When Whit­ti­er Street Health Cen­ter unveiled its glass-sheathed, six-sto­ry, envi­ron­men­tal­ly-advanced, state-of-the-art, new facil­i­ty in 2012, it was seen by its Boston com­mu­ni­ty as a com­mit­ment to the neigh­bor­hood and the peo­ple it serves. With bright­ly paint­ed walls and expan­sive views across the city, it sits at the heart of Rox­bury, extend­ing an invi­ta­tion of con­ve­nience and care to a pop­u­la­tion that is most­ly Black or Lat­inx and among the poor­est and least healthy in the city.

Of Whit­tier’s patients, 91 per­cent live in pover­ty; 50 per­cent deal with food inse­cu­ri­ty; two-thirds have been diag­nosed with dia­betes, hyper­ten­sion, can­cer, asth­ma or obe­si­ty; 35 per­cent of adults are with­out health insur­ance; and life expectan­cy for the area served is 58.9 years. Every­one agrees that this is a vul­ner­a­ble pop­u­la­tion in need of high­ly trained, con­sis­tent and com­mit­ted health­care. Not every­one agrees that this pop­u­la­tion is get­ting it.

The rea­sons are a mix of dif­fi­cul­ties shared by many com­mu­ni­ty health cen­ters, includ­ing polit­i­cal maneu­ver­ing, fund­ing con­straints and soci­etal dis­re­gard for the poor. But some prob­lems are dis­tinct to Whit­ti­er: Staff and patients have com­plained that ill-advised, high-hand­ed and desta­bi­liz­ing man­age­ment prac­tices inter­fere with and dis­rupt clin­i­cal care.

The dom­i­nant feel­ings among the many employ­ees who have left or were pushed out seem to be anger and dis­ap­point­ment, much of that aimed at Fred­er­i­ca Williams, the pres­i­dent and CEO of Whit­ti­er since 2002. Last sum­mer, increas­ing­ly sour man­age­ment-clin­i­cian rela­tions led to the for­ma­tion of the first labor union of pro­fes­sion­al staff at a com­mu­ni­ty health clin­ic in Mass­a­chu­setts. The union became nec­es­sary, its sup­port­ers say, to pro­tect their patients, their jobs and even the health cen­ter itself.

Through her then‑P.R. con­sul­tant, Williams cit­ed restric­tions on what she can say about patients under HIPAA or the union­iza­tion effort under the Wag­n­er Act. She respond­ed to some ques­tions in writ­ing last Octo­ber, but declined repeat­ed requests to com­ment fur­ther, instead refer­ring In These Times to the health cen­ter’s pub­lished reports and her pub­lic state­ments and let­ters to patients and staff. That left med­ical providers who have moved on, been fired or forced to leave — and unhap­py patients — to large­ly tell the sto­ry. That sto­ry is one of alleged intim­i­da­tion and union-bust­ing by Williams and her admin­is­tra­tion, which has roiled the health cen­ter and high­lights the chal­lenges to pro­vid­ing good patient care to an under­served com­mu­ni­ty. It also points out the lim­i­ta­tions of cur­rent labor laws to pro­tect work­ers at any level.

Last month, a year since the union became a real­i­ty, the antag­o­nism between its sup­port­ers and Whit­ti­er man­age­ment reached a cli­max, as a tri­al, an advanced step in the Nation­al Labor Rela­tions Board­’s unfair labor prac­tice deter­mi­na­tion, got under­way in Boston.

