Palo Alto Medical lays off 53 workers

Nurses and medical assistants are laid off before the holidays

Fifty-three positions have been eliminated at the Palo Alto Medical Foundation (PAMF), the organization announced Wednesday (Dec. 1).

The layoffs were made "to reduce cost and improve affordability for our patients," spokeswoman Cynthia Greaves said.

Those affected included nurses, medical assistants, patient-service representatives and imaging staff from multiple locations in Alameda, Santa Cruz and Santa Clara counties, Greaves said.

"Health care reform is already bringing reductions in Medicare reimbursement," Greaves said. "Commercial insurance companies are demanding lower costs, and employers are reducing their contribution to health care benefits for employees."

The changes from the health care reform have affected what Greaves called their "affordability goals," leading PAMF to terminate the 53 employees.

Before letting go any employees, PAMF offered a voluntary early-exit program and eliminated any vacant positions. While terminating positions, the organization also sought to move employees into open positions before laying the workers off.

"This action was not easily taken and was pursued only after long and careful review of many options," Greaves stated. According to a press release, PAMF will support those who lost their jobs through the transition and will keep the former employees informed of new job postings within PAMF when they arise.

"This has been a very difficult decision for all of us and a new experience for our organization and its culture," Greaves said. "We promise to respect and support the people affected by these changes, and we will continue to provide open and honest communication as we address the challenges ahead."

PAMF has approximately 4,600 employees.

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Like this comment
Posted by rhody
a resident of Barron Park
on Dec 1, 2010 at 6:09 pm

PAMF quality of service has already detiorated so much that after 'belonging' for 10+ years, I had already decided to leave as of Jan., 2011. I pity the patents who continue with them after this cut in staff.

Like this comment
Posted by neighbor
a resident of another community
on Dec 1, 2010 at 6:30 pm

Have they cancelled their plans to build a hospital in San Carlos?

Like this comment
Posted by wow
a resident of Fairmeadow
on Dec 2, 2010 at 3:23 am

wow..i gues we know where the monies are being redirected

Like this comment
Posted by Gio
a resident of another community
on Dec 2, 2010 at 10:08 am

Expect more of the same. This is the so called change we can believe in.

Like this comment
Posted by Anna
a resident of Downtown North
on Dec 2, 2010 at 10:21 am

The shoes of Obamacare continue to drop...Gio is right: Expect steady deterioration in the quality of our healthcare.

Like this comment
Posted by blimp
a resident of South of Midtown
on Dec 2, 2010 at 10:47 am

Like many, there is probably too much fat in PAMF. After things settle, most of us will notice little. What we do notice is the price we pay for helping those who have no medical care. Annoying? Yes!, but necessary. Regrdless PAMF is still better than alternatives.

Like this comment
Posted by neighbor
a resident of another community
on Dec 2, 2010 at 11:02 am

This has nothing to do with the new medical care bill. It has everything to do with the medical system's greed, which has been going on for years. PAMF expanded way too fast.

Like this comment
Posted by Ada
a resident of Midtown
on Dec 2, 2010 at 11:20 am

I am very happy with the level of service at PAMF in Palo Alto, no lines, prompt and courteous service and my doctor takes time to listen and address all issues. On the contrary, in some community hospitals and clinics doctors and nurse practitioners have explicit orders from management not to spend more than 15 min per patient and that includes writing notes. What can you do in 15 minutes, especially with the older age patients??? That said I think medical care in US is extremely inefficient. Maybe one way to deal with it is to cap the liability of doctors...

Like this comment
Posted by CV
a resident of another community
on Dec 2, 2010 at 11:26 am

Whether you like Obamacare or not, one thing is clear to me - we need universal health care available for all. My cousin who is 49 and a healthy man was turned down by insurance because he has high blood preassure. So he can not buy health insurance, don't you think it is insane??? I know many people who were turned down by Blue Cross and similar insurance companies because they had some health issues. They ended up buying emergency insurance, but they need to pay for regular Dr visits out of pocket.
It looks like Republicans will continue to paralyze any efforts in creating a universal health care plan just out of spite.

Like this comment
Posted by the_punnisher
a resident of Mountain View
on Dec 2, 2010 at 11:48 am

Note how many upper MANAGEMENT levels were NOT cut. This set of layoffs reduces an already lack of care problem to intolerable levels. The SFBA already WAREHOUSES the sick and elderly, I can personally attest to that.

