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Column: Mark Berman, pusher of unproven stem cell therapies, dies while awaiting verdict in FDA lawsuit

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Column: Mark Berman, pusher of unproven stem cell therapies, dies while awaiting verdict in FDA lawsuit

For years, California beauty surgeon Mark Berman was a pacesetter of that nook of the healthcare world pushing unproven and unapproved stem cell therapies for a number of medical circumstances.

Berman aired his claims for what he known as “magic cells” in a e-book, video appearances and thru a community of affiliated clinics across the nation. These claims caught the eye of the Meals and Drug Administration, which has been attempting to stamp out clinics claiming that stem cell injections can deal with illnesses and circumstances comparable to Alzheimer’s, Parkinson’s, autism and even— most lately — COVID-19.

I can not condone exploitation of determined people who find themselves led to consider that they are going to be cured and even helped by a clinic or a tablet or any purported remedy that’s not based mostly in science.

— Jeanne Loring, Scripps Analysis Institute

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A 2018 lawsuit the FDA filed towards Berman, his skilled accomplice Elliot Lander and their two stem cell companies is awaiting a verdict from U.S. District Decide Jesus Bernal in Riverside. Whichever approach it goes, Bernal’s ruling would set the stage for the subsequent section of the FDA’s marketing campaign towards stem cell clinics — both endorsing its place that the injection process quantities to administering unlawful medication or erecting an impediment to enforcement of its guidelines.

Berman died April 19, in response to his workplace. His dying hasn’t been publicly introduced. An electronic mail despatched final week to a affected person and signed by an workplace supervisor at Cell Surgical Community, which Berman co-founded with urologist Elliot Lander in 2012, said that he died after being hospitalized in early January.

Lander instructed me by electronic mail, “The household will launch all pertinent info in an obituary which has not been accomplished and revealed but.” Berman’s son, Sean, confirmed that an obit is being written.

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Berman’s dying supplies us with a possibility to evaluation the FDA’s marketing campaign towards clinics purveying bogus stem cell therapies.

The company’s targets are clinics that depend on a way just like the one promoted by Berman and his colleagues at clinics branded because the California Stem Cell Therapy Heart in Rancho Mirage and Beverly Hills and at scores of clinics affiliated with the Cell Surgical Community. The therapy facilities have been co-founded by Berman and Lander in 2010.

The strategy begins with extracting fats from a buyer by way of liposuction. The fats is then refined to isolate what is named the “stromal vascular fraction,” or SVF, which Berman asserted is wealthy in stem cells. The SVF is then reinjected into the client.

Clients of greater than 1,000 clinics across the nation, a few of that are affiliated with the Cell Surgical Community, have been charged as a lot as a number of thousand {dollars} for such procedures, that are seldom, if ever, lined by medical health insurance.

In a 2015 e-book titled “The Stem Cell Revolution,” Berman and Lander asserted that their colleagues within the community have been treating “a variety of circumstances” comparable to Alzheimer’s, autism, cerebral palsy, a number of sclerosis, muscular dystrophy, Parkinson’s, stroke and traumatic mind damage.

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Extra lately, Berman, Lander and different stem cell promoters have been implying that stem cells can be utilized to deal with COVID-19.

The FDA’s place on these claims is crystal clear. The company observes that there isn’t a scientifically validated proof for these therapy claims. The company has warned potential clients to avoid the claims’ promoters.

“Don’t consider the hype,” the company says on its web site. “Some unscrupulous suppliers supply stem cell merchandise which might be each unapproved and unproven,” in addition to “probably harmful.”

The FDA says it has not authorized stem cell therapies for any circumstances aside from uncommon blood system illnesses, for which it has authorized therapies utilizing blood-forming stem cells derived from umbilical wire blood. The company has particularly warned towards claims that stem cells can be utilized to deal with autism, macular degeneration, blindness, power ache, fatigue; neurological problems comparable to a number of sclerosis, Alzheimer’s and Parkinson’s; or cardiovascular or pulmonary illnesses.

The company additionally has warned towards claims, that are additionally unproven, that stem cells can be utilized for “the therapy or prevention of COVID-19, acute respiratory misery syndrome (ARDS), or some other complication associated to COVID-19.”

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In sensible phrases, nevertheless, the FDA’s marketing campaign has not been going effectively. In 2017, the FDA closed a loophole that allowed the stem cell clinics to proceed pitching unproven, ineffective and probably hazardous stem cell therapies on to customers. The stem cells extracted from fats, the FDA dominated, have been medication underneath the regulation, which means that the clinics would should be licensed and subjected to inspection.

