A Shining City on Marquam Hill?

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—guest post by Local 328 executive-board member Trisha Crabb—

Every day, I pass beneath the OHSU campus soaring over Portland. I’ve always thought of it as a “Shining City on the Hill,” combining the political rhetoric of my formative years and the ideal of a beacon of good for the world to emulate. I’ve always seen the possibility of what OHSU could be — and should be. I spent the formative years of my life at OHSU. I’ve been shaped by the opportunities it brought into my life as I made Portland home for me and my family. OHSU has brought amazing work experiences and growth my way; my experiences here have made me a better person, and given me friends that I cherish. There is so much that is amazing about OHSU.

Part of my growth has been the development of my political and cultural self, an awakening to realities of economic justice, systemic bias and privilege. Somewhere along the way, I came to see that the “shining city” wasn’t lit by glowing ideals that I should emulate, but rather by the glint of gilded edges polished to a high shine so no one would see the flaws and weaknesses of the structure beneath. I know that OHSU as an entity has never been, at its core, more than a “fake it till you make it” endeavor. I know this because, for the past two decades, I have watched the constant erosion of potential.

OHSU is not reaching its full potential, despite reaching its financial goals. And for the first time, I fear it never will. Not as long as employees and patients are seen only as expense and revenue entries in a spreadsheet. Not as long the only employees who are always asked to sacrifice are the lowest paid workers. Not as long as those sacrifices are made so that OHSU can meet financial objectives that result in fat bonuses for highly paid executives. Not as long as only high-prestige projects and recruits are seen as worthy. Not as long as endless financial growth is the only focus and the money only flows uphill.

OHSU has a communications department that crafts and markets a specific image to the public. OHSU uses its public reputation, built by the marketing strategists, to promote its services to the public. Medical providers, nurses, AFSCME-represented employees and others deliver those services. Every single day, in thousands of moments, in hundreds of locations around the state, we deliver for OHSU. Our efforts give OHSU a platform to stand upon to market itself as a health-care, research and academic leader. But OHSU’s marketing image doesn’t capture the true culture of OHSU — the everyday interactions between coworkers and management, between patients and providers, between business partners and the community. The version of OHSU that is marketed to the public bears little resemblance to the culture we see reflected in OHSU’s actions at the bargaining table in AFSCME Local 328’s current contract negotiations.

I came to OHSU because it had marketed itself as a place where the mission ruled all actions, and in my first year at OHSU I met people every day who lived and breathed the mission with passion and integrity. For me, the first crack in the polished image appeared when the nurses went on strike at the end of 2001. The behaviors I observed — the harmful and retaliatory choices that leadership made, the willingness to throw money away needlessly to fight and to punish the nurses for daring to advocate for themselves and for their patients — tarnished my view of my employer. The determination of the nurses and their union showed me that the only thing that would move the leadership was a threat to the public’s perception of OHSU. It was so puzzling to me that the idea of OHSU was more powerful to OHSU’s leadership than the actual structure and strength of OHSU.

ANNC Magnet status was finally awarded to OHSU because the nurses bargained for it, fought for it and pushed for a decade to make sure it happened. Now OHSU uses that designation to polish its brand; never once have I heard an acknowledgement that it had to be dragged kicking and screaming into the program in the first place, or that only the determination, passion and ceaseless work of those nurses brought down barriers and made it happen. I could likely name a couple dozen smaller projects where the exact same pattern plays out: the employees advocate, agitate and force OHSU into growth, and then OHSU markets that growth to polish those gilded edges, often without acknowledging the difficult path to the change or the incredible dedication of the groups who make change happen.


“We are disappointed that AFSCME did not meaningfully engage with us to help create a more competitive and market-appropriate benefits system.”

“OHSU is breaking ground in so many ways“

Look at those two statements. The Local 328 bargaining team has dedicated an incredible amount of energy and integrity to the proposals they have brought to the table, while OHSU brought austerity proposals (in a time of record profits) that will — literally — make thousands of represented employees poorer. What’s groundbreaking about a health-care organization making health care less affordable for its own employees?