Oh well, upper management probably are all lawyers. Sutter will need them pretty soon as the elder abuse charges start spiking...

Like this comment
Posted by Bob
a resident of Mountain View
on Dec 2, 2010 at 12:26 pm

My wife and I have been with PAMF for over 20 years and have had excellent care and service. This doesn't necessarily mean that cutting some positions will bring about a level of service that is lower. We do not believe in universal health care as a right. We believe in taking personal responsibility for our lives. Is health care expensive, yes, and how much of that expense is for people who have no coverage, but get the same care as those who pay. This is simply more class warfare. I am not for turning away those without coverage who are injured or have emergency needs, that is what Valley Med is for. There does need to be a change as to pre-existing condition coverage and the cost of prescriptions. But the basic concept is are you a grasshopper or an ant.

Like this comment
Posted by ChrisC
a resident of College Terrace
on Dec 2, 2010 at 12:40 pm

Everything is going to be blamed on Health "Reform" now. It doesn't make sense to me since it's supposed to let more people go to doctors, therefore increasing demand I too appreciate PAMF and am happy with the service I have received there. In April, I had surgery and the billing was error-free and easy to understand. The only doctor whose billing was a mess and who actually cheated my insurance company is not a member of PAMF. However, PAMF's rates are higher than private doctors, which I don't understand since they are non-profit. The problem all along in this area is very low payments by Blue Cross to doctors -- they pay less than Medicare. Many doctors have dropped it altogether. This was way before Health Care "Reform."

Like this comment
Posted by Sylvia
a resident of Midtown
on Dec 2, 2010 at 4:32 pm

I have been a PAMF patient for over 25 years. My internist saved my life with an early diagnosis. I have always been completely satisfied with any of the doctors I've seen there over the years. I have also had conversations with some of the the employees there in which they raved about what a good place it was to work.

I think the knee-jerk reaction that these layoffs are because of Health Care Reform is ridiculous. Obviously the economy continues to be in bad shape. Many people lost their jobs, and COBRA is seriously expensive. I would guess that some people just gave up on affording health insurance after losing their jobs - and stopped going to the doctor. This could certainly account for lower revenues for PAMF.

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Posted by Anna
a resident of Downtown North
on Dec 2, 2010 at 10:36 pm

Sylvia and others aren't bothering to read the story this post is based on prior to commenting.

According to PAMF, says the article, "The changes from the health care reform have affected what Greaves called their "affordability goals," leading PAMF to terminate the 53 employees.."

Obamacare is already having many deleterious effects on our healthcare. There's no reason to think this will not continue as its rollout continues.

Like this comment
Posted by pro business
a resident of Another Palo Alto neighborhood
on Dec 3, 2010 at 12:54 am

Hey Bob,
Do you know that the cost of bureaucracy in the healthcare system, largely due to private for-profit health insurers, runs our nation over $450 billion every year? That's on the same order of magnitude of peace-time defense budget of the US. It's stupid to let that continue, just stupid, the health reform law will only make it worse, and unfortunately the people who are supposed to be the fiscal conservatives in government have too many ideological blinders to deal with this enormous (ahem) elephant in the room.

I'd much rather be spending that money giving everyone healthcare than supporting a massive insurance-controlled bureaucracy to cheat people out of it.

(And no, for the record, I'm not for single payer. I do think we'd be better off with a system more like they have in Japan, Germany, or Switzerland. Those places are providing universal healthcare, higher usage, higher level of service -- in some cases, perks we can only dream of here -- better outcomes, in private delivery systems using private (non-profit ONLY insurance, the US is the only advanced nation still allowing healthinsurers to profit for healthcare financing)-- all for way less money per capita. (And even though the minimum wage in a place like CH is three or four times what it is here.)

It's time to think of healthcare delivery like we do other public services, like the roads, fire and police protections, armed services protection, etc. You can always get more if you want to pay for it yourself but we do better for the majority of Americans by offering the public service. (I dare you to diss the armed services, I will sic my friends in the tea party on you.) Imagine what this country would be like if only private interests built roads.

Like this comment
Posted by Nurse
a resident of Old Palo Alto
on Dec 3, 2010 at 7:45 am

The community should be aware that 24 registered nurses were laid off this past week. The RNs are being replaced with medical assistants or their positions have been eliminated period. The patients at PAMF will now be served by more and more unlicensed staff.

Like this comment
Posted by Hmmm
a resident of East Palo Alto
on Dec 3, 2010 at 11:56 am

Hmmm is a registered user.

