In the first weeks of the pandemic Dr. Lorenzo GonzálezHe was a second-year resident in family medicine at Harbor UCL Medical Center. He worked as much as 80 hours per week in the ICU. He was terrified that he would contract the covid-19 virus, and he felt guilty for not being able to care enough for his father.
His father, a retired landscaper and landowner, died in April 2020 from heart and lung disease. González mourned alone. His job as a doctor-in-training put him at high risk of catching the virus, and he didn’t want to inadvertently spread it to his family. As he faced high burial costs, financial stress set in.
Now, González is calling for better pay and benefits for residents who work grueling schedules at Los Angeles County’s public hospitals for what he said amounts to less than $18 an hour — while caring for the county’s most vulnerable patients.
“They’re preying on our altruism,” González said of the hospitals. He is now Harbor-UCLA’s Chief Resident of Family Medicine and President of the Committee of Interns and Residents. It is a national union representing physician trainees and is part of Service Employees International Union.
“We need acknowledgment of the sacrifices we’ve made,” he said.
Residents are newly-minted doctors who have completed medical school. They must spend three to seven year training at established teaching hospitals before being able to practice on their own. Residents work under the guidance of a teaching physician to examine, diagnose and treat patients. Some seek additional training in medical specialties as “fellows.”
In California and other states, these trainees are joining forces to demand better wages and benefits during intensifying burnout due to the pandemic. They join nurses, nursing assistants and other health care workers, who are unionizing. staffing shortagesThe rising cost of living, and inconsistent supplies personal protective equipment covid vaccinesThey have been pushed to the edge.
After months of negotiations, more than 1,300 unionized residents, as well as other trainees at three L.A. County hospital public hospitals, Harbor-UCLA, will vote on May 30 whether they want to strike for a hike in their salaries and housing allowances. Residents have been at Stanford Health Care, Keck School of Medicine at the University of Southern California, and the University of Vermont Medical CenterThey have merged.
“Residents were always working crazy hours, then the stress of the pandemic hit them really hard,” said John August, a director at Cornell University’s School of Industrial and Labor Relations.
The Association of American Medical Colleges, a group that represents teaching hospitals and medical schools, did not address the unionization trend among residents directly, but the organization’s chief health care officer, Dr. Janis Orlowski, said through a spokesperson that a residency is a working apprenticeship and that a resident’s primary role is to be trained.
Orlowski stated that residents are paid to train while they study, train and work. The association works hard to ensure that they get the best training and support.
David Simon, spokesperson of the California Hospital Association, declined comment. He did forward however a studyJAMA Network Open published a September report that showed that surgical residents in unionized programs had lower burnout rates than those who were in nonunionized programs.
The national union stated that so far, no new chapters have been able to negotiate their first contracts. Some of the more established ones have seen improvements. pay, benefits, and working conditions. Last year, a resident association at the University of California-DavisIt secured housing subsidies and paid parental time through its first contract.
CIR is home to more than 20,000 members. 1 in 7 physician traineesSusan Naranjo, U.S. Executive director, stated that there was a new chapter for each year before the pandemic and that eight of them have joined in the last year and a quarter.
Residents’ working conditions had come under scrutiny long before the pandemic.
The average salary of a resident in the United States in 2021 was $64,000According to Medscape, a physician news website, residents can work up to 24 hours in a shift but no more than 80 hours per week. One survey, however, was released last year. found that 43% of residents felt they were adequately compensated, those who are unionizing say wages are too low, especially given residents’ workload, their student loan debt, and the rising cost of living.
The pay rate disproportionately affects residents from low-income communities and communities of color, González said, because they have less financial assistance from family to subsidize their medical education and to pay for other costs.
But with little control over where they train — medical school graduates are matched to their residency by an algorithm — individual residents have limited negotiating power with hospitals.
Naranjo stated that for residents unionizing to get a seat at table, benefits such as housing stipends and wage increases are often top of their list.
Patients deserve doctors who aren’t exhausted and preoccupied by financial stress, said Dr. Shreya AminShe is an endocrinology fellow from the University of Vermont Medical Center. She was surprised when the institution declined to recognize the residents’ union, she said, considering the personal sacrifices they had made to provide care during the pandemic.
CIR can request that the National Labor Relations Board conduct an election for hospitals that refuse to recognize a union. Naranjo stated that the national Union did so in April. The Vermont chapter can now begin collective negotiations with a certified majority vote.
Annie Mackin, the spokesperson for the medical centre, stated in an email that the center is proud of its residents’ exceptional care during the pandemic. She also expressed gratitude for their decision to join a union. Mackin declined to address residents’ workplace concerns.
Dr. Candice Chen, an associate professor of health policy at George Washington University, believes that the federal Centers for Medicare & Medicaid Services also bears some responsibility for residents’ working conditions. The agency pays teaching hospitals for residents to be trained, so it should hold these facilities responsible for how they treat them. The Accreditation Council of Graduate Medical Education, which sets educational standards and work requirements for residency programs, is moving in a positive direction, she said, but still needs to do more.
It remains to be seen how far these unions can go to achieve their goals.
Strikes among doctors are rare. The last CIR strike occurred in in 1975Submitted by residents at 11 New York hospitals.
Naranjo stated that a strike was the only option for L.A. County members. However, he blamed the county of continually delaying and cancelling bargaining sessions. The union wants the county to match the SEIU 721 wage increase and to provide a $10,000 housing allowance.
The union’s member surveys have found that most L.A. County residents report working 80 hours a week, Naranjo said.
A spokesperson for L.A. County’s Department of Health Services, Coral Itzcalli, thanked its “heroic” front-line workforce for providing “best-in-class care” and acknowledged the significant toll that the pandemic has taken on their personal and professional lives. She said limits on hours are set by the Accreditation Council for Graduate Medical Education and that most trainees report working “significantly less” than 80 hours a week.
Jesus Ruiz, a spokesperson for the L.A. County Chief Executive Office, which manages labor negotiations for the county, said via email that the county hopes to reach a “fair and fiscally responsible contract” with the union.
The union stated that the union expects to announce the results of the strike vote on May 31.
This story was produced and edited by KHNThe publication is published by. California Healthline, an independent editorial service of The California Health Care Foundation.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. With Policy Analysis and Polling, KHNThis is one of three major operating programs. KFF(Kaiser Family Foundation). KFF is an endowed, nonprofit organization that provides information on health issues for the nation.
