Title: City Doctors Threaten to Strike.

Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. You don't usually think of doctors as being in a union, or going on strike, but doctors at New York City's public hospitals are in a union and they are threatening a strike for next Monday at four major hospitals. Jacobi Hospital on Pelham Parkway in the Bronx, North Central Bronx Hospital near Montefiore in the Botanical Gardens and around there, the Queens Hospital Center in Jamaica, and South Brooklyn Health in Coney Island.

Top issues include pay and staffing levels. Mayor Adams is calling for mediation and a 60-day cooling off period. We will hear now from a leader in the union known as the Doctors Council, which represents physicians in the city's public hospitals. We'll talk about their demands, the conditions they describe and what would happen to patients in the hospitals if doctors do walk out. Our guest is Dr. Gray Ballinger, a primary care physician at the Queens Hospital Center. Dr. Ballinger, thanks for joining us. Welcome to WNYC.

Dr. Gray Ballinger: Thrilled to be here. Thank you so much for having me.

Brian Lehrer: Would you first tell our listeners a little about yourself? What's your job at Queens Hospital Center? Who in general are the patients who you treat?

Dr. Gray Ballinger: I am a primary care physician in adult medicine. I finished my residency at Lenox Hill in Manhattan in 2021. This was my first job at Queens Hospital Center in Jamaica. I love this job. Essentially, my only complaint about practicing medicine in an affluent area in Manhattan was that I sometimes felt like my patients really didn't need me that much. I would get on a case, as a younger physician, there'd be six specialists who'd been there for the last 15 years and knew the patient well and were managing all their conditions.

Here at Queens, I'm frequently the first doctor my patients have ever seen. When I ask them, "When was the last time you saw a doctor?" They will proudly tell me occasionally that they went to an emergency room a couple of times, but overall, these are people who grew up in a place where a doctor didn't attend their birth. They never got most of their childhood vaccines. They don't understand anything about the healthcare system. About 60% are functionally illiterate at an 8th grade level in English. About 30% of my encounters I do with a formal translator, with Spanish being the most common language, but certainly not the only one. That's who I take care of.

Brian Lehrer: In that context, which is so important for our listeners to hear because it certainly suggests a two-tiered system of medical care in New York City, even in New York City, one of the things about your job that may have surprised some people is that there even is a role for a primary care physician in a hospital. People may generally think of the primary care physician as somebody you go to in their office, and then when you're sick enough, you go to the hospital not to get primary care. Can you talk even a little bit more about the context of your job in that respect?

Dr. Gray Ballinger: Well, I actually am clinic-based, even though internal medicine physicians most frequently do both hospitalists, meaning they take care of sick patients in a hospital, as well as primary care work or trained for both, the whole goal of having a large, well-resourced primary care clinic at Queens Hospital is that it costs the taxpayer an average of $300 to $400 for the patient to see me every 3 to 6 months versus $4,000, $10,000, $40,000 for that preventable emergency room visit, hospital inpatient stay, or worse yet, an ICU stay from a diabetic crisis, a preventable stroke, a preventable heart attack.

I am very much the primary care physician that you would think of in the community. It's just that I'm across a bridge to the main hospital, the ER and the inpatient facility.

Brian Lehrer: Got it. For people who don't realize that doctors are in a union, can you describe the Doctors Council, and who it represents, and what the union does? Then we'll go on to the potential scenario of doctors going on a strike.

Dr. Gray Ballinger: What I'll start by saying is that historically, you're correct. Doctors didn't have unions. 20 years in the past, this would be probably surprising for a physician to here. That said, as medicine has become more corporate, and more focused on the margins of profit, there has become a very serious need, especially in New York, where the margins for profit are due to real estate are always pretty narrow for us to advocate on our own behalf.

Typically, resident physicians have unions of their own. Attending physicians like myself who are fully trained have unions, and of course nursing ancillary health staff, these people have unions as well. The goal being that we want to see parity from department to department, from center to center within a system. If you're providing a certain amount of care, you should be getting the same benefits, the same pay, the same treatment. Essentially, we want to see parity and fairness.

Brian Lehrer: What are you asking for specifically in your contract negotiations with the city? Why has it come to a strike threat for Next Monday?

Dr. Gray Ballinger: The largest issue for physicians system wide in NYC H+H, the public hospital system isn't that we aren't getting personally enough money or enough benefits. The issue is that right now we are facing a recruitment crisis for new physicians. Those of us who work here are the die-hard believers in public health who really, really want to be seeing underserved and disserved New Yorkers. Specifically, we can't attract a broad swath of physicians due to the fact that the salaries here are so low, the benefits are so meager, and we don't even have the benefits that city hospital employees normally have.