However the company unwisely gave clinics as much as three years to adjust to its new laws. Then it prolonged the deadline by six months due to the pandemic, so its interval of regulatory “forbearance” expired Could 31, 2021.

By then, a torrent of shady operations had poured into the sphere — so many who the duty of defending the general public from them could exceed the FDA’s capabilities. In line with a research by Leigh Turner of UC Irvine, by midyear 2021 there have been 1,480 companies working 2,754 clinics nationwide.

“That hardly looks like progress,” Turner instructed me final 12 months. “The issue the FDA faces is 4 instances bigger than what existed in 2016. The FDA solely has so many staff and so many inspectors. They don’t actually have sufficient inspectors to ship them to 1,480 companies.”

Earlier than his dying at age 69, Berman and his associates reportedly had been learning whether or not stem cells could possibly be used to deal with COVID. In testimony throughout the federal trial, Berman said that Cell Surgical Community was working with a Florida stem cell firm, American Cell Expertise, “to deal with COVID-19 sufferers” in accordance with a therapy protocol the community developed, as an FDA post-trial transient filed in June describe his statements from the witness field.

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Sean Berman, Mark Berman’s son, who says he’s a advisor to ACT, instructed me that so far as he’s conscious, no sufferers have been handled for COVID in response to the protocol the FDA talked about.

Lander appeared to point, nevertheless, {that a} research of some kind had taken place. “No sufferers have been ever charged any charges in our Covid-19 research,” he instructed me by electronic mail.

Particulars about Berman’s dying haven’t been made public.

An individual who answered the telephone at California Stem Cell Therapy Heart instructed me that Berman died of “issues from Covid.”

Lander, nevertheless, instructed me: “Any one who represented themselves to be an agent of California Stem Cell over the telephone was neither educated sufficient, nor licensed, to debate Dr. Berman’s medical historical past.”

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One affected person says Berman’s workers canceled a pre-op process in January, stating that Berman had COVID. The affected person, who doesn’t need to be recognized, says Berman’s workplace stored providing to reschedule the appointment, however finally the process didn’t happen.

The FDA has been taking a look at Berman’s operations at the very least since 2017. In two inspection experiences in July 2017, the company listed quite a few “objectionable circumstances” on the California Stem Cell Therapy Heart services in Rancho Mirage and Beverly Hills that it asserted have been in violation of regulatory requirements .

The experiences criticized sterilization procedures, coaching and record-keeping on the places. At Rancho Mirage, at the very least 4 “severe adversarial occasions” after stem cell procedures had not been investigated by the clinic or reported to the FDA as required, the company mentioned.

They included a affected person’s retinal detachment after the SVF was injected into the affected person’s eyes, hospitalization of one other affected person for “confusion and headache,” and two instances of an infection.

Berman and Lander wrote of their e-book that that they had discovered “extraordinary security and no severe adversarial results associated to SVF deployment.”

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The FDA’s most decided assault on Berman got here within the lawsuit filed in Riverside federal court docket in Could 2018, aimed basically at forcing him and his services to stop treating sufferers with the fats extractions. The lawsuit was largely an identical to 1 the company filed the identical day towards U.S. Stem Cell, a Florida clinic operator, in Miami federal court docket.

Each units of plaintiffs mounted related defenses — mainly that they have been merely treating sufferers with their very own tissues, so their merchandise fell exterior the FDA definition of a drug and thus have been exempt from the company’s jurisdiction. The FDA disagreed. The extracted tissues have been so totally manipulated earlier than reinjection, the company argued, that they have been correctly outlined as a drug and didn’t qualify for the exemption.

The 2 lawsuits have adopted divergent paths. In Miami, District Decide Ursula Ungaro agreed with the FDA in a serious victory for the company’s marketing campaign towards stem cell clinics.

Ungaro held in June 2019 that the SVF was certainly a drug and subsequently used illegally. She additional noticed that U.S. Stem Cell’s procedures “contain the next threat of communicable illness and different security issues and are subsequently topic to FDA regulation.” Her resolution siding with the company by way of abstract judgment — that’s, with out trial — successfully shut down U.S. Stem Cell’s clinic.

Ungaro’s ruling was upheld in June by the U.S. eleventh Circuit Court docket of Appeals in Atlanta.

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In Riverside, nevertheless, Bernal denied the FDA’s movement for abstract judgment. As an alternative, he held a seven-day trial in Could 2021. Submit-trial briefs by either side have been submitted in August, however Bernal has but to problem a verdict. There are not any indications of when he may rule.

Berman’s dying gained’t require Bernal to droop his deliberations, as there are nonetheless three different defendants — Lander, California Stem Cell Therapy Heart and Cell Surgical Community.

