Corporate Cannibal

By Anonymous / Spring 2022

It’s February 2020, just another random weekday. Another monotonous 24 hours cycle of sleeping, waking up, and going to school. After a long day of school I clock into my dynamic job as an urgent care medical assistant. It was a seemingly normal shift until it came time to take back a concerned mother with an appointment for her son who had flu-like symptoms. Towards the end of the triage process the mother exclaimed, “I think it might be coronavirus! Do you think my son has coronavirus”? As a medical assistant I’m not allowed to diagnose or give opinions unless authorized by a medical provider. I told her something to that effect as a response, assuring her that our provider will directly address all of her questions and concerns. It was my first-time hearing about covid. I didn’t think anything of it, I didn’t research the virus after the triage either. Mid-March came and news about the virus became inescapable. It became my life. The virus affected everyone up and down America's social hierarchy forcing us all into an isolated lockdown state. While everyone was in quarantine I was at the clinic on the frontlines playing my part in covid and non-covid patient care. Blindly playing my part in American healthcare as a pawn for legalized criminals, the capitalistic corporate cannibals who ran my clinic. They salivate over large profits prioritizing them over people as corporations did in the gilded age. Patients and healthcare teams are their life support, exploiting our lives is their literal sport. The pandemic gave me a glimpse into how sinister corporate greed in healthcare can be. It gave me a chance to navigate the dark and twisted side of the healthcare system I one day hope to be a light in as a physician.

My journey to becoming a physician began in 2019. A majority of applicants accepted into medical schools expose themselves to a variety of extracurricular/work experiences related to public service and healthcare during their undergrad years. Main experiences sought after are volunteer, research and clinical. By mid 2019 I personally felt I’ve acquired enough volunteer experience having volunteered at a hospital and food bank for the past 2 years. Leading me to scavenge the internet for any clinical related listing that would allow me to provide patient care. Lo and behold I came across an indeed post, “Medical Scribes needed! Certifications and relative experience preferred but not required, looking for individuals with a passion for building the future of healthcare etc.”. A paid medical scribe position with a GED being the only solid requirement, it seemed too good to be true. I applied and during the interview process was told how I’d be a better fit for their medical assistant position despite me not having certification or experience. My eyes lit up knowing how much more medical assistants are involved in patient care. Baited by the clinical experience I could use for personal growth as well as the med school applications I accepted the offer. I became trapped into the sport of exploitation, a sport the CEO and COO of this company play well.

Day 1 came. I began to quickly learn what most certified medical assistants pay thousands of dollars to learn over the course of a year. By day 8 I was expected to know it all: blood draws, EKG tests, how to operate a multi telephone system, apply splints to broken bones, run insurances, how to interact with doctors and more. The icing on this exploitative company's cake was the fact that I was being trained by another uncertified medical assistant who was recruited and trained the exact same way I was. He wasn’t even fully confident when performing the procedures he was teaching me. The crookedness doesn’t stop there, everyone in management aside from people in billing, the CEO and COO were all hired into the company as medical assistants. Everyone in management along with every Medical Assistant I’ve worked with were all baited by a scribe listing online then hired to be a medical assistant just like me. At least 90% of the company (Excluding medical providers and billing) is operated/ran by ambitious 20 something pre-health students desperate for clinical and leadership experience. It felt parallel to the ambitious immigrant women seeking employment in The Triangle Fire Story of 1911. No one would employ those immigrant women except a deceptive, exploitative company. No clinic or hospital would seek out uncertified inexperienced students to provide patient care except deceptive, exploitative ones. Just like the immigrant women, we risked it all. We knew we were being exploited, we wanted some way, anyway into healthcare. We knew systemic problems led us here. Most of us were 1st gen college students with no family members or connections to help get our feet into patient care. We risked seriously injuring or killing a patient and lawsuits. We were fully aware of the poor working conditions. Nonetheless we did our best with the inadequate tools and constant shortage of supplies we were left to work with. Every shift lasted 5 hours with a flow of around 15-20 patients. Staffing two medical assistants and a provider to tend to 15-20 patients with supply shortages looked good from the standpoint of a business looking to maximize profits. From my standpoint as the medical assistant working with the patients it was incredibly taxing and exploitative. Every shift felt like a triangle fire in my brain. Invigorating me to be the best uncertified medical assistant at my clinic. Not to outshine my coworkers but to make sure I’m giving patients optimal care knowing this company would never hire actual certified assistants with pay standards.

