In February, the county laid off 1,200 employees who provided health care for some of the poorest people in the Chicago area. Those cuts also rocked the doctors and nurses left behind. Unhappy and insecure many are leaving their jobs. And that’s creating more instability in the already struggling public health care system in Cook County.
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Switching between forward and reverse, Tina Smith maneuvers her electric wheel chair around a crowded windowless waiting room at Cook County hospital. She makes her way to a semi-quiet corner and starts chatting with the woman beside her about how much she loves Dr. Bar.
Smith: “He takes his time with his patients. He’s interested in you and he has a memory that’s unbelievable. You feel that someone cares about you and that’s why I’m so devoted to him because he has been so wonderful to me for all the years that I’ve known him.”
Smith has been coming here for 20 years. But she says in the last few months, the doctors and nurses have seemed rushed.
Smith: “I see them running from room to room and it just looks like everybody’s kind of overrun.”
As Smith talks about how she wants to feel cared for, a nurse comes from behind a locked door and barks out her name. It takes Smith a few seconds to turn toward the examination rooms. Remember, she’s 70 and in a wheel chair. The nurse sighs impatiently and goes on to another task, leaving Smith to wait facing the locked door.
Rubin: “We’re being forced to do things in a way that doesn’t allow us to give optimal care to the patients that we do see and it has reached the breaking point.”
Dr. Rachel Rubin has been with the county hospital, now called Stroger, for 23 years. She says, in March, doctors were told they need to start seeing at least four patients every hour instead of three. She says that doesn’t leave enough time to diagnose someone who has severe health issues and may not have been to the doctor for quite a while. Rubin says doctors at Stroger just don’t want to practice medicine under those kinds of constraints. And she says hospital administrators have been unresponsive to the concerns of the medical staff.
Rubin: “In planning and attempts to deal with the budget deficits and how best to take care of our patients we are basically being told this is what you’re going to do and suck it up or leave.”
So, many are leaving. Rubin will be starting a new job over the summer. Other dedicated and skilled physicians are doing the same. One nurse says that everyone with a Cook County I-D badge is currently conducting a job search. Dr. Robert Simon heads the Cook County Bureau of Health Services. He says whenever you cut 1,200 of 8,200 jobs, morale is going to be low.
Simon: “We really don’t want to do this. We’re stuck. There’s a half a billion dollar deficit. No one would want to inherit that and make all these cuts.”
Hospital staff live in fear that more pink slips are just around the corner. And they’re worried personnel cuts could be political as well as practical. Outside the hospital, mic in hand, I approach two employees leaving work and ask them about the cuts.
“Sheraton:" “My name is Cathy. Cathy...(pause)...Sheraton.
That was a long pause while she tried to remember her name. Needless to say Cathy Sheraton is not the name on the I-D badge prominently displayed on her lapel. But anyway.
“Sheraton:" “We need these little jobs. If we say something out of the way then we might be persecuted for it.”
Whether the cuts have been political or not, they’ve been chaotic. Dr. Janice Benson is the president of the medical staff. She represents physicians’ concerns to hospital administrators. On February 20 she received one of about 1,000 layoff notices the county sent out to employees that day. A week later the notices were rescinded, but now Dr. Benson and others realize they can be fired at the drop of a hat. She worries the instability will affect the quality of the staff.
Benson: “Can we keep good doctors and bring in new good doctors or will they say, you’re just too insecure. I can not risk my families economic well-being for the next year by taking a chance by joining county.”
Benson is pushing administrators to give doctors contracts that would guarantee their employment for a certain length of time. She says that would prevent Stroger hospital from ending up with doctors who can’t get jobs anywhere else. County health chief Robert Simon says he hopes the federal and state governments step up their funding and pull the county out of the current crisis. Today Simon’s scheduled to update Cook County Commissioners on how the restructuring is going, and what the financial picture looks like.