Striking Allina doctors say they fear burnout will hurt patient care

Doctors striking outside Allina Health clinics on Wednesday said they are being stretched too thin by an employer that expects them to see more and more patients while giving them less and less support.

The one-day strike by hundreds of doctors is believed to be a first in Minnesota and one of the largest involving physicians in U.S. history. The walkout followed 20 months of negotiations that failed to produce a first contract for the newly unionized Allina doctors.

Among their demands: four paid hours each week to complete paperwork and respond to the rising volume of patient emails and electronic messages.

Doing this work without pay, often late at night, is leading to burnout among primary care doctors that is threatening the stability of the profession and patients’ access to timely care, said Julie Donahue, a nurse practitioner at Allina’s Faribault clinic.

“What we’re doing now is not sustainable,” said Donahue, who joined with colleagues to picket outside Allina’s West St. Paul clinic. “We can’t see patients all day, go home and, when our kids go to bed, log back on and do more work.”

Allina in a statement said some of the doctors’ demands are unaffordable amid “ongoing financial challenges,” including budget cuts proposed by President Donald Trump’s administration and approved by Congress that could reduce how much the federal Medicaid program reimburses providers for the treatment of low-income and disabled patients.

“It would be irresponsible for either party to agree to a contract that adds significant new expenses that will undermine access and increase costs to those who pay for care,” the statement said.

Allina patient Toni Sommers, 72, said her West St. Paul clinic seemed slower but all she needed was a vitamin B shot anyway.

“I don’t know if people stayed away, but there’s nobody there,” Sommers said after her visit. She said she wasn’t upset by the strike, and assumed the doctors had a good reason.

Minnesota has encountered strikes by hospital nurses and other health care professionals. Allina faced two strikes by its Twin Cities hospital nurses for a combined 44 days in 2016 in a dispute over health benefits. But a physician walkout is new.

The doctors picketed outside clinics in Coon Rapids, Minneapolis and West St. Paul on Wednesday, chanting “doctors on the outside? Trouble on the inside.”

More doctors participated in the strike than the 325 who voted in fall 2023 to be represented by the Doctors Council SEIU union, said Dr. Matt Hoffman, a family practice provider in Allina’s Vadnais Heights clinic and a leader of the union movement.

“We need to keep people in this job,” he said.

Allina’s doctors have been at odds with their health system in the years following the COVID-19 pandemic. They publicly opposed a health system policy, which was later rescinded and then banned by state medical debt legislation, of denying nonemergency care to patients with substantial overdue bills.

The also criticized Allina’s recent decision to close five primary care clinics, where some doctors said they were so busy that they couldn’t take new patients, and its outsourcing of basic laboratory work to Quest Diagnostics.

“Our patients are still facing excessively long wait times just to have their labs drawn after seeing their provider,” said Dr. Cora Walsh, a family practitioner who picketed her clinic in West St. Paul. Some are being sent “to the ER for care that we used to be able to provide in clinic,” she added.

Health care is changing. Online visits can manage many garden variety health concerns. AI-enabled recording systems can transcribe doctors’ notes instead of paid scribes. But the striking doctors said Allina has gone too far in cutting support staff.

“You can’t just take that away” without affecting patient care, she said.

Strikes by doctors are a rarity in the U.S., because only about 8% have union representation. In 1975, doctors in California struck over rising malpractice costs while residents and interns in Chicago and New York struck over excessive hours and workloads.

More recently, emergency room physicians engaged in a one-day strike of Ascension St. John Hospital in Detroit last year over working conditions and staffing shortages.

The Allina doctors make up the largest unionized group of private sector primary care providers in the U.S. The “whole country” will be watching the course of their negotiations, said Dr. Frances Quee, president of the New York-based Doctors Council union who joined in the picket in West St. Paul.