For example, my assistant and my nurses have pensions. I don't. No physician does in our system. What we are asking is essentially adjusting the structure of what we are looking for because our-- For example, it takes three months for me to get a patient a new cardiology appointment even if they just had a heart attack. It takes me nine months to get someone in to see a dermatologist for something that might be cancer on their skin or a new diagnosis of rheumatoid arthritis. With lung damage, eye damage and excruciating pain, that takes nine months as well.

When physicians leave or even die because no one here ever really retires, we stay as long as we can to serve the community, those places cannot be filled. Many of the specialist departments in particular are staffed at 25% or less of the physicians that they should have and that there are technically space and money for. We don't want more money or more benefits. We want more colleagues. It's what we need to do to take care of these patients and make it so that there isn't, as you say, a two-tiered system in New York.

Brian Lehrer: Listeners, we invite your calls. If you have ever used a New York City public hospital as a patient, or if you have ever worked in one as a physician or in any other position, talk about that two-tiered system. Talk about the role and importance of the public hospitals in the city or ask a question about the contract negotiations. 212-433-WNYC. Anyone may call whether or not you've worked at a public hospital.

How about other physicians who work elsewhere, does it look like a two-tiered system to you? Do you support your colleagues in the public hospital system, who as our guest Dr. Ballinger is describing, only go there for their careers if they're really dedicated to mission-driven health and are making sacrifices to do that? Do you support a single tier system of how doctors get compensated in the city, in this country. 212-433-WNYC or anyone can ask a question. 212-433-9692. With this doctor strike now being threat for four New York City public hospitals for next Monday, call or text 212-433-9692.

Can you get even more specific for our listeners? What do health and hospital corporation doctors get paid, Dr. Ballinger? How does it compare to doctors, say, doing the same work, charging per visit or per procedure or being hospital staffers at private hospitals in the city?

Dr. Gray Ballinger: That's a huge question insofar as physicians with different backgrounds and different degrees of specialty training have wide gulfs in their compensation. On average, that's something we all expect and accept. That said, in many cases, physicians, emergency room physicians, surgeons, primary care, pediatrics all across the line are making in the 25th percentile or 30th percentile of salaries in New York City in the five boroughs, which for me, for example, I have a partner, but I don't have children. I don't have a lot of financial commitments. I don't have elders in my family who depend on me financially. What I make is perfectly feasible.

For many of my colleagues, who wanted to have children, at kid number three, they had to find another job. It wasn't that they weren't dedicated to their patients. It's that they had to make a choice between taking care of their family and taking care of these people in need. That's really the degree to which a person's income potential here is limited compared to what we can find literally down the road, literally blocks away at a corporate private hospital.

Brian Lehrer: Are your hours different from those at what you call a corporate private hospital, although those are nonprofit institutions in New York City, too?

Dr. Gray Ballinger: Hours, again, these differ widely between specialties. Those with inpatient services obviously have an element of call, meaning that is when you are technically not doing anything right now. However, if someone comes in with an emergency that is in your specialty, it is your job to either wake up in your call room at the hospital and deal with it or come in from home.

What happens when you are understaffed? For example, I know the urology department at Elmhurst, which is our sister hospital, I would say our older sister hospital in Queens, they are supposed to have four urologists, so four urologic surgeons for male health concerns, prostate cancer, everything you can imagine, trauma to that area, they currently have one. What that means is that physician is currently technically on call 24/7 or is passing off call through to a general surgeon, a person who does not necessarily may be able to triage a complex urologic procedure, but does not have specific training in operating on the anatomy and will ultimately have to defer to a urologic surgeon in many if not most cases.

That is as far as quality of life and the mental health of a provider. I remember in residency you do a lot of call. It is caustic to mental health and a rapid slide into burnout. As far as not even feeling the passion that you felt 6 or 12 months ago for your work, and it's a passion you can regain easily if you have that kind of incredible stress alleviated for just a few months. Many of our specialist surgeons are facing that right now.

Brian Lehrer: Really, in your series of answers so far in our conversation, you're describing a whole interconnected web of conditions that I guess start with the lower pay that doctors in the public hospital system get compared to doctors in private hospitals, and that leads to staffing shortages because most doctors will choose not to work in that setting if they have a choice. That leads to burnout like you were just describing, with long hours because there aren't enough doctors to spread the work among fewer hours per person and that leads to worse outcomes for the patients.

