Episode Details

Two topics today. First, unionization, which is having a real moment in healthcare. Banner Health's hospitalists just formed the largest physician union in Arizona. The Brigham and Women's nurses recently held the largest one-day strike in Massachusetts history. I get into why physicians are so far behind on this, historically we've been independent, and you can't unionize as a practice owner or contractor, and why we're catching up now that companies like Apollo MD, Sound Physicians, SCP Health, and even Optum are employing us.

After the break, another eye drop recall. This one is a big one. 2.5 million bottles of prednisolone from Lupin Pharmaceuticals recalled after a foreign substance was found. Prednisolone is one of the most commonly prescribed drops in ophthalmology and standard after cataract surgery, so this one is going to be felt.

Takeaways:

• Physician unionization is accelerating: Banner Health's hospitalists just formed Arizona's largest physician union, and the Brigham and Women's nurses recently held the largest one-day strike in Massachusetts history

• Physicians have lagged nurses on unionization because they were historically independent, practice owners and contractors can't unionize, but as more doctors become W2 employees of health systems, private equity groups, and corporations like UnitedHealthcare (the country's largest employer of physicians), unions become both viable and appealing

• SCP Health's move to hire displaced Valley Health emergency physicians as 1099 contractors has multiple downstream effects, no benefits obligations for the company, and no legal path to unionization for those doctors

• Lupin Pharmaceuticals is recalling 2.5 million bottles of generic prednisolone eye drops after a foreign substance was found; prednisolone is one of the most commonly prescribed post-cataract drops in ophthalmology, so a shortage could disrupt post-op inflammation control

• Instead of intra-healthcare-worker infighting, Will's ask is radical transparency from hospitals, actual prices, actual reimbursement rates, actual margins, actual payer contracts, so everyone can see where the money is really going before accepting the argument that one group's raise costs another its own

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