Nurse, thank you for your post. Question: Did any of the fat cat bureacrats get laid off?

As a long time PAMF patient w/many medical professionals in the family, I figured the nurse layoff was coming. I have concerns about less knowledgeable staff doing more & more. Ironically, the one time I had poor service at PAMF's UCC was from a doctor who didn't order xrays for an injury, one that still causes problems for me. I did notice how much she joked & flirted w/other staff, though.

PAMF, like any healthcare org, has its pluses & minuses. In recent years, on the patient side, I have experienced less wait times, increased professionalism of non-medical staff, and very thorough work by doctors & other medical staff. But hey, I had the same experience at Kaiser a few years ago, too. I think that vigilance on behalf of the patient is important, especially when a medical organization just had a layoff. Of course, I'd prefer PAMF layoff some of their fat cats to keep the hard working medical staff employed.

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Posted by Charlie
a resident of College Terrace
on Dec 3, 2010 at 12:56 pm

I have used PAMF for my healthcare for over 50 years, and have been very happy with the level of care my doctors have provided. I do know one case, with a family member, where I think the doctor did not do a good job but that could happen anywyere.

So put this in perspective: what organizations and businesses have not faced layoffs in the last year or two? And while it is always sad to eliminate jobs, in this case the percentage of the workforce departing is not significant and should not create problems with patient care.

Like this comment
Posted by mike
a resident of Crescent Park
on Dec 3, 2010 at 2:59 pm

This is going to be the future pattern of health care changes under Obamacare. You don't add 30 million new people to be covered without some effects. You don't add thousands of new rules and constraints without changes in the health care providers.

About 80% of Palo Alto voted for the current administration. This must be what you wanted.

Like this comment
Posted by pro b
a resident of Another Palo Alto neighborhood
on Dec 3, 2010 at 11:51 pm

As a patient, having that integrated digital medical record that I can access myself when I have tests and imaging -- it's priceless. I'm used to getting imaging and then no one who ordered it even looking at the films, and spending frustrating weeks or months trying to get copies to the right physicians who ask for them. (In theory, this is supposed to happen without me, in practice, it never does_ Now it's all there in the PAMF system, along with all of me medical visits.

Like this comment
Posted by bick
a resident of University South
on Dec 4, 2010 at 8:56 am

The problem with PAMF is they charge way too much for service. For a "non-profit", their prices are way too high. I suspect layoffs are necessary because of mis-management at the top.

Like this comment
Posted by Steve C
a resident of Menlo Park
on Dec 4, 2010 at 11:57 am

Notice the first driver mentioned for this cutback was: "commercial insurance companies are demanding lower costs..."
That pretty much tells you who is driving the bus; the same companies that have created the need for reform.

Like this comment
Posted by JoAnn
a resident of Ventura
on Dec 4, 2010 at 7:12 pm

"National surveys have found that family premiums for employer-sponsored health coverages increased 52 percent from 2003 to 2009, while median family income rose 13 percent...If insurance premiums for employer-sponsored health plans in each state continued to grow at the same average annual rate seen from 2003 to 2009, the average premium for family coverage would rise to $23,342 by 2020—an increase of 79 percent."

Web Link

We who voted for Obama wanted single payer or at least a public option, but we didn't get it. He got something but it won't fix the underlying problems. The drug insurance companies are still making money hand over fist. The price will keep going up until the whole system implodes.

Like this comment
Posted by Perspective
a resident of Meadow Park
on Dec 5, 2010 at 6:15 am

Bottom line: The more like Europe we get, the more like Europe we will suffer.

We are seeing the results in all areas in our "new normal".

I don't want to live like Europe, I want to live here. Bring back America. Amazingly enough, if you pay attention to places like France, you learn that there is no such thing as "universal" health care. Those who want choices and quality and timely access are buying..guess what?...PRIVATE insurance plans. Unfortunately, they are exhorbitantly priced because their insurance companies are forced to cover the absurd in a system which is fraught with bureacratic costs.

Solutions in health care to lower costs so all can afford insurance.

First, don't repeat Europe's mistakes. Some of us like to learn from the mistakes of others. So, reverse this "universal" care concept, where some pay for all. Instead, cut to the solutions that work..