We'll get a little more into the dollars and cents of it as we go. Our lines are filling up and we're getting text messages from listeners as well with questions for you. Some listeners will have questions about the basic morality of doctors going on strike at all, as they would about any emergency life and death personnel. What will happen to patients if you go on strike next Monday? Can you ethically impose that kind of risk?

Dr. Gray Ballinger: As with all Health Corps workers, ethically speaking, there is a 10-day notification period so that we can all move the critical patients, stabilize who we can and get them-- For example, Queens Hospital Center is going on strike, but Elmhurst is not. I know a lot of our critical patients, not that they need more people to take care of, they are just as understaffed and overtaxed. Our critical patients are going there. We are diverting them in any way possible, avoiding new admissions wherever possible in order to make it so that there is as little actual emergencies that occur.

Thankfully, our sister hospitals who are not on strike or have not gotten to the core and required to go on strike yet have been understanding, accommodating, and supportive doesn't mean that it's easy. I, like most of my colleagues, I agonized over this decision because my patients need me. We opened up, talking about I am their doctor, full stop, most of the time, the only one that they've ever had, their first, and I'm really trying not to be their last physician.

I know that they need me. I've been calling the people who are on my list for that week-and-a-half ensuing afterwards that we don't know how long this is going to go and letting them know. They're scared, they're worried, they're asking what they can do to make sure that they can keep seeing me here. Thankfully, they're understanding and supportive when I talk to them about our concerns. It's heartbreaking, but we have to make a stand and choose to not care for our patients for a short interval so that we can continue to actually provide excellent care for these patients who need us so badly. The state of play right now is not sustainable in the city hospital system and we have to do something.

Brian Lehrer: State law prohibits many emergency workers from striking at all. Many kinds of public employees, even teachers. Does that state law not apply to the doctors at public hospitals?

Dr. Gray Ballinger: Excellent question. Way back in the Giuliani administration, there was a push to privatize certain elements of many branches of government. Many of the outlying hospitals outside of Manhattan, such as our own, Elmhurst, Jacobi, were switched to a system where contracting organizations, for example, Pagni, I'm under Mount Sinai, technically, as an employee, they are essentially employing the physicians and then getting money from the city and state government in order to fund that.

The exact rationale is way outside the scope of this conversation today. However, the effect is that unlike my assistant, my nurse, the pharmacist, the phlebotomist in my clinic, I am not technically a city employee, which is why those of us who are either planning to strike or are going through the strike votes right now have that option. This is one of the many, I would say from the city's perspectives, potentially negative consequences of choosing to privatize something, add a middle band, increase costs, and decrease the direct oversight of the city over people who are essentially city employees and would love to be literal city employees.

Brian Lehrer: That's fascinating. There's a lot of that that I actually did not know. Are you saying that basically Mount Sinai is a subcontractor with the city to employ you and some of your other colleagues, but you don't get the same kind of pay as you would if you were working at actual Mount Sinai?

Dr. Gray Ballinger: Correct, yes, absolutely. I don't make the money that Sinai does. I don't get a city pension. It's very much a structure that I believe even from the beginning was designed to demoralize and dilute the influence of physicians over the hospital itself, meaning that we do not directly have a line into literal hospital administration here. We have physician administration being fully separate from the other administration.

It also, I think, is demoralizing and confusing for the other staff members because when they see that happen to physicians, there's still a certain perception. Listen, I consider myself co-equal to my nurses and my assistant. We are allied health professionals together. However, I do write orders. They do look up to me as far as a source of leadership. That is my role in a team. If I'm getting this, I think there's a lot of concern on their part about how much their unions can ask for, how much is fair for them to even consider possible. It's demoralizing and confusing for the entire workforce, not just physicians.

Brian Lehrer: Let's take a phone call. Here is Roland. I'll reset this first for our listeners who've been joining us along the way. Doctors in New York City's public hospitals, in case you didn't know, are in a union. If you don't think about doctors being unionized. They are threatening a strike for next Monday at four major hospitals, Jacobi in the Bronx, North Central Bronx Hospital, the Queens Hospital Center in Jamaica, where my guest works, and South Brooklyn Health in Coney Island.

Their top issues include pay and very much staffing levels, inadequate staffing levels that our guest with the union and who is a doctor is arguing low staffing levels stem from the low pay. Our guest is Dr. Gray Ballinger, a primary care physician at the Queens Hospital Center. We're going to take a call now from Roland in Tampa who says he used to work in the General Counsel's Office at the New York City Health and Hospitals Corporation. That's the public hospital system. Roland, you're on WNYC. Thank you for calling in.

