Valley News – Jim Kenyon: Division of labor at Dartmouth College, Dartmouth Health

The distance between Dartmouth College and Dartmouth-Hitchcock Medical Center is only a few miles. But for some underpaid workers, the two largest employers in the Upper Valley are worlds apart.

Recent examples:

A small group of hourly employees at the Dartmouth Art Museum were seeking, among other things, better pay. One of the visitor service guides, as they’re called, told me she makes about $19 an hour, which comes out to less than $40,000 a year.

That’s barely a living wage in many Upper Valley communities where housing costs are sky-high.

The drivers, who all hold bachelor’s degrees, turned to Local 560 of the Service Employees International Union (SEIU) for help. Last month, they voted to join the union that has represented college employees for more than 50 years. The union currently has around 400 members ranging from cooks to carpenters.

SEIU President Chris Peck, an artist at the college for more than 30 years, hopes contract negotiations will result in raises of about $3 an hour for museum workers, who are mostly women.

This would bring them on par with the starting salary of college janitors and washermen.

“We’re looking for equality,” said Grace Ross, who worked at museums in Massachusetts before joining Hood’s team a year ago.

The tour guides’ duties include opening and closing the museum. While Hood is open on Saturdays and some evenings, drivers do not receive differential shift pay, which SEIU hopes to change.

“Many of us also have master’s degrees and experience in our field,” Ross said, sharing an email collected by the group. “We would like compensation that is commensurate with our skills, experience and the cost of living in the area.”

It’s not just about the dollars, Peck told me. “People also want to be heard,” he said. “Non-union employees sometimes don’t feel comfortable going to their bosses with problems they may have.”

On the face of it, adding a half-dozen employees (the vote to join the union was 5-0) to SEIU’s ranks doesn’t seem like a big deal.

But Local 560 hopes it will prompt other groups of Dartmouth employees to consider unionization.

DHMC officials may also consider this.

Last month, 50 DHMC employees who register patients at the hospital’s front desk learned that their jobs had been awarded to a private company in Texas.

The officials were powerless. If they wanted to keep their jobs at Lebanon Medical Center, they had to go to work for Conifer Health Solutions, a subsidiary of Dallas-based for-profit hospital chain Tenet Healthcare

This isn’t the first time Dartmouth Health, as the “rebranded” mega health care system is being called these days, has let go of rank-and-file employees.

Dartmouth Health has done business with Conifer since 2015, when it transferred about 340 jobs to its revenue management department, including billing and debt collection.

Most recently, Dartmouth Health sent “registration services” jobs to Conifer from the four other Vermont and New Hampshire hospitals in its network.

“Managing our registration process within one system allows us to improve our patient experience by providing a consistent experience at every Dartmouth Health location,” Dartmouth Health spokeswoman Audra Burns told me via email.

DHMC officials had less than three weeks to decide whether they wanted to partner with Conifer, which bills itself as a “partner in care – delivering revenue cycle and value-based care solutions that optimize financial performance, improve business outcomes and elevate the healthcare experience.”

The marketing nonsense didn’t seem to impress the DHMC registration services staff. In a recent internal document an employee shared with me, 39 of the 50 front-desk employees turned down Conifer’s offer. (A spokeswoman for Conifer did not respond to my request for comment.)

Instead of joining Conifer, which has more than 13,000 employees, many front desk workers are struggling to find new jobs at DHMC.

Apparently, even Conifer’s offer of a $1,000 “switching” bonus for anyone who stayed with the company for six months wasn’t worth it.

Who could blame them?

On Glassdoor’s list of worst-rated companies to work for in the US, Conifer ranked 7th. “While the company strives to improve the processes of others (in the healthcare world), many of Conifer’s employees highlighted poor management and a lack of communication in their reviews,” reported in December 2020.

In a Sept. 14 letter to prospective former DHMC employees, Conifer announced it is offering a starting wage of just under $19 an hour. (I was told same field as DHMC.)

But it was unclear whether Conifer’s benefits package could rival DHMC’s. Employees were worried about losing their accrued vacation time, as well as access to the medical center’s children’s center.

Some of the employees also had ethical concerns. Along with checking in patients, I was told that Conifer expects front desk workers to act as bill collectors.

Which is really what outsourcing is all about.

When a patient arrives for an appointment, the front desk staff should ask about unpaid hospital bills. This is not a task that many DHMC staff want to perform or feel is appropriate in a not-for-profit medical center. (I asked a Conifer spokeswoman about the practice, but again didn’t hear back.) Hitting patients for outstanding balances when they’ve just arrived for an appointment can have a chilling effect. People who are already behind on their hospital bills may be reluctant to seek the medical care they need.

It might improve the health of the bottom line for DHMC — and Conifer — but it hardly seems like good medicine.

Jim Kenyon can be reached at [email protected]

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