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Less than a year after voting to unionize, emergency medicine physicians contracted through the private equity-backed staffing firm TeamHealth to work at Ascension St. John Hospital in Detroit walked off the job and onto a picket line.

The one-day strike by members of the Greater Detroit Association of Emergency Physicians occurred Thursday afternoon after the union announced earlier this month that, following "months of negotiations with little progress," the emergency department (ED) physicians and physician assistants at St. John Hospital had voted to strike.

At the time, the union had filed its 10-day notice to strike for unfair labor practices, noting concerns over staffing, working conditions, and quality of patient care.

"I believe there is a sacred bond between physicians and patients that is in direct conflict with the goals of a corporate organization," Michelle Wiener, MD, an emergency physician, stated at the time. "It is sad that it has come to this. This vote to strike shouldn't be necessary."

"The fact that you have an entity that won't even meet our minimum demands only validates the fact that they are prioritizing profits over patient care," she added in part. "But we want to treat and care for patients and we are committed to working with our employer to achieve a resolution to this crisis."

Overall, the "frustration of feeling like we can't do our jobs anymore is what has led to the strike," Wiener told 番茄社区app in a phone interview from the picket line, amid honking and cheers from passersby and those who turned out to support the physicians, including nurses and other staff from the hospital, members of Congress, and doctors from several states interested in and inspired by their efforts.

"This is a nationwide problem," said emergency physician John Bahling, MD, speaking from the picket line.

Amid long wait times for care and persistent short staffing, Bahling told 番茄社区app that he and other union members are striking to fight for their colleagues, including nurses, as well as patients they serve as emergency medicine physicians.

The American Academy of Emergency Medicine (AAEM) also lent their support for the physicians at St. John Hospital in a letter of concern to hospital leadership about the emergency department contract there.

To date, unionization by emergency medicine physicians has been rare, Robert McNamara, MD, past president of AAEM, told 番茄社区app. Now, seeing such efforts within this group is a "red flag" in the specialty of emergency medicine, he said.

Asking why private equity is involved with the nation's emergency departments, which provide care to the most vulnerable patients, he said "private equity is there to make money at a high rate of return."

Indeed, efforts at St. John Hospital are representative of ongoing and broader scrutiny around private equity in healthcare.

Spokespersons for both Ascension and TeamHealth confirmed that the emergency department at St. John Hospital would remain open and operational during the strike.

"The safety and well-being of our patients, visitors, associates, and physicians is our first priority," a spokesperson for Ascension said in a statement provided to 番茄社区app in an email. "TeamHealth has a comprehensive contingency plan in place with the hospital that will ensure these contracted provider services, and safe patient care, will be uninterrupted."

In his own emailed statement, Josh Hopson, vice president of communications at TeamHealth, wrote, "TeamHealth's top priorities are delivering high-quality patient care and supporting our frontline clinicians, as they care for our communities 24 hours a day, 365 days a year. TeamHealth has provided clinicians with support and resources for over 40 years, even in the face of material reimbursement pressure from private insurers and Medicare."

"We have negotiated in good faith with the union, and any statement to the contrary is false," Hopson added. "We invite the union's leadership to return to the bargaining table and secure a resolution on reasonable and sustainable terms."

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