Illustration: Shoshana Gordon/Axios
Burnout and consolidation in the healthcare industry are pushing more doctors and doctors-in-training to unionize to demand better wages, benefits and working conditions.
Driving the news: More than 1,200 residents and trainees at Montefiore Medical Center last week asked the hospital in Bronx, New York, to recognize their bargaining unit after an organizing vote.
- It was another sign that 80-plus-hour workweeks, combined with inflation and other stressors, are causing more doctors to demand a seat at the table.
- The Interns and Residents Committee, part of the Service Employees International Union, said it had a banner year organizing unions in five hospitals across the country and now has more than 22,000 members.
- Doctors also joined other major labor organizations, including the American Federation of State, County, and Municipal Employees and the American Federation of Teachers.
By the numbers: According to American Medical Association. The numbers have likely increased since then, in response to hospital consolidation and more doctors working as employees of a health system or other provider.
- The average salary for a resident physician in the United States in 2021 was $64,000, according to Medscape. Young doctors who unionize say that’s not enough to keep up with general inflation and the cost of living, especially in markets like New York and Los Angeles. Workload and indebted residents are also factors, for Fierce Health.
- The Accreditation Council for Graduate Medical Education has set a maximum number hours a resident can work each week at 80 hours.
- Residents are demanding not just higher salaries, but better working conditions, from longer breaks and meal options to moving allowances and salaries that make living near their hospitals affordable.
Yes, but: There are concerns that physicians who take collective action could undermine public trust and compromise patient safety. And the prospect of doctors leaving work almost came true over the summer in a labor dispute involving 1,300 residents and fellows at three major hospitals in Los Angeles County.
- Hospitals face complex financial calculations that go beyond paying for hours worked, especially when it comes to their interns, said Janis Orlowski, health care manager for the Association of American Medical Colleges, in a article. Posted by AAMC.
- “On the one hand, residents work long hours and contribute significantly to patient care. For this, they receive a stipend,” Orlowski said. “On the other hand, they are apprentices who receive very valuable training that is expensive to provide to institutions.”
The plot: So far, Montefiore Medical Center has not recognized the residents’ union and has opted out of voluntarily recognizing it beginning Friday.
- “The National Labor Relations Act guarantees our residents the right to determine whether or not they should be represented by a union. We respect their right to make that decision through a secret ballot, free from influence. exterior,” the hospital said in a statement. released on Friday.
What they say : “For me, as a supplier, to provide solutions to some of these gaps that I see, I need a voice and a seat at the table and to be able to express what I see to people who have the power to make those decisions,” Sejal Shah, a second-year primary care and social medicine resident at Montefiore Medical Center, told Axios.
- Physician inquiries to the trainee and resident committee increased to double or triple the rate before the pandemic, Sunyata Altenor, director of communications for the committee, told Axios.
- Residents like Isuree Katugampala, a third-year pediatric resident at Montefiore Medical Center, have had to help with the COVID response during the pandemic due to the influx of patients and understaffing.
- Difficulties obtaining protective equipment and vaccines during the pandemic have underscored the need for more formal organization, Bronx residents said.
Zoom out: Doctors who are not in supervisory positions have the right to bargain collectively – and experts say the pandemic experience and business terms will encourage more activity.
- “I think doctors will find a way to unionize,” John August, director of healthcare labor relations at the Cornell School of Labor and Industrial Relations, told Axios.
- Antitrust laws prevent most clinicians from unionizing if they are independent practitioners, but August thinks that, like medical residents, providers will likely begin to organize in the coming years.
- Medical resident unions are unique in that members will only circulate for the duration of their residency.
- “I probably won’t see the benefits of this union, and I’m totally okay with that, knowing that I’ve contributed and tried to play a role, along with my colleagues, that will be better for us and our patients in long term,” Katugampala said. .
The bottom line: As healthcare systems move beyond COVID-19 and rely less on traveling and temporary staff, relationships with physicians will become a critical business barometer.