In the past, when we helped physicians, PAs, NPs and other healthcare workers negotiate employment contracts, we were mainly concerned with workload, termination, noncompete restrictions, and compensation. Recently though, for those contemplating hospital employment, we have added to our list the hospital’s financial stability and union status.

Hospitals across the country have recently filed for bankruptcy, closed, or announced closure, including hospitals in Missouri, Iowa, North Carolina, Michigan, NY, California, Texas, Ohio, Massachusetts, and Illinois. According to a report published earlier this year by the Center for Healthcare Quality and Payment Reform, 30% of all the rural hospitals in the US are at risk of closure for financial reasons. Others are staying afloat by closing departments or discontinuing services, with behavioral health and maternal and childcare being particularly hard hit. Union strikes are also on the upswing nationwide, with a recent example being over 68,000 Kaiser Permanente employees in seven states, including Maryland, Virginia, and DC, authorizing a strike if the company and unions can’t reach a deal by the end of this month.

Bottom line, before you take a job with a hospital, be sure that it is financially stable and on good terms with its union members and that your department is not slated for closure.

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