1) Take away tax breaks for employer sponsored insurance, put it all on we run car insurance. Let people choose the level of health care they want to pay for. I am betting most of us would prefer to have the level of care, for CATASTROPHES ONLY, that we had 30 years ago, and let us pay for our own day to day colds, etc, like we used to do. Along the lines of choices we have in any other insurance realm, from car insurance to home insurance. That worked great, until govt got involved and started "protecting" us by mandating insurances cover more and more stuff, including, now here, language translation services. I don't want to pay for everyone else's language translation, hair transplants, massage therapy, chiropractic, accupuncture etc. I just want to pay for insurance to cover catastrophes, like cancer, heart attacks or other diseases which can kill me. I can take care of my own other costs, choosing the options that suit me, going to my annual checkups or not, paying for accupuncture treatments or not, as I see fit.

This has been proposed as "buy insurance across State lines" because some States don't force one size fits all Mercedes class insurance laws.

3) Everyone who wants a privilege, perhaps tied to a driver's license, since the vast majority of us want that, has to show proof of medical insurance before getting a license. That would drastically increase the number of insured young people who now choose not to insure themselves, though they could buy every month for less than they spend on a pair of shoes, or a night at a bar. But they don't see the point since they are healthy. Imagine a system where we could buy auto insurance AFTER we are in a car wreck. That is what we are trying to do with medical insurance. If everyone had medical insurance from a young age, we wouldn't have most of the "preexisting" problems.

The example of the guy above who can't find insurance because he has high blood pressure, I have to ask myself, why didn't he buy it and keep it from a young, healthy age? He would have it now if he had taken the responsible choice of buying his insurance years ago...and keeping it. Instead there are cries from people who believe I should pay to fix the car for the guy who didn't see fit to buy insurance on his car.

We are free to make wise choices only when we are free to make poor choices and pay the price.

4) Tort reform. Lower medical malpractice insurance rates by lowering the insane pay-out options.

I work in health care, and have for 30 years. I have watched the ever rising insanity, and watched the ever decreasing amount of time we can each spend on each patient over the years as there are fewer and fewer actual dollars per patient. I can clearly see ( from my backyard! lol) a future where the best and brightest of us don't choose health care because it is a no-win situation. Where will all the "choice" and "best health care" desires be then?

Just do that much, and watch more folks choose to buy their own insurance, lowering insurance costs for all of us from having more folks in the system and tiered options legal again... and watch health care costs plummet, yet still attract the creative best of us.

PHARMACY COMPANIES: Make a lower profit than most,for example, Microsoft.

They spend literally billions of dollars and 10 years testing out a thousand possible life saving and enhancing medications and are lucky if 1/1000 make it to market. That ONE that makes it has to be worth doing, so it has to make a lot of money to pay for the cost of developing it and the other 999 medications that didn't make it. There has to be a profit in it, or why bother doing it? Who would spend years getting a PhD, then many more years working their whole lives to develop medications that we take for granted, if there weren't a financial incentive?

Or do we really want to keep punishing those who make all our lives better? I guess what some of us really want is to make sure there aren't any new medicines or machines invented to help our lives. Better we all suffer than any get an "obscene" reward for saving lives.

Simple test...ask how many new medicines have come out of Europe? Canada? Then ask yourself why it has been the USA that creates the "new bests"? Or, I guess we can just live with what we already know about asthma and cancer and diabetes and heart normal? No hope for better?

Like this comment
Posted by An employee
a resident of another community
on Dec 7, 2010 at 8:47 pm

this layoff had NOTHING to do with obama.. it had to do with upper management not knowing how to handle the budget for 2011, so to save there own ass.. they had to layoff, HARD WORKING nurses, PAMF would be NOTHING without the clinical staff... I really hope this comes back and bites the big wigs in the ass... I hope they are sleeping well after laying off nurses 25 days before Christmas...

Like this comment
Posted by Perspective
a resident of Meadow Park
on Dec 9, 2010 at 6:23 am

to an employee:

across this nation health care workers are being laid off, planned hospitals are not being built, wages are being frozen or reduced, more productivity is being expected.....and you don't think it has anything to do with the assault on our health care choices we are under?

Smart management has to predict at least a few years in the future to plan and survive.

I am certain this is just a function of that. Turning our health care into a "cost" means it "costs" money to have employees, instead of employees being a profit earner.

Thanks a lot, Obamacare camel's nose under the tent, a harbinger of single payer where we will ALL be under one, huge, government
HMO. ( Where the best way to save money is to not provide care).

People are always so excited when they join an HMO because it saves them money and hassle...until they see that they have less care and much fewer choices than if they had joined a traditional insurance. Just wait for the other shoe to drop.

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