The FDA, in its post-trial transient in June, correctly raised the alarm that the defendants may be aiming their pitch at victims of COVID-19, regardless of the dearth of proof that stem cells are efficient in treating the illness. Why ought to that be a shock? The sector of stem cell clinics has been feeding on the desperation of sick folks nearly since its inception.

“Has a physician ever instructed you ‘there’s nothing we will do?’” Berman and Lander wrote of their e-book. “We sincerely hope you gained’t settle for that as the ultimate reply.” The FDA’s response has been, in impact: Beware, as a result of they don’t have the reply both.

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Column: Courts finally move to end right-wing judge shopping, but the damage may already be done

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Column: Courts finally move to end right-wing judge shopping, but the damage may already be done

Some lawsuits are won by smart lawyers and some on the facts. But nothing spells success as much as the ability to pick your own judge.

That’s the lesson taught by conservative activists who have moved in federal courts to overturn government programs and policies on abortion, contraception, immigration, gun control, student loan relief and vaccine mandates, among other issues.

In recent years they’ve gamed the judicial system to get their lawsuits heard by judges they knew would be sure to see things their way. The process is known as judge shopping, and the committee that makes policy for the federal courts just moved to put an end to it.

The courts have now formally recognized the need to do something about a really troubling pattern of judge shopping.

— Amanda Shanor, University of Pennsylvania constitutional law expert

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In a policy statement and official guidance issued last week, the Judicial Conference of the United States said that henceforth, any lawsuit seeking a statewide or nationwide injunction against a government policy or action should be assigned at random to a judge in the federal district where it’s filed.

If that sounds a bit vague to the layperson, its target is crystal clear to legal experts: It’s aimed at right-wing activists and politicians who have filed their cases in federal courthouses presided over by highly partisan judges in Texas. Most of those judges were appointed by Donald Trump.

It would be bad enough if those judges’ rulings applied only within their judicial districts or affected only the plaintiffs. But the judges have issued sweeping nationwide injunctions that block government programs and policies coast-to-coast.

As Ian Millhiser of Vox put it, this is America’s “Matthew Kacsmaryk problem.” Kacsmaryk is the Trump-appointed Texas federal judge who most recently attempted to outlaw mifepristone, a widely used abortion medication, nationwide. His April 2023 ruling has been temporarily stayed by the Supreme Court, but it’s still on the docket, ticking away.

But Kacsmaryk is not alone. As recently as March 8, Judge J. Campbell Barker, a Trump appointee who presides over 50% of the civil cases filed in his rustic courthouse in Tyler, Texas, invalidated a ruling by the National Labor Relations Board broadening the standard by which big corporations could be held jointly responsible for the welfare and unionization rights of workers employed by their franchisees.

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How serious a blow could the judicial conference’s policy be to conservatives aiming to roll back civil rights? Massive, judging from the reaction of Senate Minority Leader Mitch McConnell (R-Ky.). Only 48 hours after the conference announced its initiative, McConnell wrote to the chief judges of all judicial districts urging them to ignore the new policy.

This was an audacious move, considering that the presiding officer of the Judicial Council is Chief Justice John G. Roberts Jr., its membership comprises the chief judges of the 12 judicial circuits and one judge from a district court in each circuit, and its role is to set policy for the entire federal court system.

McConnell asserted that only Congress can make the rules for the assignment of federal trial judges, but that’s dubious. In an analysis last year, the Justice Department concluded that the Supreme Court has full authority to impose rules of civil procedure in the federal courts, including a rule mandating that all federal judicial districts assign judges randomly to civil lawsuits aimed at statewide or nationwide injunctions. The Judicial Council’s policy isn’t the same as as a Supreme Court rule, but it’s a fair bet that if pushed, the court would issue the rule.

McConnell also asserted that the Judicial Conference had been pressured into acting by Senate Majority Leader Charles E. Schumer (D-N.Y.), but that’s untrue. Although Schumer has spoken out against judge shopping, numerous legal experts and Roberts himself have expressed concerns about the practice.

“The courts have now formally recognized the need to do something about a really troubling pattern of judge shopping,” Amanda Shanor, a constitutional law expert at the University of Pennsylvania, said of the Judicial Conference’s initiative.

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What’s yet unclear is whether the conference’s initiative goes far enough. Its policy statement is described as “guidance,” not a mandate. it acknowledges the district courts’ “authority and discretion” to manage their dockets as they see fit.

Last year, Shanor, with Alice Clapman and Jennifer Ahearn of NYU’s Brennan Center for Justice, proposed that the conference require all judicial districts to use a “random or blind procedure” to distribute cases among all the judges in the district when the litigants seek an injunction or other relief that would extend beyond the district’s borders.