Roland: Good morning. Thanks for the enlightening program. When I worked at Health and Hospitals Corporation, Mike Holloman, a dedicated Black physician in Harlem, was the president of the corporation. I was there at a time when the Committee of Internment residents went on strike. My column's vision was that people who go to Sydney get the same care as people who go to Columbia Presbyterian, and the affiliates contract was supposed to do that. The reality though is that we depend too much on the intern residence contracts and the hours that they put in. They do so much staffing and so much work that they wind up being called to do things outside their specialty.

They're also called upon to work incredibly horrible hours. I'd like to ask your guest, Dr. Ballinger. I know the Hippocratic oath says first do no harm, but if you've been on duty for 75 hours, and I've got residents in my family, people who've gone through residency programs, if you've been up for 65, 75 hours with maybe 1 hour's sleep, are you likely to be in your A game? Are you likely to be in a position of not being up to what you should be to be treating a patient? That's my comment. That's my question. Thank you very much for the help. Thanks.

Brian Lehrer: Roland, thank you very much. Dr. Ballinger?

Dr. Gray Ballinger: I think the pandemic was a wake up call for a lot of us physicians. I am what I would refer to as a COVID trained physician. I was in residency from 2018 to 2021 in New York City. There were many times when for weeks on end, I would get two to four hours of sleep in the first wave. Even after that, you don't sleep so great after you see some of the things that we saw, I'll put it that way for months or years afterwards.

When I look back at that person and my ability to reason, my ability to provide high quality care, the drive and the training were there. The sheer cognitive capacity definitionally was not. One of the things that physicians have been gaslit about over the years, it's so baked into our culture that the patient is the one who's sick and that doctors don't have organs or brains. We don't need food or sleep, and that needing these things makes you weaker. I haven't taken a lunch break in 10 years. I'm allowed to take lunch breaks now as an attending, I have time to do that, but I'm not hungry during the day because I got so used to not eating.

That's the way that we go through our lives at a hospital that has normal staffing. You can get a lot out of the doctors who are here at NYCH right now, but again, definitionally, the basic cognitive reality is, yes, you're absolutely right, Roland. We're not providing the best care that we are capable of, not just because there aren't enough of us, but because when you are stretched that thin, things get missed, and when things get missed, patients die. It's a reality hanging over us, and it's honestly what motivates us to be willing to go on strike.

Brian Lehrer: Let's take another call. Here's Rick in Dobbs Ferry. You're on WNYC. Hi, Rick.

Rick: Hi, Brian. Brian, I was listening to your guest and I totally can sympathize with the idea of working hours, being extensive, and not having retirement benefits. I think that's a travesty. I wish that she would be more specific with giving information about salary and specific hours because it just feels like I lose her when I feel like she's trying to-- I get the sense she's trying to avoid giving that information. It makes me a little bit less sympathetic when I hear that.

Dr. Gray Ballinger: Understood. One of the issues, of course, is that all of this is specialty and hospital specific, but let me talk to you a little bit about what our experience has been in primary care. In fact, this gets to the root of why Queens was the flashpoint for us going on strike. In fact, my department, the hall of offices where I work is where this started. As far as the push for the actual strike action, I see 20 patients, or rather, as of 3months ago, I saw 20 patients a day, 2 to 4 of whom are expected to be new patients.

Again, we're going to have 35 to 55 years of undiagnosed medical concerns that I'm going to have to start sorting out and probably don't speak English or read. They cut the time for our new patient visits to from 40 minutes to 20 minutes. They made it so that they can add up to six new patients per day, and we all tried. That rolled out fully. We all tried our best. We were thinking maybe we can make it work, each of us individually.

In the ensuing week or so, there was nothing but people I'd never seen frown. I saw angry and shouting. Not that there was anyone to shout at, just shouting in parallel with one another because they realized that this was something that it just wasn't going to work no matter how hard we tried, no matter how used to it we got that this is, and that this was just the first step. You end up using another hour or an hour-and-a-half of your own time. I already get in two hours early. Like I said, I don't take a lunch. Then I try to leave on time.

It's easy with a new patient that's very complex to add another hour-and-a-half to your day. If that's position one, all of us are trained to think, "Well, the only doctors that don't think about what's next are coroners." Of course, we're trying to wonder what next. How else are they going to erode patient care? They've also gotten rid of our front desktop and tried to replace it with kiosks, so there's no one for the patients to ask for refills of medication, which then goes to us. It is a spiraling situation.