Orga­niz­ing drive

The union came from the orga­niz­ing efforts of John Jew­ett, a doc­tor; Bill Dain, a clin­i­cal social work­er; and Caitrin Mac­Don­ald, a nurse prac­ti­tion­er. Dain, who had been at Whit­ti­er for 14 years, had expe­ri­ence with anoth­er union, so he was all in when Jew­ett and Mac­Don­ald said, ​“Let’s do it.” In March 2018, the trio began get­ting sig­na­tures on cards autho­riz­ing a union elec­tion under the guid­ance of 1199 Ser­vice Employ­ees Inter­na­tion­al Union (SEIU), which rep­re­sents some 56,000 health­care work­ers in Mass­a­chu­setts. In mid-May, they filed notice with the Nation­al Labor Rela­tions Board (NLRB) to begin a union cam­paign among Whit­tier’s pro­fes­sion­al clin­i­cal staff. The goal was to fos­ter a work­ing part­ner­ship with man­age­ment, which would involve the entire staff, then num­ber­ing about 300, in the orga­ni­za­tion­al deci­sions that con­trolled their work envi­ron­ment and the health­care they pro­vid­ed. But as a prac­ti­cal deci­sion, Jew­ett says, they start­ed with this small­er, col­le­gial group, sev­er­al of whom had had issues with man­age­ment and felt par­tic­u­lar­ly frus­trat­ed by the respons­es they got. When the union began, it had more than 60 mem­bers; as of this May, it had 50. (The decrease reflects cut­backs in Whit­ti­er staffing

Jew­ett, age 62, has a degree in med­i­cine with a focus on pub­lic health. He came to Whit­ti­er because he was fed up with the paper­work in pri­vate care and liked the one-to-one inter­ac­tion in com­mu­ni­ty health. Dain, 77, who loved the intense rela­tion­ship of indi­vid­ual ther­a­py and the chance to use his flu­en­cy in Span­ish, also fell into this old­er cat­e­go­ry. Younger providers, includ­ing Mac­Don­ald and Sher­ar Andal­cio — a doc­tor who was active in the union orga­niz­ing from a dif­fer­ent com­mu­ni­ty health cen­ter, hav­ing been fired from Whit­ti­er the year before — were no less committed.

Mac­Don­ald, 40, came to Whit­ti­er in 2016, and said, ​“My dream work is com­mu­ni­ty health…serving patients who rep­re­sent all of Boston, not priv­i­leged peo­ple like me.” For Andal­cio, 36, who grew up near­by, ​“My dream job was to come back and give back to the com­mu­ni­ty.” These are high­ly-trained pro­fes­sion­als who could opt for eas­i­er, more remu­ner­a­tive posi­tions, but chose to work under the demand­ing and dif­fi­cult con­di­tions of com­mu­ni­ty health care, where burnout is common.

Asked last Novem­ber about the dis­sat­is­fac­tion among the clin­i­cians, Williams answered in an email to In These Times, ​“Whit­ti­er Street is far from alone among Mass­a­chu­setts health cen­ters in expe­ri­enc­ing finan­cial chal­lenges and employ­ee turnover. … We have been enhanc­ing our recruit­ment efforts to ensure that we are hir­ing staff who tru­ly under­stand and are com­mit­ted to ful­fill­ing our mis­sion of pro­vid­ing qual­i­ty care to the vul­ner­a­ble pop­u­la­tions we serve.” But the dis­pute, which result­ed in the orga­niz­ing dri­ve, seemed less about mis­sion buy-in on the part of providers than about how that mis­sion would be car­ried out day-to-day. The providers charged that prob­lems arose when they made sug­ges­tions, chal­lenged abrupt and unex­plained changes in poli­cies, asked for greater involve­ment in deci­sions affect­ing their work and their patients, or held man­age­ment to the terms of their contracts.