OHSU states that it is “a mission-based organization with a vision to improve the health and wellbeing of Oregonians…” and that it embraces “the pursuit of quality in the broadest possible sense — a commitment to excellence in our mission areas and integrity in our behavior.” Does OHSU’s vision of improving the health and wellbeing of Oregonians not extend to its own employees? Does short-staffing its units signal a commitment to excellence? Is nickel-and-diming its employees a sign of integrity?

By proposing a few weeks of paid parental leave for some members of our bargaining unit, OHSU has failed to recognize (or care?) that an aging workforce needs to care for parents, not children. Why not be a leader and propose paid family leave that all employees could use? By rejecting Local 328’s proposal to offer free transit passes to employees upon request, OHSU has demonstrated a lack of understanding of the difficulties our members face just to get to work. OHSU claims to want to reduce the demand for parking on the hill, yet has turned away a chance to remove a barrier that would help do that. By refusing to engage in discussions with our union about staffing, OHSU has ignored study after study that shows how much of an impact stress has on one’s health. Is the pursuit of ever-higher profits worth the damage done to the morale and health of its employees, many of who are also OHSU patients?

By ignoring Local 328’s proposal to form a community advisory board, OHSU has turned its back on part of its own mission: to “lead and advocate for programs that improve health for all Oregonians, and extend OHSU’s education, research and healthcare missions through community service, partnerships and outreach.” This advisory board will bring together faculty, union-represented employees, students and other OHSU stakeholders address concerns such as health-care costs, housing and transportation issues, sustainability and clinic access. Why would an organization that wants to be a leader in innovation not want to participate?

Sound business strategies that lead to financial success are, of course, important to any corporation. Our union wants OHSU to operate with a sound financial foundation. Profits cannot be the end-all be-all, though — not if OHSU wants to truly be an innovator and leader in the ways that count. During this round of negotiations, OHSU has a chance to break out of the boundaries dictated by “the market” and create a culture where workers at all levels are appreciated, respected and valued.

Attracting and keeping top tier-talent never used to be a problem for OHSU. People with amazing gifts have always flocked to the hill and OHSU’s far-reaching programs for the chance to realize a vision “to make Oregon a national leader in health and science innovation.” If they aren’t coming now (or they aren’t staying) it’s not because OHSU’s wages and benefits aren’t competitive — it’s because the word is out that the real OHSU is hidden by a gilded veneer. That veneer is cracking.

During my time at OHSU, I have been naïve and hopeful, I have been hurt and disillusioned, I have been pragmatic and willing to sacrifice. Through it all I have been understanding and have always given OHSU’s leaders the benefit of the doubt in my heart. Until now. Now I am tired and disappointed, and sad that the OHSU I have always believed we could be become, will never be.

58 thoughts on “A Shining City on Marquam Hill?”

  1. Wow….powerful story! Wonderfully written and oh, so sadly true. I hope OHSU leadership takes some notes and makes some changes. I have never understood how they could keep nickel and diming us to death when they are making such good profits.

  2. “OHSU is not reaching its full potential, despite reaching its financial goals.”

    THIS, thank you for stating it so well. If OHSU has indeed pulled in so much from our workers, why are they so reluctant/negligent to raise us up with them? I know – corporate greed, etc., but I was just hopeful I had been working for someone with more integrity, with how they spout their taglines and mottos. If they refuse to raise us up with them, I will likely look elsewhere for employment. I am so hopeful they will though. Thanks for everything you’re doing!

  3. Well said. So frustrating to do our best day in and day out and be rewarded with an effective pay cut and decreased benefits when we have record profits.

  4. Beautifully written! OHSU can make this a better place to work, or make it harder for its employees. I’m very disappointed in what I’m hearing from them.

  5. I cant even begin to Express how moved I was by this ….we are clearly heading in the opposite direction of greatness

  6. Well stated. It’s been so hard to face the reality of working here. We have all been working full steam, non-Stop. We’re all exhausted and now this contract negotiation feels like a slap in the face.