The practice traditionally labeled “forum shopping” is not especially new. The earliest case cited by legal experts dates back to 1842, when a litigant chose to file a lawsuit in federal rather than state court in New York to gain a strategic advantage over his adversary.

Plaintiffs have been known to choose a venue based on local statutes of limitation, or a sense that juries in a region might be more amenable to their case, or because their location may be more convenient for parties or witnesses.

More recently, however, the practice has been heavily abused for partisan and ideological purposes. This results from two trends. One is the increasing partisanship of individual federal judges, especially those appointed by Trump. The second is those judges’ habit of issuing nationwide injunctions against government policies or programs.

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Nationwide injunctions can impose parochial partisan ideologies on the whole country. Through 2023, the state of Texas filed more than 31 federal lawsuits challenging Biden administration policies — but not a single one in federal court in Austin, which is the state capital but an island of blue in a red state.

The state had filed seven lawsuits in Amarillo, where by local procedure every one was automatically assigned to Kacsmaryk; six in Victoria, where all civil cases are assigned to Trump appointee Drew B. Tipton; and four in Galveston, where all civil cases come before Trump appointee Jeff Brown.

The rest were filed in divisions with two judges, most of whom are also Trump appointees or conservative appointees of George W. Bush. In the Tyler division from which Barker issued his NLRB decision, all the cases he doesn’t get are assigned to Judge Jeremy Kernodle, also a Trump appointee.

Although some nationwide injunctions have been lifted by the Supreme Court, that process seldom happens speedily. The result is that the plaintiffs effectively win by losing, as injunctions against government policies can have “the lasting systemic effect of blocking these policies for months or years,” Shanor, Clapman and Ahearn observed.

Kacsmaryk got the mifepristone case for two reasons. First, antiabortion activists knew of his strong antiabortion inclinations. Second, the policy in the Northern District of Texas is to assign cases to judges in the division where they’re filed.

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Kacsmaryk is the only judge sitting in the Amarillo division of the Northern District of Texas. So it was an easy call for the mifepristone plaintiffs to file there, knowing that their chance of drawing Kacsmaryk as their judge was 100%.

The same pattern drove plaintiffs to file lawsuits against Biden administration initiatives in the same district’s Fort Worth division, which has two judges, Trump appointee Mark T. Pittman and George W. Bush appointee Reed O’Connor. Both have been sought by conservative litigants. O’Connor also presides over 100% of the cases filed in the district’s Wichita Falls courthouse, where he is the only judge.

Pittman obligingly overturned Biden’s student loan relief program in 2022. Just this month, he ruled the government’s 55-year-old Minority Business Development Agency to be unconstitutional and ordered it opened to contract applicants of all races — obviously a ruling that defeats the purpose of a program designed to help minorities get a start in the business world. O’Connor tried to declare the entire Affordable Care Act unconstitutional in 2018. The Supreme Court overruled him in 2021.

The judicial conference’s initiative is long overdue.

Customarily, rulings by federal trial judges have constituted precedents binding at most on other judges in a particular judicial district or resulted in court orders benefiting only the plaintiffs who filed the case.

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Matters are different “when a court effectively can bind the entire nation with an injunction” that applies to “an unlimited range of persons and to conduct occurring in … an equally unlimited array of places,” legal scholar Ronald A. Cass wrote in 2018.

The prospect of sweeping rulings incentivizes “an extreme race to courthouses more inclined to issue nationwide injunctions and more sympathetic to the plaintiff’s position,” Cass wrote.

In its latest incarnation, “litigants effectively have the ability to effectively choose an actual judge,” Shanor told me.

“We don’t know how the policy will be rolled out, what exactly is in it, or how much of it is a recommendation rather than a requirement,” she says. “A policy may be effective, but having a rule would advance the fairness and randomness of the distribution of these nationally important cases, and ensure the perceived legitimacy of the courts.”

One is that the policy won’t apply to cases that have already been assigned to a judge. Another is that litigants can still try to game the system by filing their lawsuits in states from which appeals are heard by circuit courts known to have a particular partisan lean.

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That’s a major issue with Texas cases, which are funneled on appeal to the 5th Circuit, sitting in New Orleans. That court has been the source of right-wing decisions so loopy that they’ve been slapped down by the conservative majority on the Supreme Court. Of that circuit’s 17 active judges, six are Trump appointees.

McConnell’s objection to the Judicial Conference’s policy thus should be seen in context. He had more to do than anyone else with embedding Trumpian judges in the federal judiciary, where they wreak havoc on government policies and programs that help ordinary Americans, not just corporations and the rich. The conference’s initiative may be the first step toward a more fair-minded judiciary, but it’s a crucial one.

