Valley News – Jim Kenyon: Dartmouth College, Dartmouth Health Department

Dartmouth College and Dartmouth-Hitchcock Medical Center are just a few miles away. But for some underpaid workers, the Upper Valley’s two largest employers are worlds apart.

Recent examples:

A small group of watchmen at Dartmouth’s Hood Museum of Art wanted, among other things, better pay. One of the visitor services guides, when called, told me that she makes $19 an hour, which is less than $40,000 a year.

That’s just because housing costs in many Upper Valley communities are through the roof with living wages.

The guides, all with bachelor’s degrees, turned to Local 560 of the Service Employees International Union (SEIU) for help. Last month, they voted to join the union, which has represented the college’s blue-collar workers for more than 50 years. Currently, the union has about 400 members, from kitchen workers to carpenters.

SEIU President Chris Peck, a painter at the college for more than 30-plus years, hopes contract negotiations will result in a $3-an-hour raise for museum workers or more.

It brings them in line with the starting pay of the college custodians and dishwashers.

“We want equality,” said Grace Ross, who worked in Massachusetts museums before joining the Hood staff a year ago.

The duties of the guides include opening and closing the museum. While the Hood is open on Saturdays and some evenings, tour operators do not receive shift differential pay, which SEIU is hoping to change.

“Many of us have master’s degrees and expertise in our fields,” Ross said, sharing an email the team put together. “We want compensation commensurate with our skills, experience and the cost of living in the area.”

Not just in dollars, Peck told me. “And people want to hear it,” he said. “Non-union workers sometimes don’t feel comfortable going to their bosses about issues they may have.”

On the surface, adding half a dozen workers (the vote to join the union was 5-0) to SEIU’s ranks doesn’t seem like a big deal.

But Local 560 hopes other pockets of Dartmouth workers will lead the union to rally.

DHMC staff may also want to think about it.

Last month, 50 DHMC employees who register patients at the hospital’s front desk learned their jobs had been outsourced to a private company in Texas.

The workers were powerless. If they wanted to stay in their roles at the medical center in Lebanon, they had to go to work for Conifer Health Solutions, a subsidiary of Dallas-based for-profit hospital chain Tenet Healthcare.

Dartmouth Health isn’t the first time the “revamped” mega health care system it’s currently calling itself has let go of rank and file employees.

Dartmouth Health has been doing business with Conifer since 2015, including about 340 jobs in revenue management, billing and debt collection.

Recently, Dartmouth Health outsourced “enrollment services” jobs to Conifer from the four Vermont and New Hampshire hospitals in its network.

“Managing our enrollment process in one system allows us to improve our patient experience,” Dartmouth Health spokeswoman Audra Burns told me in an email.

DHMC employees had less than three weeks to decide if they wanted to sign up with Conifer, a company that presents itself as a “care partner – delivering revenue cycle and value-based care solutions that improve financial performance, improve business outcomes and enhance the healthcare experience.”

Marketing gibberish doesn’t seem to have impressed DMMC’s registration service staff. According to a recent internal document an employee shared with me, 39 out of 50 front desk employees declined the conference offer. (A Confer spokeswoman did not respond to a request for comment.)

Instead of joining Conifer, which has more than 13,000 employees, many front desk workers have been scrambling for new jobs at DHMC.

Apparently, Confer didn’t even make it worthwhile to offer a $1,000 “transition” bonus to anyone who stayed with the company for six months.

Who can blame them?

Conifer is ranked 7th on Glassdoor’s list of the worst rated US companies. “While the company strives to improve the processes of others (in the healthcare world), many Conifer employees cite poor management and a lack of communication in their evaluations,” reported in December 2020.

In a Sept. 14 letter to former DMMC employees, Conifer announced it was offering a starting wage of slightly less than $19 an hour. (Same ballpark as DHMC, I’m told).

But it was unclear whether Conifer’s benefits could rival DHMC’s. The workers are worried about losing their accrued vacation time and getting to the medical center’s childcare center.

Some employees also had behavioral problems. Along with checking in patients, I’m told Confer expects the front desk staff to act as bill collectors.

This is actually outsourcing.

When a patient comes in for an appointment, the front desk staff should ask about any unpaid hospital bills. It is not a task that many DhMC staff members at a non-profit medical center want or think is appropriate. (I asked a spokeswoman for Conifer about the practice, but again, I didn’t hear back.) Hitting patients on good balances when they come in for appointments can have a chilling effect. People who are already behind on their hospital bills may be willing to seek the necessary medical care.

For DHMC – and Conifer – it may improve the health of the bottom line – but it doesn’t sound like good medicine.

Jim Kenyon can be reached at

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