  7. It is time for OHSU to wake up and be a leader, by doing what is the right thing for the AFSCME represented employees . Because We Work, OHSU works, not the other way around .

    1. It’s time OHSU does what’s right for ALL their employees. Unclassified employees are not treated any better but we, unfortunately, don’t have the strong representation of the AFSCME bargaining team. Many of us hang our hopes on your contract negotiations hoping not to lose even more of the benefits we were promised when we accepted our positions.

      You are not fighting this alone! Stand strong and keep fighting for what you, and all OHSU employees, deserve. Respect, dignity, fair wages and fair benefits!

      1. Thank you for the support! We are definitely mindful that what happens with our contract influences the conditions for other workers at OHSU. We hope you and other unclassified folks are able to join us for our rally on June 13. :)

  8. You know those billboards for DCH with the 2 kids that read “We’re #1, because they’re #1″? Anyone who works here knows that there would be more truth in it if the kids were replaced by photos of Lawrence Furnstahl and Danny Jacobs.

    OHSU froze hiring and implemented cost-containment measures that were incompatible with safe patient care during a time of record profit. Now they want to ensure that me and my family will be struggling more in the next 2-3 years than we are today. Shameful. It’s time the general public sees OHSU for who they really are.

    Thank you for speaking up.

  9. This is completely accurate and beautifully written. OHSU just doesn’t care about anything but the bottom line. It’s easily the most toxic place I’ve ever worked.

  10. Yep, it was bad long-term news for all when CFO Larry managed to consolidate so much power a few years ago.

  11. This summons up more than just OHSU, it sums up a changing business culture that is fooling its young and old employees that will ultimately hurt themselves in the future.

  12. A powerful, thoughtful and damn near poetic article. Thank you for putting into words the complexity of the emotions we feel. The disappointment, frustration and disrespect with the proposals and attitudes of the executive team at the bargaining table. But, in at least equal measure the passion, commitment and dedication that we feel to our co-workers and patients. So well done. Again, thank you.

  13. Words could not be written that would better describe the truth of working for OHSU. I have appreciated my coworkers, patients, and the opportunity to help heal for 16 years at OHSU. I am ashamed of the part of this institution that cares absolutely nothing about me. Seems the only thing they are willing to give is a tote bag. Thanks but no thanks. I dont need a free plastic OHSU tote bag. I need my earned retirement to be safe. I need insurance to be affordable. I need adequate staffing. I need equal pay for all races and gender. I need to be able to afford to keep working for OHSU. I NEED to be proud of the place i work.

  14. Well said! Thank you for taking the time to spell it out in such a thoughtfully eloquent way. I agree wholeheartedly with everything you wrote.

  15. Not just a statement of how I, we, many feel. A statement of fact and truth. Truth as evidenced by all the broken and missing chairs for patients to sit in. Truth as evidenced by all the patients missing vital services from professionals because there are not enough of them to see the patients. Truth as evidenced by the awful proposals from OHSU.
    OHSU: you can change course. But it starts now. Show up at bargaining with financial and vacation and health care proposals that respect us. Show up willing to engage with the community and employees and support outreach and staffing proposals from AFSCME. You can change course, there is still time. But it has to start now. Do our voices matter? Are you listening?

  16. Very well said my friend!
    I couldn’t agree more I am ready and willing to Strike with my fellow Union members if OHSU wants to give all the money to the executives because they obviously forget who is collecting that money for them to pay the big wigs that’s fine. My co worker and I collect on average $150,000 to $200,000 a Month each for service that haven’t even been render pre collections! Our best Month together we collected over $575,000, so when we are striking because they don’t want to share a piece of the pie, those executives can call patients and ask for money before surgey:) Power to the people together we stand strong!

  17. Very well stated Tricia.
    One of the sections that struck me the most was “… the real OHSU is hidden by a gilded veneer. That veneer is cracking.” We have seen difficulty hiring for posted positions in our department, and nearly all of the new employees we have hired in recent years have been either new grads or people from out-of-state. It seems as if no one local or experienced is interested in working for rehab at OHSU – and I don’t blame them. I am reconsidering my decision to stand by an employer who so clearly chooses profits over my hard work, dedication, experience, and compassion on every occasion possible.