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A sign of the times: Tearing down an emptying O.C. office complex to build a warehouse

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A sign of the times: Tearing down an emptying O.C. office complex to build a warehouse

In the hierarchy of commercial real estate, office space has long been king.

Developers and landlords lived by the conventional wisdom that there was no better use for your square footage than business offices because they commanded higher rents than industrial spaces.

Simple math, the thinking went.

Well, not so simple anymore. At least in Santa Ana, where a perfectly good office complex is being demolished in a dramatic demonstration of how weak the office rental market has become and how deep the demand for Amazon-style distribution centers runs in Southern California.

The owners of the shiny glass building on Harbor Boulevard close to John Wayne Airport made the counterintuitive calculation that they will be better off owning warehouses than trying to wrangle tenants willing to pony up for conference rooms and corner offices.

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“We had to make a strategic shift,” said Dan Broder, who is in charge of the redevelopment by Kearny Real Estate Co., owner of the property formerly known as Elevate @Harbor.

Lagging post-pandemic occupancy rates prompted owners of the office complex formerly known as Elevate @Harbor in Santa Ana to tear it down and build a warehouse.

(Lawrence M. Pierce)

The shift was prompted in large part by the COVID-19 pandemic, which contributed nationwide to shrinking office populations and rising demand for home delivery of all manner of goods. Four years on, overall demand for offices remains well below pre-pandemic levels, raising questions about how many buildings built for white-collar labor still have a viable economic future.

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“There are a lot of office owners looking at their properties and wondering if those properties still make sense as offices,” said Michael Soto, Southern California research director for real estate brokerage Savills.

Some have decided they don’t, and the result has been a shrinking inventory of offices over the last year in several U.S. markets, including Orange County, Savills said in a recent report.

While those in urban centers making the decision to get out of the office game increasingly have looked to convert unloved offices to apartments, in some areas warehouses are hard to come by and, consequently, bring a premium, Soto said.

Orange County is prime territory for such switches, he said, because while it is still suburban in nature, it is densely developed with few empty sites available to build new distribution centers.

“There’s real pressure to redevelop older office buildings,” Soto said.

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The incentive to redevelop Kearny’s property was enhanced by its location in an industrial district, which spared the company from having to go through time-consuming and challenging process of getting it rezoned for industrial use.

 An office building in Santa Ana is being demolished to make way for a distribution center.

Demolition is underway of an office complex on Harbor Boulevard in Santa Ana that will be replaced by a distribution center.

(Dania Maxwell/Los Angeles Times)

It was a different world for office landlords in 2018, when Kearny bought the office campus for nearly $35 million. The landlord took over a property that was almost fully leased, Broder said. And even though a large tenant was set to move out, Kearny was unconcerned because there was every reason to expect the vacancy would be an opportunity to sign new tenants at higher rents.

Kearny announced that it would spend about $15 million to upgrade the property into a campus-like setting with landscaped grounds, a fitness center and 24-hour access meant to appeal to tenants in creative fields such as technology. Marketing materials boasted that South Coast Plaza shopping center was nearby.

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Then came the pandemic, and by early 2022, with occupancy rates hovering at about 60% and the office rental market losing ground, Kearny started to discuss converting the property to another use, Broder said. He declined to disclose further financial aspects of the project.

Kearny negotiated lease terminations with its tenants and set about to knock down the building that dates to 1982 and replace it with Harbor Logistics Center, a far less sleek 163,000-square-foot warehouse and distribution complex designed by SKH Architect set to be complete by the end of the year.

It’s intended to be a “last-mile” facility, Broder said, for goods arriving from elsewhere to be distributed to the surrounding community.

Last-mile facilities have “dramatically” increased in value in recent years and provide “solid rent growth” for their owners, the commercial real estate trade group NAIOP said, as e-commerce businesses such as Amazon compete to deliver within one day of a customer order or even on the same day it is placed.

Frequently ordered goods can be delivered more quickly from a compact nearby warehouse than from a farther-away sprawling fulfillment center such as those found in the Inland Empire.

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Meanwhile, office rentals and onsite attendance by tenants continued to lag in in Southern California in 2023 as companies have tried to balance hybrid work policies with their desire for more employee engagement, real estate services company CBRE said in a recent report.

The value of office buildings has been falling nationwide, with average property values down by at least 25% from a year ago, according to a February report by real estate data provider CommercialEdge.

Rendering of the warehouse-distribution center.

Rendering of the less sleek 163,000-square-foot warehouse and distribution complex that will replace the office complex.