Williams’ descrip­tion of the dif­fi­cult con­text in which Whit­ti­er exists is accu­rate. Since it began as a well-baby clin­ic in 1933 and even in the late 1960s when Boston led the nation in neigh­bor­hood health cen­ters, fund­ing has been a chal­lenge. Today, it relies heav­i­ly on grants and fed­er­al fund­ing. Still, Williams could point then with well-earned pride to her accom­plish­ments: run­ning a health cen­ter with a $25 mil­lion bud­get, over 30,000 patients a year, some 40 pro­grams, and a per­fect score on its most recent fed­er­al audit mea­sur­ing statu­to­ry and reg­u­la­to­ry com­pli­ance; and build­ing the new facil­i­ty, which no one had man­aged to do before. ​“She’s real­ly bril­liant at build­ing pro­grams and get­ting mon­ey for them,” said Jew­ett. ​“She’s great on the lan­guage of pover­ty and eco­nom­ic dis­par­i­ty,” not­ed Andal­cio. Mac­Don­ald added that when she inter­viewed for her job, Williams ​“seemed like an engag­ing and com­pelling human being.”

Williams was born in 1958 in Sier­ra Leone and stud­ied man­age­ment in Eng­land and Mass­a­chu­setts. As one of the city’s few women of col­or in top man­age­ment posi­tions, she is a high­ly vis­i­ble, much-award­ed cham­pi­on of women in lead­er­ship. She sits on cor­po­rate boards, appears on notable-leader lists, and cul­ti­vates friend­ships with local politi­cians and power­bro­kers. She even appeared in Mitt Rom­ney’s infa­mous ​“binders full of women.” It can­not be easy to be a pow­er­ful black woman in a Boston still reck­on­ing with racism and sex­ism, but her detrac­tors charge that hav­ing to deal with these obsta­cles does­n’t excuse what they see as her demor­al­iz­ing man­age­ment style and actions; they claim these under­mined their work at Whit­ti­er. Andal­cio, who is also black, summed up this sen­ti­ment by say­ing, ​“If a man was doing what Fred­er­i­ca is doing, it would still be 110 per­cent wrong.”

Mass fir­ings

A typ­i­cal response to feel­ing that you’re los­ing con­trol is to try for more con­trol. In June 2018, less than a week before the union vote was sched­uled, Williams abrupt­ly fired Jew­ett, Dain, Mac­Don­ald and 11 oth­ers whom Jew­ett knew to be union sup­port­ers. They say they were hus­tled out of the build­ing as their patients wait­ed for appoint­ments. Williams main­tained that the fir­ings were neces­si­tat­ed by a bud­get short­fall, and cit­ed the loss of two antic­i­pat­ed grants, which she declined to name, equal­ing over $600,000. By the end of that fis­cal year, the deficit would reach $1.35 mil­lion, Whit­tier’s first oper­at­ing loss in 18 years.

The next day, Fri­day, Whit­ti­er staff, patients, sup­port­ers and local politi­cians demon­strat­ed res­olute­ly out­side the build­ing, demand­ing that the staff mem­bers be rehired imme­di­ate­ly. It was hard to miss the swarm of pur­ple SEIU T‑shirts, and the media soon arrived to cov­er the protest. In response to the out­cry and bad optics, Boston’s may­or, Mar­tin J. Walsh, stepped in to craft a set­tle­ment, which Williams described in a let­ter to the WSHC com­mu­ni­ty as ​“a path­way for­ward that will put Whit­ti­er on a sta­ble finan­cial foot­ing for now.” The employ­ees were told on Sun­day that they had been rein­stat­ed, though it is unclear by whom, as became clear in the tes­ti­mo­ny and cross-ques­tion­ing of Ragan McNeely, a behav­ioral ther­a­pist, at the NLRB tri­al, and Williams announced pub­licly that she would take a vol­un­tary pay cut. Accord­ing to a report on WBUR, a local NPR sta­tion, her salary before the cut out­stripped those of CEOs at com­mu­ni­ty health cen­ters in sim­i­lar Boston neigh­bor­hoods, although they served more patients.

