The reported proposal cuts time off, removes a valued benefit, and eliminates WVMG’s board while offering minority physician representation. Our position: preserve physician-led partnership and vote no on these terms.
Physicians are being asked to consider a closer employment relationship. The public record raises a prior question: has the leadership relationship been repaired?
Why become employees of the organization whose leadership physicians reportedly lacked confidence in—before trust is restored?
Direct employment would change the relationship between WVMG physicians and Confluence Health. Our argument: do not replace an independent physician organization with individual employment agreements on the strength of reassurance alone.
In their February 2026 guest opinion, former CEOs Peter Rutherford and Jack Evans described a WVMG board letter reporting that an overwhelming majority of its physicians lacked confidence in CEO Andrew Jones.
Read the former CEOs’ account [1] ↗KPQ reported the former leaders’ concerns about physician confidence, the cancer-center dispute, and the implications for the region’s healthcare partnership.
Read KPQ’s reporting [2] ↗CH’s board said its review found no grounds to remove Jones. It disputed the critics’ account, defended the capital-planning process, and cited improvements in finances, access, and satisfaction.
Read the board’s full response [3] ↗The reported 4% wRVU-rate increase comes with removal of a $7,800 annual wellness and technology stipend. Compare recurring compensation before adding temporary bonuses.
At unchanged productivity, a 4% increase on $300,000 of eligible annual wRVU pay adds $12,000. Removing the $7,800 stipend leaves $4,200 a year—just 1.4% of that wRVU pay, or 1.36% of the current $307,800 package.
Eligible annual wRVU pay at which the stipend loss consumes half the advertised 4% increase.
Break-even eligible wRVU pay: the entire 4% increase is offset by the lost stipend.
The stipend also signals that physician wellbeing and the tools of practice matter. Removing it weakens that cultural commitment while the proposal asks physicians to give up time off.
The 4% is assumed to apply to eligible wRVU compensation—not automatically to salary, administrative pay, call pay, or total compensation. Stipend value is modeled dollar for dollar before tax; reimbursement or tax treatment could alter its after-tax value.
Hold annual wRVU output constant. Exclude the retention bonuses.
At the simplified 205 → 215 workday baseline, this package is about 3.35% lower per required workday at the same annual wRVU output.
| Eligible wRVU pay | 4% increase | Net recurring gain | Net / eligible pay |
|---|---|---|---|
| $200,000 | $8,000 | $200 | 0.10% |
| $300,000 | $12,000 | $4,200 | 1.40% |
| $390,000 | $15,600 | $7,800 | 2.00% |
| $500,000 | $20,000 | $12,200 | 2.44% |
| $750,000 | $30,000 | $22,200 | 2.96% |
“Net” here means after the stipend offset, before tax. The exact point at which the increase is 2% of the old eligible-pay-plus-stipend package is $397,800 of eligible wRVU pay; $390,000 is the half-offset threshold measured against eligible pay alone.
The reported reduction from 11 to 9 weeks off changes a defining part of the employment bargain. A region that attracts physicians through quality of life should protect that recruiting advantage.
The reported recurring offer is 4% more on eligible wRVU pay, less a $7,800 annual benefit. The $25,000 / $15,000 / $10,000 retention schedule is temporary. Require the conversion factor, bonus conditions, and future amendment rules in writing.
Physicians report an 11-to-9-week reduction in time off and a reduction in sick-leave banks, with the sick-bank details not yet available. They also report a 205-day annual requirement but approximately 214 days actually worked on average. Verify the definitions before treating the current overage as a new contractual minimum.
Professional independence needs a practical way to challenge a decision without immediately losing employment.
Compare total compensation and the cost of leaving, not simply base pay.
Determine which document controls if an individual contract, employer handbook, governance charter, or future collective agreement conflicts.
North Central Washington attracts physicians who value both meaningful clinical work and life outside medicine. Removing two weeks of flexibility can undermine that bargain, especially when physicians already report working beyond their nominal requirement.