(SKH Architect)

“The downward trend in office valuation is more pronounced in older and less ideally located buildings,” the report said, perhaps such as the aging campus Kearny is knocking down.

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“This is not a one-off,” Soto said of the landlord’s switch from office to industrial use of its property. “Especially in dense suburban markets like Orange County where land is expensive, we are going to see more of this.”

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Quiet quitting. RTO. Coffee badging. What this new vocabulary says about your workplace

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Quiet quitting. RTO. Coffee badging. What this new vocabulary says about your workplace

Abygail Liera sympathized when she first read about people who were “quiet quitting,” refusing to go above and beyond at their jobs.

But it wasn’t until a few months later that she understood.

The Winnetka resident got a new boss and was expected to train him, but when she asked for a raise, she said she was told, “We’ll see.” Her boss discouraged open and honest feedback, making her work environment feel toxic and disrespectful.

“I remember reading it, and I’m like, ‘Damn, this sucks that people have to go through this,’” Liera, 32, said of the news article on quiet quitting. “At the same time, I was like, ‘Oh, I don’t know what that feels like.’ But now I do.”

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Since the pandemic, work-related phrases such as “quiet quitting” and “Great Resignation” have taken over the internet — and are now part of our everyday vocabulary. Social media are filled with work-related memes and videos that describe “rage applying” or “lazy girl jobs.” People share tips on Reddit about how to effectively — and surreptitiously — “polywork,” or hold multiple jobs at the same time.

This proliferation of workplace lingo is more than a fad: It’s a viral language showing how workers are trying to hold on to the power they suddenly gained during the pandemic, workplace experts say.

After March 2020, workers were able to leverage the tight labor market to get what they want. But recent layoffs across a number of industries have shown that the balance of power between employee and employer today is, at best, a constantly tilting seesaw.

The job cuts and mandatory return-to-office policies imply that companies are gaining the upper hand on their employees, yet the persistence of hybrid work policies may show that workers have made a permanent mark on how work gets done in the future.

Employment data suggest that a growing number of people are prioritizing work-life balance in a more meaningful way or, increasingly cynical about traditional work arrangements, are tailoring those structures to work for them.

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“As cynicism grows with the status-quo aspects of work, it feels like this push and pull between management and workers,” said Eric Anicich, associate professor of management and organization at USC’s Marshall School of Business.

“This idea of disliking your boss and hating your job is as old as time,” Anicich said. “Now we have a certain language for it, and there’s a certain way of tapping into a community of people who feel the same way that we haven’t had in the past.”

Pandemic epiphanies, burnout and coining a new term

Los Angeles buildings with signs on them reading "We Quit" and "Out of Office"

(Andrew Rae / For The Times)

For 10 years, Alisha Miranda juggled two careers — a 9-to-5 job in creative and digital agencies and, in her spare time, freelance journalism.

But by June 2021, she’d had enough.

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Working from home during the pandemic blurred the lines between work and her personal life, exacerbating a years-long feeling of burnout. Miranda had toiled for years at her day job without receiving a promotion or a pay raise, despite indications from her managers that one was coming. She even continued working while grieving the deaths of loved ones from COVID-19. The final straw came when a large ad campaign she’d been working on was suddenly pushed back indefinitely.

“I can’t picture doing this for one more day,” Miranda, 38, remembers telling herself. “I have got to go.”

Miranda joined the historic wave of millions of U.S. workers who left their jobs in 2021 and 2022 because of high levels of burnout or “pandemic epiphanies,” in which about two-thirds of employees took a step back and reconsidered the role of work in their lives.

Add to that the increased prevalence of remote work, which finally allowed workers to have some measure of control over their schedule, and it’s no wonder there was a wave of resignations, said Anthony Klotz, an associate professor of organizational behavior at the UCL School of Management in London, who coined the term “Great Resignation.”

Klotz has spent his career studying how and why people quit their jobs. In an interview with a reporter in 2021, Klotz said he expected to see a wave of resignations after the initial shock of the pandemic. He had previously discussed his theory with his wife, describing it to her as the “Great Resignation” and just so happened to use the term in his chat with the reporter. It caught fire.

“There was this pressure that the economy was going to reopen, and everybody was going to get back to life as it was,” he said. “It gave people something to grab on to and feel like, ‘I’m not alone.’ We need a pause about what we learned here, we can’t just go back to the way things were.”

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As Liera, the Winnetka resident, was grappling with her difficult work situation, her younger sister Daisy was independently having her own pandemic epiphany.

Daisy Liera

Daisy Liera quit her job during the Great Resignation and has a new outlook on work-life balance since the pandemic.