The dra­ma con­tin­ued on Mon­day, when sev­er­al of the sup­pos­ed­ly rehired staff tried to inquire about their sta­tus and, as McNeely tes­ti­fied, were not allowed to enter the build­ing past the secu­ri­ty desk. The employ­ees were final­ly per­mit­ted to return to work on Wednes­day, when the vote took place as planned. It was 50 to 9 in favor of union­iz­ing. Less than three weeks lat­er, in a remark­ably tone-deaf move, the board of direc­tors vot­ed to hon­or Williams by nam­ing the build­ing after her.

Like most sto­ries with dif­fer­ing per­cep­tions of what’s fair, right or nec­es­sary, try­ing to pin down who did what to whom is a study in yes-buts. Williams emailed, ​“The pri­ma­ry rea­son for this deficit was the fail­ure of spe­cif­ic staffers to reach indus­try-stan­dard pro­duc­tiv­i­ty lev­els.” Data com­piled by Jew­ett for the pro-union web­site, ​“Whit­ti­er staff, union and com­mu­ni­ty news,” show WSHC’s expect­ed pro­duc­tiv­i­ty lev­els for 2017 to 2018 to be high­er than Mass­a­chu­setts and nation­al lev­els. Jew­ett worked with data from a 2017 report by the fed­er­al Health Resources and Ser­vices Admin­is­tra­tion (HRSA). How­ev­er, both the Health Cen­ter Pro­gram at HRSA and the Mass­a­chu­setts League of Com­mu­ni­ty Health Cen­ters, where Whit­ti­er is a mem­ber and Williams was on a board, said in sep­a­rate emails that they have no pro­duc­tiv­i­ty stan­dards for providers.

And while there had been a decline in clin­ic vis­its from 2016 to 2017, they rose slight­ly to 115,448 in 2018. Jew­ett cal­cu­lat­ed that Whit­ti­er doc­tors gen­er­ate sig­nif­i­cant­ly more rev­enue than they cost, so he argues that cut­ting their num­ber is coun­ter­pro­duc­tive to attract­ing and retain­ing patients.

In the sum­mer of 2018, Williams elim­i­nat­ed the cen­ter’s urgent care clin­ic and the ortho­don­tics pro­gram that fall, cut some clin­i­cal and admin­is­tra­tive posi­tions and insti­tut­ed a hir­ing freeze, defend­ing her deci­sions, for instance, in a Decem­ber 2018 let­ter to staff, as nec­es­sary cost-cut­ting mea­sures. She announced then that Whit­ti­er was on a ​“break-even bud­get,” and some vacan­cies have since been filled, though the cur­rent WSHC web­site shows a stripped-down clin­i­cal staff.

The tar­get­ed employ­ees, how­ev­er, read those moves as the kind of retal­ia­to­ry mea­sures that had been going on for a long time and added up to what Mac­Don­ald described as a tox­ic work­place. When Andal­cio, the doc­tor who had come on staff with high expec­ta­tions, felt under­pre­pared to treat his HIV-pos­i­tive patients and request­ed more train­ing, he con­tend­ed that his request was denied. When Jew­ett sug­gest­ed ways to engage man­age­ment pro­duc­tive­ly — for exam­ple, insti­tut­ing set meet­ing times for staff to exchange ideas and dis­cuss prob­lems — he was crit­i­cized for not going through chan­nels and ask­ing ques­tions out of turn, a claim he reit­er­at­ed in his affi­davit for the NLRB. And Mac­Don­ald report­ed that after a good­bye par­ty for Andal­cio, a doc­tor and anoth­er staff mem­ber were sent a pho­to­graph tak­en there of the staff in atten­dance, with a black arrow and a ques­tion mark point­ed at her head. Giv­en the ten­sions at Whit­ti­er, it looked to her like a threat.