Then like I said, you have surgeons on the other end of things who are sub, sub specialists and they are on call 24/7, 7 days a week. Literally that's their numbers right now because they are the only one. A colleague in medicine who's also obviously on the clinic side, meaning does mostly outpatient with some inpatient, an excellent rheumatologist, the other, she has no program director, she has no colleague, even though she's supposed to have one or two colleagues. She has a panel of a 1,000 very sick patients. A 1,000 for one person. The fact that she is an excellent physician doesn't change the fact that she's here 12 hours a day.

Brian Lehrer: All heard and understood, but I think the caller wants to know numbers. I think the caller wants to make, wants to know what people in your job category, for example, or some of the others that you're describing make compared-

Dr. Gray Ballinger: Okay, got it.

Brian Lehrer: -to equivalent doctors in the private hospitals and specifically what you're asking for from the city to close that disparity.

Dr. Gray Ballinger: As far as, for example, my salary, a starting salary for a primary care physician at our hospital is $168,000 a year. That is assuming that most physicians who are taking a new job here have low to mid triple digit federal loans that they're paying off as well as families, lives, everything that everybody else has. On average, in New York City over the past, I believe, five years, the data was starting salaries are between $180 to $220,000 a year. Many of those skew higher with things like pay for performance, for example, where if a physician volitionally wants to add four patients to their panel that day, they get to bill separately for that almost like overtime.

At our facility, that isn't-- Basically, there is very limited earning potential and more importantly advancement. There isn't a pay scale at all that reflects the amount of time you have been here. You do not get incremental raises. We were once promised retention bonuses which have evaporated to ameliorate that fact, which is ridiculous. I have colleagues who went to residency here and have been working here 30 years and they make maybe $10,000 more than I do, which that degree of seniority is unheard of.

Brian Lehrer: Listener asked in a text message because this says-- Sorry, the listener says, "This strike is only one of the many examples of the terrible fallout of the private insurance versus Medicaid landscape. How much do you agree?"

Dr. Gray Ballinger: I would say that there is a great deal of truth in that, but I also think you need to also the corporatization of medicine and the motive. For example, I work for Sinai, correct. There is a profit motive for their flagship private hospitals to have more procedures, to have better doctors and shorter wait times while they're also administrating my hospital where if you can't pay your coinsurance which is very, very high for your necessary surgery, we send you to financial services and we fee scale you so that your family is only paying a fair amount that you can afford with and keep the lights on.

There is a direct motivation because of the insurance industry and the ludicrous way that patients are asked to cover huge chunks of their own medical care even though they've been playing paying for their health insurance for years, and this is the whole thing health insurance is supposed to protect them from. That is making it essentially very beneficial for them to come to us if they are at financial risk and can't afford it and very beneficial for private hospitals to choke us and starve us and make it so that the care here is so inconvenient or even eventually, inevitably it may become subpar that no one will want to come here.

Brian Lehrer: I think we have a call from a doctor who wants to expand on this point exactly, the private insurance versus Medicaid disparity. Leslie in Monmouth County, you're on WNYC. Hello, Leslie.

Leslie: Hi. Thank you for taking my call. Long time listener, first time call. I just want to say three things briefly. One is kudos and thank you so much to Dr. Ballinger for doing the kind of medicine you do. I retired-

Dr. Gray Ballinger: Thank you.

Leslie: -December 31st after about 50 years in medicine. I'm 70 years old now. I went to med school in '75. It's a heroic struggle.

Brian Lehrer: Do I see that you did your residency at Queens General?

Leslie: It split. At that time, it was Long Island Jewish and Queens General, so we rotated between the affluent private hospital and the dirt poor city hospital where a large warden un air conditioned in the summer held 20 poor people, including people living on ventilators. It was just a terrible-- The inequality in our society was profoundly demonstrated. The buildings were built under LaGuardia administration.

Originally as tuberculosis sanitariums back in the day. It was completely outdated infrastructure, but that was all that we give to poor people, and it's gotten worse since. Thank you, Dr. Ballinger, for doing what you do. It's a heroic struggle to take care of human beings. We don't live in a democracy. We live in a corporatocracy. Everything is for the profit motive, even nonprofits like Mount Sinai. That makes taking care of human beings just to help human beings impossible.