(Dania Maxwell / Los Angeles Times)

The Burbank resident knew she needed a reset after working for months in a pressure-cooker workplace run by a boss who seemed to have “no care about health safety measures” during the pandemic. She started getting stomachaches, couldn’t sleep at night and would count down the minutes until her lunch break or until she could leave for the day.

She quit her job, found a new one at a legal assistance organization and eventually went to graduate school to focus on organizational psychology. As the daughter of immigrants, Liera said her parents’ ethic of hard work and working multiple jobs to support the family made her feel that she had to make the most of all of the opportunities her parents gave her and “use it to show that we were able to do it.”

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“Prior to the pandemic, I was very like, ‘I need to get a job, I need to stay with a job, and I need to be good at my job all the time,’ which is one thing that led to my anxiety,” said Liera, 28, who now works for the city of Los Angeles. “After the pandemic and after leaving my job and going back to grad school, I de-prioritized work.”

Usually, the company is the one with power over workers because bosses can fire them at any moment. But the word “resignation” shifts that power to workers, giving them control over their own job, Klotz said. That applies, too, to other viral work phrases, such as “bare minimum Mondays.”

After Miranda, the journalist, quit her job, she went to work for a startup wine magazine. Her new colleagues were nice and “super supportive,” and the improved work-life balance meant she could focus more on freelance writing. (The magazine ran out of funding in 2022.)

Now freelancing full time, Miranda says she’s more intentional about the work she takes.

“I only want to pursue projects that are rewarding and things that I’ll be happy with, money aside,” she said.

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Doing only what’s required of you, and no more

Illustration of a woman working on her computer in an office while lying in a bed

(Andrew Rae / For The Times)

After her boss started cracking down, Abygail Liera cut back on her productivity and started typing emails at a snail’s pace or revising them six or seven times, and dialing phone numbers with extra care.

Abygail Liera began "quiet quitting" after clashing with a new boss.

Abygail Liera began “quiet quitting” after clashing with a new boss.

(Brian van der Brug / Los Angeles Times)

“My work ethic is going to reflect on your leadership,” she recalled thinking.

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Eventually Liera’s “quiet quitting” turned into actual quitting. She left her job in December and is now looking for a new gig.

Although the job market has been discouraging, hearing from former co-workers about the problems at her old office confirms to her that she made the right choice.

The term “quiet quitting” is difficult to define, said Yongseok Shin, an economics professor at Washington University in St. Louis. Although some interpret it as a way to increase work-life balance, others define it as a way to recoup unpaid or unappreciated hours of service.

Intrigued by the viral term, Shin and his colleagues conducted research on whether the number of hours employees worked contributed to the tight labor market.

In his research on the phenomenon, Shin and colleagues found that from 2019 to 2023, workers voluntarily reduced the number of hours they worked. In that time, the average employed person worked about 31 fewer hours per year. This came after employees had spent the previous six years working an average of 17 extra hours per year.

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The reduction was greater among educated men in their prime, who worked an average of 44.3 fewer hours per year over the same time period. Women reduced their working hours by an average of 14.6 hours per year, on average, a consequence of gender disparities in caregiving responsibilities.

In essence, these workers were reducing the intensity of their work and reassessing their relationship to their jobs, whether it was cutting back on weekend hours or potentially decreasing their work in response to a lack of appreciation at the office, Shin said.

“These people can afford to do this because they’re valued employees,” he said. “But if your bosses work fewer hours, that’s good for everybody, right? If your boss is less of a workaholic, other people in the organization will feel more comfortable working fewer hours.”

But don’t mistake this for a nationwide shift in work-life balance. Shin said the U.S. has a long way to go before catching up with countries in Europe, which champion more generous benefits such as paid family leave, sick leave and vacation.

The battle over remote work continues

Illustration of a woman wearing a blazer and pajamas getting coffee from an office coffee maker.

(Andrew Rae / For The Times)

After Bryan Wilson was laid off from his job in higher education, he pivoted full time to audio production — a choice that allowed him to work from home for the first time.

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The flexibility was game-changing. He and his wife were able to split child-rearing responsibilities for their two kids while also spending more time together, planning meals and eating healthfully. Remote work also allowed Wilson, 39, to apply for more jobs outside the limits of his Auburn, Ala., home, where audio jobs are few and far between.

“There is relatively no market for audio production outside of major cities,” Wilson said. “I want to do this work because I’m really good at this work, and this is work I love, but where do I find it? During the pandemic … it was really easy to find that work.”

No pandemic-era office battle has been as fierce as that between the work-from-home and return-to-office camps. And 2024 doesn’t look like the end of it.

Last year, a group of economists published a paper in the National Bureau of Economic Research tracking millions of online job listings and whether they permitted remote or hybrid work.