Per­haps most telling was the unusu­al­ly high rate of turnover among clin­i­cians. By Andal­cio’s count, 20 doc­tors, nurs­es and physi­cian assis­tants in pri­ma­ry care and obstet­rics left between Octo­ber 2016 and Octo­ber 2018. Of the 22 who had worked there in 2016, only three are still at Whit­ti­er less than three years lat­er. Because new hires are less pro­duc­tive than expe­ri­enced providers, Jew­ett esti­mat­ed that the cost of turnover in pri­ma­ry care in that time was at least $1.4 mil­lion. Oth­er, unquan­tifi­able loss­es includ­ed insti­tu­tion­al mem­o­ry and shared knowl­edge of how things work, but a big­ger prob­lem was the dam­age to patients, who were shuf­fled from provider to provider, with missed fol­low-ups and track­ing of cases.

Patients impact­ed

Whit­ti­er touts its high scores on patient sat­is­fac­tion sur­veys, but some patients have been skep­ti­cal of their valid­i­ty. They laud­ed their providers, but com­plained about the cul­ture. Shon­dell Davis came to Whit­ti­er in 2013 after a dif­fi­cult search for respon­sive care. Her son had been killed and she was close to a break­down when she found Ragan McNeely, the behav­ioral health ther­a­pist. He was a god­send. Over the next sev­er­al years, Davis said, he pro­vid­ed ​“a com­fort zone every Tues­day.” Just look­ing at his phone num­ber between appoint­ments made her feel bet­ter. McNeely was fired last Octo­ber, which Davis said she learned only when she came for her appoint­ment. ​“No calls, no fol­low-up, no warn­ing,” she said a cou­ple of months lat­er. ​“To me it was uneth­i­cal. I don’t have a ther­a­pist now. I don’t want to start over again. I just know from my expe­ri­ence, I real­ly felt hurt. I don’t think I will ever trust there again.”

Mar­lon Wallen, a mul­tira­cial, HIV-pos­i­tive activist from Trinidad, who lived near­by, became a patient at Whit­ti­er in 2016. Wallen report­ed that he was asked to be an out­reach work­er and appoint­ed to the Patient Advi­so­ry Board. But when he object­ed that it was a con­flict of inter­est for the chair of Whit­tier’s board of direc­tors to also sit on the patient board, in addi­tion to rais­ing oth­er griev­ances, he said he was ​“fired” — from the board and as a patient — and banned from the build­ing. With HIV patients, espe­cial­ly, he main­tained, the con­stant shift­ing of doc­tors under­mines trust and treat­ment. He sug­gest­ed grim­ly that Whit­tier’s patients put up with it because, ​“Where they come from, they’re used to this stuff.”

At a ​“patient rights hear­ing” orga­nized by the labor-friend­ly coali­tion, Mass­a­chu­setts Jobs With Jus­tice, this past March, Davis and Wallen were among the some 60 peo­ple who tes­ti­fied about their expe­ri­ences at Whit­ti­er. Near­ly all talked of feel­ing betrayed and aban­doned and reit­er­at­ed com­plaints about val­ued clin­i­cians dis­ap­pear­ing with­out warn­ing or expla­na­tion; dif­fi­cul­ty get­ting some­one to answer the phone, let alone get­ting an appoint­ment; and undue bur­dens caused by clos­ing urgent care and the ortho­don­tics depart­ment. Some man­agers attend­ed, but Williams did not.

Local politi­cians had ral­lied in sup­port of the fired clin­i­cians the sum­mer before and met with union activists after­wards, but of sev­er­al who were asked to speak to the issues in the fol­low­ing months, the only one who agreed to talk with In These Times was the doyen of Boston pol­i­tics, Mel King, a for­mer leg­is­la­tor and respect­ed com­mu­ni­ty activist. In a phone inter­view last Octo­ber, he sum­ma­rized the Whit­ti­er sit­u­a­tion sim­ply: ​“It’s an incred­i­bly impor­tant insti­tu­tion in the com­mu­ni­ty. To have an issue like this con­tin­ue is uncon­scionable. Peo­ple’s health is at stake.”

Con­tract fight

Form­ing a union is one thing; suc­cess­ful­ly nego­ti­at­ing a con­tract is another.

