Jim Kenyon: Division of labor at Dartmouth College, Dartmouth Health

Valley News Columnist
Published: 10/15/2022 11:33:37 PM
Modified: 10/15/2022 11:33:50 PM

The distance between Dartmouth College and Dartmouth-Hitchcock Medical Center is only a few miles. But for some workers who aren’t paid a lot of money, the Upper Valley’s two largest employers are worlds apart.

Recent examples:

A small group of hourly employees at Dartmouth’s Hood Museum of Art was looking for, among other things, better pay. One of the visitor services guides, as they’re called, told me that she makes about $19 a hour, which amounts to less than $40,000 a year.

That’s barely a living wage in many Upper Valley communities, where housing costs are through the roof.

The guides, 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, which has represented the college’s blue-collar employees for more than 50 years. Currently, the union has roughly 400 members from cooks to carpenters.

SEIU President Chris Peck, a painter at the college for 30-plus years, hopes that contract negotiations will result in raises of $3 or so an hour for the museum workers, who are mostly women.

It would put them in line with the starting pay of the college’s custodians and dishwashers.

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

The guides’ duties include opening and closing the museum. While the Hood is open Saturdays and some evenings, the guides don’t receive shift differential pay, which the SEIU is hoping to change.

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

It’s not just about dollars, Peck told me. “People also want to be heard,” he said. “Non-union employees sometimes aren’t comfortable going to their bosses with issues that they might have.”

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

But Local 560 hopes it will lead other pockets of Dartmouth employees to consider unionizing.

DHMC employees may want to think about it as well.

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

The employees were powerless. If they wanted to stay in their roles at the medical center in Lebanon, they had to go to work for Conifer Health Solutions, a subsidiary of the Dallas-based for-profit hospital chain Tenet Healthcare

It’s not the first time that Dartmouth Health, as the “rebranded” mega health care system is calling itself these days, has abandoned rank-and-file employees.

Dartmouth Health has been doing business with Conifer since 2015 when it turned over about 340 jobs in its revenue management division, including billing and debt collections.

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

“Managing our registration process under 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 employees had less than three weeks to decide if they wanted to sign on with Conifer, which promotes itself as a “partner in care — providing revenue cycle and value-based care solutions that optimize financial performance, improve business outcomes and elevate the healthcare experience.”

The marketing gibberish didn’t seem to impress DHMC’s registration services staff. In a recent internal document that an employee shared with me, 39 of the 50 front desk workers had declined Conifer’s offer. (A Conifer spokeswoman didn’t respond to my request for comment.)

Rather than join Conifer, which has more than 13,000 employees, many front desk workers have been scrambling to find new jobs inside DHMC.

Apparently, not even Conifer’s offer of a $1,000 “transition” bonus to anyone who stayed with the company for six months made it worthwhile.

Who could blame them?

On a list of the worst-rated U.S. companies to work for compiled by Glassdoor, Conifer ranked No. 7. “Though the company strives to improve the processes of others (in the healthcare world), many of Conifer’s employees stress poor management and a lack of communication in their reviews,” Yahoo.com reported in December 2020.

In a Sept. 14 letter to the soon-to-be former DHMC employees, Conifer announced it was offering a starting pay of slightly less than $19 an hour. (The same ballpark as DHMC, I’m told.)

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

Some of the employees had ethical concerns as well. Along with checking in patients, I’ve been told Conifer expects its front desk workers to act as bill collectors as well.

Which is really what the outsourcing is all about.

When a patient arrives for an appointment, the front desk staff is supposed to ask about any unpaid hospital bills. It’s not a task that many DHMC employees want to perform or think is appropriate at a nonprofit medical center. (I asked Conifer’s spokeswoman about the practice, but again, I didn’t hear back.) Hitting up patients about outstanding balances when they’ve just arrived for an appointment could have a chilling effect. People who are already behind on their hospital bills could be reluctant to seek needed medical care.

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 jkenyon@vnews.com.

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