Before the pandemic, the share of U.S. job postings that said new employees could work remotely one or more day per week was less than 4% in 2019. Over the next three years, that share would triple, according to the latest available data on the researchers’ website, WFH Map.

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Although census data show the number of employed people working remotely began to fall in 2021, a “new normal” of remote and hybrid work has emerged, said Peter John Lambert, an economist at the London School of Economics and co-creator of WFH Map.

Based on job postings and survey data, Lambert said he sees no evidence that hybrid work will soften in the coming year.

“Both employers and workers seem to find this partial flexibility to be the best of both worlds, providing flexibility to workers but allowing for in-person teamwork during on-site days,” Lambert said. “While workers learned this quickly, it has taken business a bit longer to realize the huge benefits to offering workers flexibility.”

Right in the middle of this is the term “coffee badging,” which was popularized by videoconferencing
company Owl Labs and describes a way for employees to meet their in-office mandate but spend as little time as possible in the workplace.

According to the company’s report, 58% of hybrid workers say they are already “coffee badging,” with an additional 8% saying they’re interested in trying it out.

For Wilson, as interest rates shot up and layoffs roiled media companies, those remote audio production opportunities dried up. Wilson currently works two part-time jobs in audio, which is not enough to keep him out of debt. He’s now looking for local, in-person jobs while he finishes certifications in tech and cybersecurity, a field he picked, in part, because of its prevalence of remote work opportunities.

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He’s curious whether the ubiquity of remote work will return when the economy improves and companies again face pitched battles to attract new employees.

“That, I think, will be the real test of whether remote work can be normalized,” Wilson said. “When the money is flowing again … will they be offered remote jobs? I’m definitely going to keep my eye on that.”

When one job of $150,000 is not enough

Illustration of a person wearing the equipment needed for many jobs including an apron, tool belt and gadgets.

(Andrew Rae / For The Times)

Since the pandemic began, wealth advisor Fernando Reyes has been hearing from clients that they were taking on second or even third jobs.

It’s not a novel concept — people have always worked multiple jobs to make ends meet. What’s new is that Reyes’ clients were highly paid aerospace workers, tech employees and mortgage brokers, people who earn annual salaries ranging from $150,000 to $400,000. Although their salaries seem high by any measure, these clients said they needed to take on additional work to help pay mortgages or send their kids to college.

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Working an additional 20 to 30 hours a week can provide an extra $50,000 to $60,000 of household income, Reyes said. Today, he’s seeing higher rates of polyworking than ever before in his 20-year career.

“What used to be a comfortable income now is not so comfortable anymore,” said Reyes, who works for EP Wealth Advisors and is based in Torrance. “You’re seeing more educated people doing this, more tech workers, more people with college degrees, master’s degrees, doctorates even.”

According to U.S. Census Bureau economists, rates of multiple jobholders have increased over the last two decades.

A 2020 analysis found that, on average, 7.2% of workers held more than one job between 1996 and 2018. In that time period, the rate of multiple jobholders increased by 1 percentage point, to 7.8% of all employed people at the beginning of 2018.

The trend was influenced by economic fluctuations: People were less likely to hold multiple jobs during a recession.

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The rise of remote work since the pandemic has also changed the calculus for many workers — if they don’t have to commute to an office, adding another, typically contract, job is much easier. Oftentimes, the employers don’t know their shared employee is moonlighting.

Sometimes, the impetus for a second job is the state of the economy. One mortgage loan worker Reyes knows went from earning more than $1 million a year to making $40,000 last year as home sales and refinancing cratered amid the hike in interest rates.

“People have to live,” Reyes said. “Everybody wants to buy a home, everybody wants to buy a car, everybody wants to go to school, everybody wants to take a vacation. How do you pay for it all?”

For the majority of multiple jobholders, their side gigs made up about 25% of their total income, according to the Census Bureau analysis of Longitudinal Employer-Household Dynamics data. For lower earners, the share was closer to 30%. Surprisingly, high-earning polyworkers — those making at least $113,200 in 2018 — brought in a fourth of their earnings from second jobs.

Financial advisor Lazetta Rainey Braxton encourages her clients, particularly those from underrepresented backgrounds, to polywork and diversify their income streams. She noted the racial and gender pay disparities that plague many workers, such as Black women earning about 62 cents to the dollar compared with white men.

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“We’re starting at a deficit, right? If we commit to just one institution, and know we’re already behind 38 cents, we’ve got to do polywork to make up the 38 cents,” said Braxton, founder and chief executive of Lazetta & Associates. “And if we don’t, the wealth gap is going to continue.”

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