Unlike many union fights, salaries are not a cen­tral con­cern here. Last fall, Filaine Deron­nette, vice pres­i­dent of Health Sys­tems at 1199SEIU, said in a phone inter­view, ​“The issues are dig­ni­ty and respect.” She empha­sized that they were aim­ing for respect­ful lines of com­mu­ni­ca­tion between man­age­ment and staff. ​“The goal is to uti­lize the union to make it a bet­ter place for patients and staff.” In the ear­ly days, man­age­ment met with the union and its mem­bers as sched­uled. Then, accord­ing to Marl­ishia Aho, region­al com­mu­ni­ca­tions man­ag­er for 1199SEIU, the union stopped talk­ing pub­licly, man­age­ment start­ed chal­leng­ing who could be on the union’s nego­ti­at­ing com­mit­tee, and one-by-one, union activists were pushed out. Dain and McNeely were fired; Jew­ett was placed on admin­is­tra­tive leave, then laid off and also banned from the build­ing; and Mac­Don­ald, need­ing sta­ble employ­ment, left for anoth­er job, albeit soon­er than she want­ed. By late Octo­ber 2018, Jew­ett count­ed only a hand­ful of the union sup­port­ers who had been fired and rehired that pre­vi­ous June still at Whittier.

Last fall, the union filed a series of com­plaints about unfair labor prac­tices at Whit­ti­er with the Nation­al Labor Rela­tions Board, charg­ing that three mem­bers — Jew­ett, Dain and McNeely — had been laid off in retal­i­a­tion for their union activ­i­ties. The NLRB even­tu­al­ly deter­mined that 30 of the 32 com­plaints about how Whit­ti­er respond­ed to the union­iza­tion effort, an unusu­al­ly long list, were sub­stan­ti­at­ed enough to be brought to tri­al. While not a find­ing of guilt, this was a sig­nif­i­cant step, since the vast major­i­ty of com­plaints the board receives are dis­missed, with­drawn or set­tled out of court.

As the tri­al began on June 17, both sides had dug in: Jew­ett described intense nego­ti­a­tions between the union and man­age­ment the week before as pro­gress­ing from very far apart to mere­ly far apart, and at the tri­al, Jim Lee, Whit­ti­er Vice Pres­i­dent, CFO and part of the man­age­ment team rep­re­sent­ing the health cen­ter, declined to com­ment on the pro­ceed­ings or a desired outcome.

For three intense days, the fired clin­i­cians tes­ti­fied and were cross-exam­ined by Whit­tier’s legal team. Then, on the morn­ing of the fourth day of tes­ti­mo­ny, the judge, Paul Bogas, put the tri­al on hold to allow for fur­ther nego­ti­a­tions. Accord­ing to Lau­ra Sacks, a region­al attor­ney of the NLRB, admin­is­tra­tive judges can have many rea­sons for tem­porar­i­ly dis­rupt­ing a tri­al for set­tle­ment dis­cus­sions, but it may be because they expect it to be extreme­ly long and com­pli­cat­ed with risk for both sides. Sacks out­lined the many poten­tial steps to a final deci­sion, which include appeals, briefs, and an open-end­ed time­line for a judge to issue an opin­ion. ​“I can only agree that it’s a lengthy process,” she concluded.

Most every­one else involved seems to have under­es­ti­mat­ed how lengthy this par­tic­u­lar process would be. Orig­i­nal­ly cal­cu­lat­ed in months, it is now talk­ing sev­er­al years. In a dif­fi­cult con­ver­sa­tion, Jew­ett, McNeely and Dain con­sid­ered their options. What made it so hard was that all three had to agree to the same response and, until recent­ly, they had held out hope of return­ing to their jobs, their patients and their col­leagues. Ulti­mate­ly, they bowed to real­i­ty and forged a set­tle­ment: They would not return to Whit­ti­er and Whit­ti­er would pay each 15 months’ salary. When those pay-outs are added to Whit­tier’s legal fees for the case, resist­ing a union will have been an expen­sive bat­tle to pursue.

