Disparities in Healthcare and Staff Discipline at UC Hospitals

The University of California Hospitals have been involved for many years in studying and pointing out the Disparities in Health care delivery and access in America between ethnic groups, genders, and other perceived disadvantaged groups. All have the same theme, disadvantaged or people of color get worse health care given the same conditions. All one has to do is Google “Disparities in Health care” and UC California and you will be treated to a whole host of studies, articles, talks, or seminars where UC researchers, mainly physicians, point out these disparities. UC seems to have taken the lead in many respects in pointing out the problem. That being said, one would think they would set an example within their own institution on equality. The tremendous body of research and the recent revelation about the disparities in disciplinary action between UC Physicians and non physicians for patient privacy breaches at UCLA Medical Center reminds me of that old saying about people in glass houses and throwing stones.

In case anyone missed it, a number of employees at UCLA Medical Center were caught recently peeking into the electronic records of Britney Spears and other celebrities. This has not been an isolated event as media reports and the citation and plan of correction from the California Department of Public Health revel that it has been going on for some time on a rather large scale. In regards to the Spears case, California Health Line reported ..

The Department of Public Health said 53 employees, including 14 doctors, at UCLA Medical Center breached Spears' records on two occasions. None of the physicians quit or were fired, while 18 other employees resigned, retired or were dismissed after the violations were discovered, according to UCLA data.

I guess I am not surprised by hypocrisy in one of the ivory towers of Academic Healthcare but I am surprised that they would hand a gift to the cases of workers that were fired. If the fired workers unions cannot capitalize on the inequity in treatment to the benefit of those fired then they are not representing their workers well. For a disciplinary action to prevail in arbitration with public or unionized employees it must be based on “Just Cause”. Over the years Arbitrators in hearing disciplinary cases have agreed that to establish Just Cause there are 7 tests that should be met. One of the 7 tests is equal treatment or discipline for similar offenses. It also can open Pandora’s box to a discrimination case if the person treated less equal is a member of a minority group or other protected class.

UC has an explanation for the treatment inequity. Physicians are peer reviewed in disciplinary cases. Everyone else deals with HR. They acknowledge that Physicians historically have been treated more leniently. Should they be? One could make a case that the the expectations and thus penalties for physicians should be higher than less educated staff.

David Feinberg, CEO of the UCLA Hospital System, said, "Historically, doctors have been treated in a way that may be more lenient than nonphysicians, and we will address that."

In their attempt to address the problem of privacy breaches and how to respond equitably to all offenders Gene Brock, UC Chancellor, has set up a committee of 11 people from various UC campus to come up with recommendations. 7 of the 11 are Physicians leaders, the rest are HR or Public Information staff. No Nurses or ancillary staff leaders. More stones for their glass houses.