A call for collective bargaining for residents across the country

[Haybrant]

Are other residency programs forming collective bargaining organizations like the Seattle kids did? If not, why not? It is time for us to do this. If you are a resident reading this post, you must consider starting this at your hosptial. I am at an organization that nets >200 million dollars a year (net!). And does what with that exactly? Remember, as medical school graduates your average starting salaries in a job should be around $80,000/year. Instead you are getting paid at some programs in the mid 40's. You are getting hosed, everyone knows it. (Hospitals claim that resident's cost them money; Im calling BS on that. It would be good to hear some thoughts on this.)

It is time to start collective bargaining organizations at all residency programs around the country. Consider starting this conversation at your housestaff meetings (or w a few coresidents) asap. Yes, different specialties are different, but we must come together as a unit now, doesn't matter if you are medicine or surgery. As physicians we are a unit, united to do the best that we can for our patients.

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[ThoracicGuy]

Are other residency programs forming collective bargaining organizations like the Seattle kids did? If not, why not? It is time for us to do this. If you are a resident reading this post, you must consider starting this at your hosptial. I am at an organization that nets 250 million dollars a year (net!). And does what with that exactly? Remember, as medical school graduates your average starting salaries in a job should be around $80,000/year. Instead you are getting paid at some programs in the mid 40's. You are getting hosed, everyone knows it. (Hospitals claim that resident's cost them money; Im calling BS on that. It would be good to hear some thoughts on this.)

It is time to start collective bargaining organizations at all residency programs around the country. Consider starting this conversation at your housestaff meetings asap. Yes, different specialties are different, but we must come together as a unit now, doesn't matter if you are medicine or surgery. As physicians we are a unit, united to do the best that we can for our patients.

I thought we already debated this topic...

 

[Haybrant]

I thought we already debated this topic...

Yes, this is part II where you get out from behind your keyboard to actually do something. The debate is academic.

 

[rokshana]

I thought we already debated this topic...

and in the end i thought the OP for that was banned…how did he come back?

 

[ThoracicGuy]

Yes, this is part II where you get out from behind your keyboard to actually do something. The debate is academic.

No thanks, I'd rather not give a portion of my salary to some union to be spent on alot of liberal politics. If I were still a resident, I'd even moreso, not want to give money to some union for a dream of collective bargaining. It's residency. It's temporary. You're paid a salary that many families would envy. In a few years you'll be making more in one year than most families will make in 5 years.

 

[ThoracicGuy]

and in the end i thought the OP for that was banned…how did he come back?

No, that was chickenandwaffles. Haybrant was the one that initially started the whole thread, though.

 

[Raryn]

Are other residency programs forming collective bargaining organizations like the Seattle kids did? If not, why not? It is time for us to do this. If you are a resident reading this post, you must consider starting this at your hosptial. I am at an organization that nets >200 million dollars a year (net!). And does what with that exactly? Remember, as medical school graduates your average starting salaries in a job should be around $80,000/year. Instead you are getting paid at some programs in the mid 40's. You are getting hosed, everyone knows it. (Hospitals claim that resident's cost them money; Im calling BS on that. It would be good to hear some thoughts on this.)

It is time to start collective bargaining organizations at all residency programs around the country. Consider starting this conversation at your housestaff meetings (or w a few coresidents) asap. Yes, different specialties are different, but we must come together as a unit now, doesn't matter if you are medicine or surgery. As physicians we are a unit, united to do the best that we can for our patients.

My salary "should" be $80k? Why $80k? I think my salary should be one billion dollars.

In other news, I have no reason to join a "collective bargaining organization" (a union) without finding out exactly what benefits I would get and at what cost. I doubt a union would have any teeth to do anything that our residents couldn't do on their own, especially given we have various councils our residents can serve as representatives on (for free!). Why do I want to support a whole infrastructure of union reps?

 

[Shikima]

When I was a resdient, I would have been happy with an appropriate COLA increase.

 

[DermViser]

Are other residency programs forming collective bargaining organizations like the Seattle kids did? If not, why not? It is time for us to do this. If you are a resident reading this post, you must consider starting this at your hosptial. I am at an organization that nets >200 million dollars a year (net!). And does what with that exactly? Remember, as medical school graduates your average starting salaries in a job should be around $80,000/year. Instead you are getting paid at some programs in the mid 40's. You are getting hosed, everyone knows it. (Hospitals claim that resident's cost them money; Im calling BS on that. It would be good to hear some thoughts on this.)

It is time to start collective bargaining organizations at all residency programs around the country. Consider starting this conversation at your housestaff meetings (or w a few coresidents) asap. Yes, different specialties are different, but we must come together as a unit now, doesn't matter if you are medicine or surgery. As physicians we are a unit, united to do the best that we can for our patients.

Seattle? UW residents are unionizing?

Edit: Wow, I guess so: http://www.bizjournals.com/seattle/...medical-center-residents-seek-better-pay.html

 

[killerleaf]

This is the same arguement that I got from my ex-husband about the child support. "I pay you $xxx a month, why do you need more money for their medical bills (or school clothes or whatever extra above and beyond)". There is more to this than just using that money to pay your salaries, just like I had to use the child support money to help pay the rent and for car payments and groceries.

That money is used to pay for the PD's time out of his normal duties, to take care of all the paperwork that is required. That money pays for my salary and benefits, which, by the way, is 1/3 less than what the PGY-1's make. That money is used to fund your call meal money, the internal extra shift pay, office supplies, the computers you use, the office space you occupy, the fees that we are charged to maintain our accreditation (ACGME, FREIDA to name a couple). It pays for your professional dues, your certification courses, your in-training exam fees. It pays for the books in your resident library, and the book fund that you get. It pays for the expenses you incur when you travel to conferences.