  18. This was very well written. Thank you for saying what so many of us wish we could put it out there so eloquently. I hope OHSU pulls there heads out of their you know where!!! Listen to its employees.

  19. This is just so sad and true. The more I talk to people around the hospital, the more it seems like OHSU places profits over patients and staff. It seems like a strategy to burn out their staff and keep turnover high, so they can continually hire people at the bottom of the pay scale. A major culture change is needed!

  20. Thank you! You said exactly what many of us are thinking and feeling. OHSU’s mission statement means NOTHING without the skills, compassion and hard work of its employees who care for patients on a daily basis. It’s time OHSU starts showing its employees that it actually appreciates the work they do to make their mission a reality.

  21. Very well said. I agree whole-heartedly. I am so frustrated, but comforted that we are standing together and speaking up.

  22. Beautifully written commentary on the current management ethic at OHSU. Thank you for taking the time to write so eloquently about the potential of OHSU and the ultimate disappointment with OHSU. It will take a LONG time to get past the derision expressed in the “too poor to strike” comment from the management bargaining team members.

  23. Exactly. This goes for all unions and workers on the hill. I’m disappointed the nursing union isn’t backing our union brothers and sisters more pubically. I’m disgusted we keep being asked to knock 10% off our unit budget while the management keeps getting bigger and bigger bonuses and ohsu keeps making more money. A line in the sand has been crossed. Address the situation, push back now or it’s only going to get worse.

  24. It really is a point of irony, isn’t it, that the management groups want to make healthcare more unaffordable for their very own employees at a healthcare institution. One would think (just spittballing here) that being a healthcare institution would provide OHSU with a little more leverage on that score. “Come work at OHSU – we are healthcare, and we therefore can give it to our employees.” Nope! More like, “come work at OHSU – we are healthcare, so we will charge you a lot for it.”

    Has senior management done anything to fight the increased cost of healthcare for its employees on the insurance side? Have they asked MODA for a cost cap for OHSU employees? Here is an idea. How about the next time we dole out a $50,000,000 unsecured loan to MODA that results in 16.5 million in losses for OHSU, how about it is given on condition that insurance costs do not increase at all for OHSU employees until the loan is repaid in full? Again, just spittballing here. I am not a financial surgeon or anything.

  25. Thanks Tricia!
    I started 14 years ago. My dept had several people who had already been at OHSU for over 20 years. They stated they felt a environmental shift when Kohler started as Pres – a shift from a public non-profit healthcare institution focuses on quality care, to a bottom-line focused business entity. The reality is a bottom-line focus inevitably leads to the sacrifice of “quality” because it is such an intangible item that is not easily identified or measured, but always known, especially after it’s gone.
    I don’t know if that is the actual cause, or just a coincidence in timing with a societal shift to a win-at-all-cost & profit-is-the-only-measure mentality, Or maybe it’s just the timing of the retirement of the business leaders born in the greatest generation ever, with leadership being taken over by those who did not have a core of values based on character, honor, integrity.
    At a time in our country where the inequity of wages is a topic of daily national discussion, where the truth of the wealthy systematically working to oppress and suppress their workforce for no reason other than to increase THEIR own wealth – just makes this offer so much more offensive.
    To know that the wage structure is broken, and then to use “market values” as the justification to make a net reduction to our wages through shifting more of our health insurance expense to us, AND also by reducing our annual across the board (COLA) increase to well below the national rate of 3% for 2019, and to also express that we should somehow be grateful that our wages are, on average, 6% above the market… when we all know that the majority of the AFSCME membership falls into the group whose wages have been virtually stagnant for the last 30 years – yeah, thanks for nothing OHSU Mgmt.
    Our new President rec’d a 36% pay increase from the previous President – or about $450,000, and then a bonus of over $100,000
    He has now proven that all his gung-ho talk about transparency and being more inclusive and respectful is nothing more than rhetorical hot air. As they say, believe what people do – not what they say.
    This is an utterly offensive offer in it’s across the board attack to cut our wages. With their offer, at the end of the 2 year contract, we will no longer have even the 6% to show for our hard work and dedication to an otherwise exceptionally institution.