It was mentally, physically, and emotionally draining for me. The process of making sure I’m checking in and running a patient's insurance correctly. Then bringing the patient back to triage them while making sure I take down detailed notes of their symptoms. Not only to provide a detailed report to the provider but for charting/insurance purposes. After reading the patient's symptoms and concerns to the provider I usually have to assist them with procedures, collect specimens for them, run labs, administer medication/injections, perform tests and more. All while documenting everything performed. Once the patient's visit is complete I’m then pressured by the provider and managers into scheduling a follow up for the patient. A majority of the time scheduling follow ups really just means ensuring future profits at the expense of a patient's life and wallet. Despite this my passion for patient care grew with every shift which kept me coming back. My silent hatred for the company also grew with every shift. I felt trapped in a mental triangle fire. It felt inescapable like the 1911 one. Trapped into staying, I felt I’d never find another opportunity quite like it unless I dish out thousands of dollars for some type of certification. A provider I trusted and loved working with even told me I’d never find another opportunity like this. She insisted I learn as much as I can about patient care while I’m working for the company. She pointed out how the company is exploiting us as much as they can, having medical assistants do what LVN/RN’s are usually responsible for at normal clinics and hospitals. She insisted I should use this as a learning opportunity and that I actually had nothing to lose. If anything were to happen to a patient the clinic and provider on shift would be at fault. She wanted me to stick around and learn as much as I can. As long as I can handle how understaffed and exploitative the job can be. Her name was Anna and she was a physician assistant I will never forget.

Anna is an immigrant from Ukraine, she came to the United States in the 2000’s. She didn’t have much upward mobility in Ukraine, she found herself bound by her country's patriarchal beliefs. This prompted her to move to the US where she had success with climbing our socio-economic hierarchy from lower working class to upper-middle. She graduated from Stanford’s physician assistant program in 2012. Despite graduating from a reputable school she had trouble finding work until she too was baited by the company's willingness to hire anyone. Anna was fully aware of how exploitative the company was but used it to her advantage while always providing exceptional patient care. Medical assistants loved working with her, patients always came back to follow up with her, management did everything to keep her with the company. Anna had charisma; she was a powerhouse. She was very transparent with us, always giving us positive critiques, always willing to retrain us. She had no problem showing us how to properly perform meticulous procedures such as blood draws and injections whenever we needed help. She wasn’t being paid to do any of that either; she did it out of the kindness of her heart. Her desire to stay with the company lasted until covid changed everything.

March 2020 came, the Corporate Cannibals, the CEO and his wife the COO who ran the Urgent Care were scrambling. Searching for new ways to milk money from patients and exploit their workers even further. They first saw telehealth as a covid friendly, innovative way to continue building onto their labor built kingdom and maximize their profits during the pandemic. After covid forced us into a lockdown state we closed our doors and opened our phone lines to patients experiencing covid like symptoms for the first 2 weeks of lockdown. As you could imagine our phones rang off the hook during this time. We would answer them, take peoples insurance, triage them then set them up to have a zoom consultation with a provider. I’ve never seen Anna so stressed. She expressed how she has a husband with vascular issues and was terrified that he wouldn’t survive a covid infection. The patient flow went from 15-20 in person to 30-60 telehealth visits a shift. Telehealth visits may seem easier and they are for medical assistants. Providers on the other hand are still required to fill out charts in great detail as if the patient was seen in person. Charting got so bad that providers began resigning because management wasn’t doing anything to mitigate the unworkable volume of patients coming in. They weren’t hiring more providers or having providers work collaboratively. They prioritized profits over people the same way the supreme courts and corporations did during the gilded age. This cost them their most profitable and valuable worker, Anna. She quietly and unexpectedly resigned in April of 2020. She secretly let us know that not only was the workload extreme, they were going to be cutting her salary by 5% which was the last straw for her akin to the labor strikes of the early 20th century.

April 2020 was also when testing became widely available. Our company thought out an intricate way to maximize profits from testing as well. They developed an incredibly exploitative app and a sister company which we’ll call Scammie. Scammie is an app all of our Covid related patients must download in order to get tested for Covid. Most patients download Scammie and accept its terms and conditions without looking at the fine print which states any data they enter can be marketed and sold. The corporate cannibals did it again. The pandemic gave them more opportunities to exploit not only their workers; now they can explicitly exploit patients through this app. Once patients download Scammie, they’re then prompted to enter in their insurance information and entire detailed medical history. After patients give away tons of personal information for our management to sell we initiate the visit process. It's similar to the one explained before we triage the patient than have the patient speak with a provider via zoom. Now during this time it was our policy to only give covid tests to patients who are explicitly displaying covid symptoms. This means a patient could download Scammie, give away sellable information, pay a insurance deductible or copay only to be denied a covid test if they aren’t exhibiting symptoms.