Some may reduce clinical FTE, accept chronic overwork, or leave to restore balance. These are workforce risks to evaluate, not measured forecasts.
Sick-leave bank reduction: reported, but amount, treatment of existing balances, and transition rules remain unknown. Obtain the full leave policy and workforce data before adoption.
Physicians report that WVMG’s board would be eliminated. CH’s initial two-seat physician offer reportedly became five seats on a 15-member board, with a 70% threshold for specified decisions. More seats than an opening offer does not establish a good final agreement.
If the 70% rule applies to all 15 board seats, 10.5 rounds up to 11 votes. Five physician directors are one-third of the board. With all ten nonphysician directors voting yes, one physician yes vote passes a measure; all five physician directors must oppose it to block it.
This does not assume community directors always vote together or equate nonphysician votes with management votes. Quorum, vacancies, abstentions, which decisions require 70%, and the rule’s denominator need the actual bylaws.
Under the reported approach, physician directors would be selected through CH board rules, rather than a guaranteed independent physician election. If CH’s process controls selection and removal, it can favor nominees it considers compatible—even if four other physician directors disagree.
Allowing selection from employed physicians without an independent constituency safeguard also permits future changes in who represents the physician body. This is a design vulnerability, not evidence that anyone has hired a physician to influence a vote.
The argument that physician appointments should simply follow community-director rules misses the difference between community stewardship and representation of a defined physician electorate.
Demand a binding physician election, clear eligibility and removal rules, protected amendment procedures, and meaningful approval rights. All directors would still owe their legal duties to the organization; physician election is not a substitute for those duties.
| Reported change [13] | Why we oppose it | Protection to require |
|---|---|---|
| WVMG board eliminated | An independent physician governing body disappears while employment authority moves to CH. | Preserve an independent physician organization, or demonstrate equally durable enforceable authority. |
| Two seats initially; five now proposed | Progress from an opening bid says little about the value of the final bargain. Five of fifteen is a minority. | Judge the final terms against current rights and the best achievable PSA—not the initial offer. |
| 70% on a 15-seat board | On the stated full-board model, ten nonphysician yes votes plus one physician yes vote can pass a measure. | Defined physician concurrence for protected clinical and governance matters. |
| CH board selection rules | Physician identity does not ensure independent accountability to the physician body. | Binding physician election, protected terms, clear removal rules, and independent nomination rights. |
| Current supermajority protection reduced | The loss cannot be fully measured without current and proposed voting provisions side by side. | Publish both sets of bylaws, including amendment thresholds, scope, quorum, and vacancies. |
Baseline to reconcile: The contributor describes seven current physician seats; CH’s published roster lists six. This review does not assert a verified two-seat reduction. The effective current bylaws must settle that comparison. The proposed 5-of-15 calculation above stands independently. Published roster [4] ↗
Unionization belongs in the risk assessment of this employment model—not as a promised remedy for the rights being surrendered.
The independent board is removed, leave is reduced, and board representation depends on CH’s selection rules.
When internal governance feels ineffective, eligible employed clinicians may seek formal independent representation.
First-contract disputes, grievances, and recurring bargaining may entrench an antagonistic relationship rather than repair it.
This is an advocacy assessment of a possible employment outcome, not a measured probability, an organizing plan, or a claim that unionization inevitably produces conflict. The avoidable risk is carrying unresolved distrust into the new structure.
Where the law applies, an independent bargaining representative brings obligations concerning employment terms. An employer-appointed physician council cannot simply stand in for that representative.
Bargaining need not produce agreement to the proposed terms. Starting with disputed governance could deepen the relationship problem the transaction is meant to solve.
Protect lawful rights while addressing the cause of conflict. Covered employees may organize without unlawful retaliation. Physician supervisory or managerial duties can affect eligibility. Unionization does not automatically remove every physician’s board seat. These questions require the actual documents and independent advice. NLRB guidance [5–7] ↗
A distribution from selling physician-owned real estate is the conversion of an existing asset into cash. It is not new compensation from CH for giving up independent governance. Judge the net proceeds, future income relinquished, and employment terms separately.