  26. Thank you so much, for putting what we all are thinking into words! I applaud you!
    “Too poor to strike” that comment alone shows how much OHSU really cares for it’s employees. I also, used to be proud to work for the big hospital on the hill! Not so much anymore! I’m sad, disappointed and scared for the future if OHSU gets their way! Take a stand OHSU! Show Portland that you are great by taking care of your employees…the employees who have always taken care of you!

  27. Thank you so much, Trisha, for taking the time to write this pitch perfect piece — too bad OHSU management is so tone deaf to how its treatment of and policies toward AFSCME-represented employees is so disrespectful and shameful.

  28. I won’t ever forget that when MODA was about to go under in 2015, OHSU gave them $50 million. Officially a loan, I guess, but one with no collateral or any other promise of payment. As far as I can tell, that “loan” has yet to be repaid.

    I also won’t ever forget during the Recession, all the sacrifices OHSU asked us employees to make so we can all get through that economically devastating time.

    Why can’t OHSU make that sort of commitment to their employees now? Why not make an investment in employees instead of an ethically questionable insurance company? We had OHSU’s back during the Recession but now, when people are struggling, they don’t have ours. I’m very disappointed.

  29. Thank you for putting all my thoughts and feelings so eloquently. We echo your heartache, and only hope that OHSU is listening. We love our jobs, we love our patients, but we aren’t blind. We are in need of a fair contract to continue our quest at OHSU. OHSU has lost its sparkle, and there are patients that need our services all over this world. It’s time to realize we have spent years giving them the benefit of the doubt. It’s time to move on with our quest.

  30. Every time I drive past a billboard with “we’re number one because they’re number one” I think “Liar liar pants on fire!”

    1. I must admit the recent tote bags are clever. I could walk around advertising OHSU on my day off. But I won’t.

      1. It’s a funny concept. Most of us are OHSU patients, so therefore, we must be “number one” right? Wrong. Because we’re also OHSU employees and they’re treating us as if we don’t even matter.

    2. It’s a funny concept. Most of us are OHSU patients, so therefore, we must be “number one” right? Wrong. Because we’re also OHSU employees and they’re treating us as if we don’t even matter.

  31. Thank you for your honesty. I agree with you 100 percent. We must stand together to make this work for our AFSCME members.

  32. This stands as a powerful statement of truth in a time of the widening gap between the rich and powerful executives at OHSU and the people who work with integrity and passion to make our community a better place. It speaks to the fact that OHSU leadership cares about public perception, but they are not willing to walk their talk.
    Thank you for putting our issues out there in such a profound and elegant way.

  33. It is so unfortunate, and so right on the money. I have only been working at Ohsu for 3 years and I already felt sad and oppressed during that hiring freeze. I stay because I love what I do and have hope in our power as a union to restore security and a sense of pride in our place of work.
    You all, plus our patients, make this a worthwhile mission!!!

  34. This is wonderfully written. I feel like I could respond at length, but would just be doing a poor job of reiterating Trisha’s points. With OHSU as the largest employer in Portland city limits, it is important to look at the big picture with this bargaining. Portland workers have been making some headway in standing up for themselves as a whole – Portland Teachers, fast food workers, IRCO, Outside In and many, many other workers have been standing up and demanding not just better working conditions and wages, but improved situations to meet the needs of those they serve. OHSU’s attempt at take-backs – at stagnating our wages – is an attack on all Portland workers who’ve put up with this for too long. We deserve to share in the profit that only exists because of our labor. All Portland workers deserve to be treated with respect and paid well for their labor. All Oregonians deserve health, healthcare, and to earn an excellent wage. OHSU has the power to do what’s right, and to encourage other organisations to do the same, and it seems to be doing what’s wrong, and encouraging a bleak future for workers at OHSU and around the region.

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