On the rest of the NLRB charges, Whit­ti­er must post at the health cen­ter a short list of employ­ee rights and a long list of ​“we will nots.” A few pro­vi­sions are ame­lio­ra­tive, while most are pledges that Whit­ti­er will not do in the future what the NLRB alleged they had done in the past to dis­cour­age the union and pun­ish its sup­port­ers. It is not clear what would hap­pen if the health cen­ter did not live up to these promis­es. Williams, through her for­mer P.R. con­sul­tant, again respect­ful­ly declined to comment.

Last win­ter, Jew­ett said he would go back to Whit­ti­er in a heart­beat. ​“I feel like I start­ed some­thing,” he explained. ​“It’s an oppor­tu­ni­ty to build some­thing I could be proud of, if it gets done.” He fluc­tu­at­ed then between hope that pres­sure from the NLRB and the union would result in providers hav­ing a greater say in how care is deliv­ered at Whit­ti­er and wor­ry that Williams would just wait out the union until no sup­port­ers were left work­ing there. He recalled ​“shoot­ing the bull with [Williams] in the hall,” when he claimed she said, ​“John, I will nev­er nego­ti­ate with the union.”

These days, con­tract nego­ti­a­tions are pro­gress­ing, and one of the most pos­tive out­comes of the set­tle­ment is that Whit­ti­er agreed to meet for bar­gain­ing ses­sions more than twice as often as before. But with so many of the orig­i­nal mem­bers gone and a sig­nif­i­cant­ly small­er staff, it’s an open ques­tion how com­mit­ted to the union new hires or those who have stayed will be.

“You can’t just assume that if you vote for a [union] elec­tion it’s going to work out,” Jew­ett said, rue­ful­ly, a few days after agree­ing to the set­tle­ment. ​“One sober­ing real­iza­tion is that the NLRB legal sys­tem is not real­ly set up to pro­tect work­ers. It was fair­ly amaz­ing to me to learn that that safe­ty net isn’t there.”

Jew­et­t’s part­ners in the labor com­plaint aren’t exact­ly singing a rous­ing cho­rus of ​“Union Maid” either. McNeely — who likes to quote Dain’s say­ing about the drawn-out NLRB process, ​“Slow jus­tice is no jus­tice” — is ready to move on. ​“There’s noth­ing to go back to,” he said. He and Dain count only four peo­ple remain­ing of the 18 who were in their Behav­ioral Health depart­ment when they formed the union. ​“I’m fear­ful for what’s left,” he concluded.

Dain, has a slight­ly more opti­mistic take on the out­come. Although their agree­ment allows Whit­ti­er to avoid cul­pa­bil­i­ty for the way they were fired, he believes they are vin­di­cat­ed because it points up the con­tra­dic­tion in Whit­tier’s pub­lic state­ments. ​“Their claim was that they need­ed to cut back on staff, unre­lat­ed to union activ­i­ty,” he said. ​“Then why would you pay us off not to come back when you have all these job openings?”

As for the oth­er prob­lems the dis­pute high­light­ed — the high rate of clin­i­cian turnover, fraught man­age­ment-staff rela­tions, incon­sis­tent patient care — it appears to be a mat­ter of solv­ing the legal issues while leav­ing the human ones raw. Yet, when asked if their fight was worth it, all three men give a qual­i­fied yes. For McNeely, because it can encour­age ​“pro­fes­sion­al and knowl­edge work­er groups” to orga­nize, which he thinks is the future for unions. For Dain, ​“You keep up the strug­gle, even if you lose a par­tic­u­lar battle.”

And for Jew­ett, who had staked so much on the suc­cess of the union? ​“Yes, it was worth it,” he agreed. ​“But it was much hard­er than I ever imagined.”