As St. Charles Health System faces financial crisis, its doctors want to unionize

By Joni Auden Land (OPB)
June 3, 2022 7:57 p.m.

Following years of financial struggles, providers at Central Oregon’s largest hospital and health care system announced Friday they intend to form a union.

Speaking outside the St. Charles Medical Center campus in Bend, a group of providers said they plan on holding an election for a union, following years of what they describe as financial mismanagement by the hospital that has led to reductions in staff and services.


“St. Charles made what we consider very poor decisions before and during the pandemic … that put our health care system in this terrible financial crisis,” said Dr. Joshua Plank, a hospitalist at St. Charles.

The proposed union would consist of around 300 physicians, nurse practitioners, physician assistants and other health care workers. Organizers said an election to approve the union is expected within the next three to four weeks.

Dr. Joshua Plank speaks outside St. Charles Medical Center in Bend, where a group of providers announced June 3, 2022 they intended to form a union.

Dr. Joshua Plank speaks outside St. Charles Medical Center in Bend, where a group of providers announced June 3, 2022 they intended to form a union.

Joni Land / OPB

It’s not the first union among St. Charles employees. Technical workers and the hospital agreed on a contract in 2021, soon after starting a strike.

Organizers said they are not looking for pay increases or a reduction in hours, but instead a greater say in future decisions at the hospital — including layoffs.

The announcement comes more than two weeks after hospital leaders announced they would lay off 105 caregivers and eliminate 76 unfilled positions because of severe financial losses in 2022. The hospital said it had losses of $21.8 million through April and faced a 6.7% operating loss.

The hospital is also the largest employer in the region.


Erin Butler, a physician assistant at St. Charles, said many of her coworkers are scared for the future of their positions and that they could be laid off at any time.

“It’s really tough to think about having a job where potentially you have one foot out the door,” Butler said.

St. Charles has cited a growing reliance on contract labor, such as travel nurses, and the rising costs of equipment during the COVID-19 pandemic as some of the financial setbacks that led to layoffs. St. Charles, like many health systems across the country, borrowed millions of dollars from the federal government for pandemic aid. This year, the U.S. Department of Health and Human Services began recouping some of that cash advance by not reimbursing Medicare.

Still, providers said poor financial decisions by hospital leadership predate the pandemic, and that they have not been included in the discussion to remedy those issues.

A St. Charles spokesperson declined to respond to claims of financial mismanagement beyond an earlier news release, which did not address the topic.

“We greatly value our employed providers and respect their right to take this step, although we’d far prefer to work directly with them in partnership while navigating these unprecedented times,” Chief Physician Executive Jeff Absalon said in the statement.

An email obtained by OPB shows hospital leadership did reach out to employees ahead of Friday’s announcement. Absalon said in the email to staff that they did not believe a union would benefit the larger community.

“We are disappointed in this shift in direction to organize, as it could hamper our ability to work directly on solutions going forward,” Absalon said.

He also said the hospital would send employees information on how a union “could change our work environment and culture.”

It’s rare for physicians and other providers to form a union, but Plank said physicians like him are not being listened to by hospital management — and they want that to change.

“It goes to show that that is kind of where things are these days in health care,” he said. “We aren’t being heard and we want to have a voice.”


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