ST. CROIX — Outdated salaries for members of the Association of Hospital Employed Physicians — unchanged for over 20 years — are hindering the territory’s hospitals from recruiting and retaining full-time staff, according to union and hospital board officials.
The low starting salary for AHEP members at both the Governor Juan F. Luis Hospital and Medical Center on St. Croix and Schneider Regional Medical Center on St. Thomas is something the union has been pushing to increase.
AHEP, whose members have been working under a collective bargaining agreement from 2002 that expired in 2007, filed a formal grievance and an unfair labor practice charge in October 2022 with the Public Employees Relations Board, according to Dr. Jessica Wilson, AHEP president.
“We are seeking what was promised and what is owed: retroactive step increases, pay equity, and enforceable protections going forward,” Wilson wrote in a statement to WTJX.
Wilson, a pediatric hospitalist at SRMC and owner of Wilson Healthcare Consultants on St. Thomas, is calling for immediate and meaningful negotiations.
“Our hospitals will not thrive until we treat our physicians fairly, compensate them adequately, and create working conditions that make them want to stay,” she stated.
Jerry Smith, who has a doctorate in physical therapy and serves as chair of the Virgin Islands Government Hospital & Health Facilities Corporation, also known as the territorial hospital board, concurs that physicians should be compensated properly. Smith, who also chairs the St. Thomas/St. John District hospital board, stressed that it is time for AHEP and the Office of Collective Bargaining to negotiate a new contract. To start the ball rolling, he said the board instructed the CEOs from JFL and SRMC in March to initiate a study outlining the appropriate salary levels of physicians at each hospital prior to engaging in negotiations.
Smith, who owns Therapy Works on St. Thomas and in the British Virgin Islands on Tortola and Virgin Gorda, said the board received the first draft submission from the hospitals on June 3.
“We’ve had conversations with the Office of Collective Bargaining, and they have asked us to go ahead and initiate the negotiations and then come back to them with what we have come up with,” he said.
Under the existing contract, starting salaries for physicians range from $70,785 to $87,165, depending on board certification status. The outdated salaries present a barrier for the hospitals to be able to attract and retain physicians.
“It has been a challenge for quite some time now,” Smith said.
Despite a pressing need to increase the salaries for the AHEP members, Smith said priority was given to first adjust the salaries for nurses.
“We have gotten that handled,” he said. “It’s a good example of what a current salary can do for recruitment. Before, we had well over 100 traveling nurses with a price tag of over $1 million a month at the height of the pandemic with the cost of temporary nursing being as high as it was.”
After negotiating new salaries for the Registered Nurses Leadership Union last year, Smith said the hospitals have been able to recruit and retain nurses.
“With that challenge behind us, the next logical step is to do the same thing with our physicians,” he said.
Instead of offering competitive salaries to attract permanent doctors, Dr. Anne Treasure, chief of the Department of Obstetrics and Gynecology and medical staff president at JFL, said JFL and SRMC both spend millions of dollars each year to hire traveling physicians, known as locum tenens.
Treasure advocates raising salaries for AHEP members to help recruit and retain doctors and reduce reliance on costly traveling physicians.
“We try to recruit our colleagues and our friends, even our relatives who are physicians to come back home and the salaries are nonstarters,” she said.
Smith agreed it would be less expensive if the hospitals offered higher salaries to attract and retain permanent physicians as opposed to paying for traveling physicians.
“It’s precisely the reason why the CEOs have been directed to come back with a number so we can get the negotiation started as soon as possible,” he said.
Smith said adjusting the salary levels for the AHEP members would make the territory’s hospitals more competitive when it comes to recruiting doctors from the U.S. mainland. He said the pool of potential recruits includes new physicians recently out of residency, seasoned physicians at the height of their career, and experienced physicians toward the end of their career.
“Those different tiers of physicians have all sorts of options stateside, so we have to have competitive salaries,” Smith said. “We can’t just sell sun, sand, and sea. We also have to have proper remuneration in order to be able to recruit.”
Treasure, an AHEP member, said the starting salaries for physicians in the union are not attractive enough for the hospital to maintain a permanent, healthy medical staff. She clarified the hospital employs two categories of physicians — unionized and nonunionized.
While the starting salary for physicians who are members of the AHEP union start at $70,785, Treasure said nonunionized physicians earn an average salary between $300,000 to $400,000. She noted the AHEP members are expected to supplement their income by billing the professional component of hospital care. She said the hospital also bills a facility fee to recover the cost of services and resources used by the patient, including nursing, pharmaceuticals, supplies, and tests.
With such low starting salaries for full-time doctors, Treasure said nearly a dozen staff physicians recently resigned from JFL.
“The biggest reason that they’re giving for the resignations is salary,” she said.
Physicians resigning over low salaries is something Wilson has witnessed for the past 12 years she has worked at SRMC.
“It’s been a constant issue since I got here in 2013,” she said.
Originally from Chicago, Wilson joined SRMC as a traveling physician. She said she initially turned down a full-time job offer due to the low salary but accepted it because she enjoys the patient population and could no longer take the cold Midwest weather. She said the new salary schedule that would be negotiated as part of the CBA must support the physicians while fitting within the budgets of the hospitals.
“We feel that if we can come to a safe contract that’s beneficial for both people, it would be in the long run cheaper for the hospitals and better for retaining loyal physicians who would like to be here,” Wilson said.