Change the assumptions. See the difference between sale price and cash in hand.
A negotiating preference for direct employment does not demonstrate that a renewed professional services agreement is unworkable. Put both developed models in front of physicians before asking for an irreversible decision.
Evaluate a renewed professional services and co-management framework that preserves an independent physician organization while addressing financial and operational concerns.
Evaluate retaining real estate, selling it separately, or continuing independent ownership. Do not assume that a property transaction requires a particular employment outcome.
If direct employment remains under consideration, negotiate durable compensation, due process, physician governance, and a legally sound representation framework before committing.
Seven principles adapted from a proposed “No on Employment” letter attributed by the contributor to Mitchell Garrison, MD, MBA, hematology/medical oncology and past WVMG president.
Separate the property distribution and temporary retention payments from the continuing value of physician ownership and governance. Tax consequences depend on entity and transaction structure; a second personal tax is not automatic in every model.
Preserve meaningful influence over clinical practice, schedules, locations, and physician-led professional accountability, with responsibilities to patients and colleagues.
The supplied draft questions Andrew Jones, Kris Deyerle, and the CH board over physician input and conflict-of-interest handling. These are attributed draft criticisms, not established findings of misconduct. CH’s public response is linked in the leadership section.
The draft challenges the $60 million-plus cancer investment and oncologist participation. Public accounts disagree about the planning process. Require documented specialty input, service priorities, and county-specific benefits.
WVMG’s independent physician organization connects specialties and provides a distinct clinical voice alongside administration and financial stewardship. Its future deserves a direct vote on that value.
The draft argues that investment is too Wenatchee-centered and describes service losses and missed partnerships elsewhere. Verify those claims with county-level data and demand concrete regional service commitments.
Insist on a developed alternative using the same financial assumptions. Treat excluding the PSA from negotiations as a choice requiring explanation, not evidence that it cannot work.
Reported facts, institutional responses, legal background, and our own analysis have different evidentiary weight. Follow the sources and make up your own mind.
Supplied by a physician contributor for this review. These are not presented as an independently authenticated term sheet. Legal effect and exact wording require the final documents.
| Item | Reported detail / status |
|---|---|
| Retention pay | $25,000 in year 1; $15,000 in year 2; $10,000 in year 3. Conditions and repayment terms not supplied. |
| Recurring compensation | 4% increase in wRVU rate; elimination of the $7,800 annual wellness and technology stipend. |
| Leave | Time off reduced from 11 to 9 weeks; sick-bank reduction reported, with specifics unavailable. |
| Workdays | 205 required days per year and approximately 214 actually worked on average, as reported. The 215-day proposal illustration uses a simplified five-day, 52-week calendar. |
| WVMG governance | WVMG board eliminated; existing supermajority protection reportedly reduced. Current and proposed bylaws are needed. |
| CH governance | Initial two physician seats increased to five of fifteen; 70% threshold reported. Rule scope, denominator, and exceptions not supplied. |
| Selection of directors | Physician directors would follow CH board selection rules used for community directors. Independent election rights and final language not supplied. |
| Current seat baseline | Seven physician seats reported by contributor; six listed in CH’s public roster. Reconcile against effective governing documents. |
Source review: October 29, 2026. Summaries reflect the linked sources and their dates, not independent verification of every underlying assertion. No statement implies endorsement of this site by a source or institution.
Written terms confirming the reported pay, bonus, and leave provisions
Current and proposed bylaws, seat counts, selection, and voting rules
Official no-confidence ballot, tally, and subsequent follow-up
Property term sheet, valuation, debts, and shareholder allocation
County-level service, capital, recruitment, and staffing commitments
Final voting process, deadlines, and alternatives analysis
Concept 02 incorporates the reported offer and governance terms. Review the three audience positions, check the calculations, and flag wording that needs the underlying documents.