The other thing I would just say is about the morality of going on strike. We actually had a situation where our chief of medicine back in the day at Long Island Jewish had decided that they had to let a couple of residents go because of a budget shortfall. We all basically lined up to join the same union that you're a member of and went through all the process. At the last minute, the hospital said, "We'll find a place to put a couple more residents," so we ended up not joining, but we had all those conversations. It was a very interesting time to do that, but you're really fighting against an impossible situation.

We really thought about joining a union. Of course, that meant unions only have one weapon, which is to go on strike. The morality of doctors going on strike, which they've done in England, looking at Australia, many of the countries in the world with more national health insurances, that's the only way to get the doctors better conditions, but more importantly, to get the patients better health care.

The system, the corporatized system, even in the nonprofits, even in the National Health of England, is not primarily interested in doing that. Their goal is to have lower overhead more profit even though it's a nonprofit. It's an insidious, horrible system. Our world is now divided into predators, if you will, from a financial perspective. Those who are predated upon in the bottom half of our society has nothing, so there it goes. All right, that was my--

Brian Lehrer: Leslie, in your view, as a physician who practiced for 50 years and just retired last week, and with all that you've been saying, and then, Dr. Ballinger, I'll ask you, what is the real structural solution to this inequity? It's got to be more than just doctors in the New York City public hospital system getting a bit of a pay raise. To increase staffing a bit, which is the immediate goal of this strike threat. Are you in favor of a Bernie Sanders style Medicare for all system or something else that would really address the problem?

Leslie: Structurally, I think Bernie Sanders is a great start, but I think at the very root of all of this, there's a disease in our culture and it affects every aspect of human life from conception until death. We have to have a society that cares about each other, a mutual aid society, not a mutual predation society. That requires starting at literally conception and building a different kind of society from that point onwards, so that human beings are valued and their welfare is valued and their quality of life is valued.

That means having doctors, nurses, physical therapists, laboratories, everything, working together to help each other live in a better world. It was the promise, but a lie of a communist system. We need a better way to treat each other.

Brian Lehrer: Leslie, thank you.

Leslie: Sorry, not simple.

Brian Lehrer: No, no, that's not simple. Thank you for calling in. Now that you're retired and choosing to spend some of your daytime hours listening to the show, at least today we're honored that you're choosing to use some of your time that way. Dr. Ballinger, same question, and then we're going to be out of time in a minute.

Dr. Gray Ballinger: Got it. I just wanted to say also thank you, doctor, for being my attending, cosmically speaking. That's really excellent. Congrats on your retirement. What I will say is this, I'm from a generation, and I've lived through things thus far in my relatively short career that makes me not necessarily be quite that optimistic. What I will say is this, every single allied healthcare worker should be in a union. Nurses and doctors understand what our patients need. Front desk staff and assistants understand what our patients need, and corporations do not.

It is impossible for us to change this system by somehow instilling morality and patient oriented care in corporations that are motivated by profit. However, we are able to change the system by banding together and going on strike. Whether you agree with the strike action that my colleagues and I are taking, and again, I reach out in solidarity to all the other hospitals within our system who are continuing to discuss this and whether or not they choose to join us, you need to be in a union so you have a way to put your heads together and address the things that come up that negatively impact your patient care or you are powerless.

Brian Lehrer: Just to be clear for our listeners before we wrap up, you're not on strike yet. This is a strike threat for next Monday if there's no contract deal with the city. Are you optimistic? Do you see the city as negotiating in good faith? What do you think about Mayor Adams call for mediation with a 60-day cooling off period?

Dr. Gray Ballinger: The 16 months up until now involved people sitting at a table without actually being at the table. We were there essentially. No one else was. Now, finally with this strike threat, we have people at the table, but it is not as though we are building upon 16 months of fruitful but contentious conversations. We are starting from zero. At our general body meeting last night, the head of our negotiations for the union said quite simply, "If something miraculous is to occur today, we will give them six days of grace, not 60 days of grace."

I think that that is appropriate given the way these negotiations were approached up till now. I will always have a little bit of optimism in me. I am a city hospital doctor after all, but I think realism is more appropriate here. I do believe we will unfortunately probably be going on strike on the 13th and we will be there until a fair contract is reached.

Brian Lehrer: Dr. Gray Ballinger is a primary care physician at the Queens Hospital Center, one of the four New York City public hospitals that might see a strike beginning next Monday. She is a member of the union, the Doctors Council. Thank you so much for joining us and making your case.

Dr. Gray Ballinger: Thank you, Brian. Have a great one.

 

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