s medical employees to unionize.

After the consent signatures have been verified for legitimacy, the question whether to unionize at Peak Vista will be put to vote, he said.

“Every provider will vote yes or no,” Guttman said.

The union believes the number of medical providers has fallen below 100 he said. With six providers being fired over the past month, three being suspended and more than 20 voluntarily resigning, Guttman said it’s been difficult for the union to pinpoint the exact tally.

The process to reach a vote should take about a month, according to Guttman.

“We’re here united, we’re not going anywhere,” he said. “Peak Vista is moving to protect patients. This is a safety net that provides quality care to people who have nowhere else to go. This is a vital organization in the functioning of this community.”

Diana Wyman, who has used Peak Vista for 14 years for services for her three adopted children, said her kids “know and love” their pediatrician, who Wyman said was “fired without cause” and that she doesn’t understand why.

“I’m trying to get answers and support the doctors,” Wyman said. “They’re not being considerate of their patients. I think taking care of patients is most important, which means returning our doctors and providing a good environment for them to work in.”

Dr. Michelle Myers, a pediatrician, said she recently was fired and, over the six years she had been employed at Peak Vista, the work environment has “gradually gotten worse and worse.”

With the involuntary and voluntary loss of doctors in such a short period of time, “You’re taking away the idea of a medical home,” she said.

Meanwhile, the National Labor Relations Board has started investigating the union’s charges that Peak Visa has engaged in unfair labor practices and has created onerous working conditions through terminations and alleged retaliation on the part of administrators, Guttman said.

The practice of quotas has become common, said Professor Kevin Laudner, dean of the Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences at the University of Colorado Colorado Springs.

“Healthcare professionals today face significant expectations, including delivering high-quality, patient-centered care while managing an increasingly heavy workload,” he said in an email.

The number of patients a doctor or assistant handles in a day varies depending on the setting, specialty and resources, he said, though on average, primary care providers might see up to 25 patients per day. The national median is 20.

“Regardless, there is an expectation that patient load and available resources must allow for sufficient time to provide proper patient care and avoid burnout,” Laudner said.

Balancing efficiency with quality is crucial for both the well-being of patients and the healthcare providers, he said.

The industry also has been affected by more providers retiring or leaving the field during and post-pandemic, Laudner said. That has left remaining providers often being asked to see more patients, which can increase provider stress.

“There have been a variety of impacts this has created on the industry, but a clear one is the increased number and need for nurse practitioners and physician assistants providing primary patient care in the absence of medical doctors,” Laudner said.

The issues that have surfaced at Peak Vista are not isolated.

Tamara Herl, a licensed professional counselor and certified art therapist, said she recently worked at two mental health centers along the Front Range that followed similar practices.

“The expectations weren’t realistic, and everyone knew it,” she said.

One facility wanted Herl to have 80 to 100 patients at any given time.

“That seemed like it was so hard to keep track of everyone and do a good job and have a full picture of their story and what they needed,” Herl said. “It’s not a healthy model expecting people to swallow with a smile.”

Herl was so unhappy she voluntarily left both clinics and started her own practice.

Students in the UCCS nursing school are being taught how to manage increases in workloads, Laudner said, including prioritizing tasks based on urgency and patient needs and delegating to support staff. Asking for help and advocating for more resources are another strategy.

“Lean on your mentors, colleagues and supervisors for additional support,” he said. “Take care of yourself physically and mentally to manage stress and avoid burnout.”