The amount of patients rightfully outraged by this was insane. The corporate cannibals didn’t care. They were too busy salivating over their insane profit margins from collecting/selling personal data and exploiting hoards of symptomless people seeking testing during that time. Fall-Winter 2020 came around and so did the first massive wave of covid. This was when our company lifted the strict testing requirements. Everyone was catching covid or being possibly exposed to covid then booking appointments through the app. I was responsible for calling and triaging the laundry list of covid patients on my schedule on top of caring for non-covid patients in the clinic during this time. I only had 1 other medical assistant to help me. This wasn’t the most exploitative part. 15 steps away from my station were doors that opened to the clinic's parking lot. This is where our “Covid Drive Through” was and during the first massive covid wave there were at least 50 cars in line to get tested at all times. During the first 3 weeks of introducing our drive through the Corporate Cannibals had the two medical assistants assisting with Scammie appointments, caring for in clinic patients then throwing on PPE to test people waiting in the endless line of cars. People from the drive through would regularly get out of their car, run into the clinic and begin screaming at us to hurry up while we’re busy with a patient. Finally the cannibals took note of what was going on and decided to permanently add an additional medical assistant position to our shifts team making them responsible for covid drive through operations. The addition of a 3rd medical assistant to shifts meant more work for clinic supervisors who are responsible for more auditing charts now. Clinic supervisors are basically medical assistants who were paid 4 more dollars to manage all clinic operations. To name a few tasks, they are responsible for sending supply order requests, auditing all charts from every shift, scheduling our shifts, clinic maintenance, signing off on daily checklists, and sending daily clinic reports. They aren’t given any benefits and are never offered full time employment despite everything they’re responsible for.

There are 6 clinics in total which means there are 6 clinic supervisors. These supervisors have weekly meetings to discuss clinic operations but most importantly follow up quotas/rates with the CEO, COO and Chief of Staff. If a supervisor’s clinic isn’t meeting a certain patient follow up % they are often threatened with termination. Since clinic supervisors are tasked with so much they oftentimes find themselves working off the clock to avoid nasty termination threats from higher up. Since the winter 2020 wave of covid started my clinic supervisor Amanda found herself auditing charts several hours past her scheduled shift. She became frustrated with her situation and proceeded to reach out to other clinic supervisors letting them know how she feels. They all agreed that they should be getting paid when working off the clock especially since patient volume has exploded since covid started. Amanda then talked them all into advocating for this during the next weekly meeting with the COO, CEO and Chief of Staff and they all promised her they would.

Amanda and I were close. She let me in on what was happening and allowed me to watch from the side of her clinic office. Amanda opened her laptop and joined the meeting. Several minutes in, Amanda found an opportunity to bring up her complaint. She spoke up for herself letting her bosses know how she felt overworked and underpaid. She advocated for getting paid when working off the clock and ended with how her fellow supervisors felt the same way. Amanda then waited for her coworkers to chime in and give their thoughts on getting paid for working off the clock. She was instead met with silence; no one said a word, “If a man would be hurt on the job, you think the employer would pay a cent to him? Why should he care? There was always another poor man to take his place”. (Rent Strike 1930) I believe this passage was similar to what rang through her fellow supervisors' minds preventing them from speaking out. This palpable silence was soon shattered by the most wicked laughs let out by the Chief of Staff (who was once in Amandas position) and the COO. Hypnotized by competitive individualism they disregarded her complaint as laziness. Indirectly letting her know she’s a failure as a result of her own personal shortcomings. They insinuated this through silence and laughter. They didn't even acknowledge the question or Amanda continuing the meeting as if she wasn’t even there. Amanda felt so violated by the situation she left the zoom meeting, sent a resignation email and began crying to me. To my surprise they were tears of joy as she exclaimed how she finally felt free. She was no longer a caged bird bound by working off the clock; she was finally a free bird able to commit more time to her passion for reading and her studies. She begged me to resign with her. I didn’t have the guts to free myself immediately but promised her that I’d resign in June 2021. This was so I can have a solid 2 years of clinical experience under my belt. I invited her to lunch later that week where we reflected on our times working together and talked about our future. Amanda had pre-nursing ambitions, she was finishing up a microbiology requirement to get into a nursing program. I was at community college finishing up physics and organic chemistry to get into UCSD. It’s 2022 now and we both accomplished our goals and used our negative job experience to get us into higher places!

What can be taken away from my story is that history repeats itself. The profit over people mindset from the gilded age thrives in American healthcare. Covid made that mindset become so palpable at my workplace to the point where our company was explicitly exploiting patients through an app. I wonder how much more exploitation it will take; how many more lives lost until America wakes up and realizes the profit over people mindset will only continue in healthcare until it is viewed as a human right. One thing Amanda said about our company that I’ll never forget was that, “We worked for a business that does health care, not a healthcare business”. Amanda telling me that helped me look deeply at jobs in American healthcare. I’ve now had a chance to navigate working for an exploitative business that does healthcare. Following this experience I hope to only work for healthcare businesses that prioritizes people over profit or at least views people and profit as equals. If I fail to find any healthcare businesses that value people as a physician then I’d like to open my own.

Works Cited

Grace Jones. “Corporate Cannibal.” Hurricane.

“Triangle Fire.” PBS, Public Broadcasting Service. Accessed 10 June 2022.

Chernin, Rose. “Organizing the Unemployed in the Bronx in the 1930s (1949): Rose Chernin.” .