For my residency program, expenses are $2,200,000 a year, approximately. That does NOT include mine or the PD's benefits and salary. That does not include the other $10,000 that is obtained from the department to help cover what the above does not. (Graduation, drinks for the resident lounge, expenses for the research symposium).

That is for 1 program, out of the 32 that are here at this institution. And size wise, we are in the middle; I know that the larger programs are going to have more expenses.

Now, for my soapbox rant:
I believe, in my own humble opinion, that those of you who are complaining about what you are being paid, need to take a step back, take a deep breath, and really examine your life. If the only driving force for you is money, then you need to stop, and go do something else. I don't want you as my doctor, ever.

I know that you have been thru 4 years of undergrad, and 4 years of med school, and now are looking at 3-7 years of residency. I know you are looking at a student loan that is more than what my house is worth. I get that. I also understand, that while you may not be making much money during residency, you are getting a paycheck, which is more than you got in medical school, were you actually paid money. And, residency has a definite, finite end point. Think of it more as an apprenticeship. Which is pretty much what it is. And I don't know of any career where the apprentice makes more than a master.

 

[Haybrant]

I dont know what you are talking about your child support for. There is absolutely no relevance to this argument. No, not everyone wants to hear about your divorce, I know that is hard to believe. This is a matter about respect and relevance. This is the trend that is occurring in every field throughout the country. We work for humongous institutions that are making hand over fist money, hand over fist! They dont give a damn about residents, and that should not be allowed.

For the rest of the people on this thread that say stupid *hit about not wanting to join until they know the exact terms, well ya duh you dont have to. But there are plenty of residents out there that feel disenfranchised and need to know there is an alternative to gaining respect. And the students at the University of Washington have done that. They actually care about their relevance and are more likely to take the same approach in the future when they are physicians while the rest of you will continue to ask the disenfranchised not to raise their voices. As for "I don't want you as my doctor, ever" well we dont want someone from a failed relationship as our doctor, ever. So dont troll here, this is a forum for residents, not people that are tyring to suppress residents.

 

[DermViser]

This is the same arguement that I got from my ex-husband about the child support. "I pay you $xxx a month, why do you need more money for their medical bills (or school clothes or whatever extra above and beyond)". There is more to this than just using that money to pay your salaries, just like I had to use the child support money to help pay the rent and for car payments and groceries.

That money is used to pay for the PD's time out of his normal duties, to take care of all the paperwork that is required. That money pays for my salary and benefits, which, by the way, is 1/3 less than what the PGY-1's make. That money is used to fund your call meal money, the internal extra shift pay, office supplies, the computers you use, the office space you occupy, the fees that we are charged to maintain our accreditation (ACGME, FREIDA to name a couple). It pays for your professional dues, your certification courses, your in-training exam fees. It pays for the books in your resident library, and the book fund that you get. It pays for the expenses you incur when you travel to conferences.

For my residency program, expenses are $2,200,000 a year, approximately. That does NOT include mine or the PD's benefits and salary. That does not include the other $10,000 that is obtained from the department to help cover what the above does not. (Graduation, drinks for the resident lounge, expenses for the research symposium).

That is for 1 program, out of the 32 that are here at this institution. And size wise, we are in the middle; I know that the larger programs are going to have more expenses.

Now, for my soapbox rant:
I believe, in my own humble opinion, that those of you who are complaining about what you are being paid, need to take a step back, take a deep breath, and really examine your life. If the only driving force for you is money, then you need to stop, and go do something else. I don't want you as my doctor, ever.

I know that you have been thru 4 years of undergrad, and 4 years of med school, and now are looking at 3-7 years of residency. I know you are looking at a student loan that is more than what my house is worth. I get that. I also understand, that while you may not be making much money during residency, you are getting a paycheck, which is more than you got in medical school, were you actually paid money. And, residency has a definite, finite end point. Think of it more as an apprenticeship. Which is pretty much what it is. And I don't know of any career where the apprentice makes more than a master.

Thank you residency program Academic Administration. @killerleaf, as a residency coordinator, you're quite tone deaf.

 

[ThoracicGuy]

I dont know what you are talking about your child support for. There is absolutely no relevance to this argument. No, not everyone wants to hear about your divorce, I know that is hard to believe. This is a matter about respect and relevance. This is the trend that is occurring in every field throughout the country. We work for humongous institutions that are making hand over fist money, hand over fist! They dont give a damn about residents, and that should not be allowed.

For the rest of the people on this thread that say stupid *hit about not wanting to join until they know the exact terms, well ya duh you dont have to. But there are plenty of residents out there that feel disenfranchised and need to know there is an alternative to gaining respect. And the students at the University of Washington have done that. They actually care about their relevance and are more likely to take the same approach in the future when they are physicians while the rest of you will continue to ask the disenfranchised not to raise their voices. As for "I don't want you as my doctor, ever" well we dont want someone from a failed relationship as our doctor, ever. So dont troll here, this is a forum for residents, not people that are tyring to suppress residents.

Wow. Just wow. You get someone that explains where some of these supposed profits are going, things that cost money, yet you just want more more more. You are looking at just your salary and have blinders to everything else it seems.

But hey, go for it. Get those unions going. They're hurting for members as people are choosing to leave unions across the country. I don't think this will be your answer, though.

Look at University of Michigan. They have a housestaff union. Their PGY1 salary for this year is $51,840. St. Joseph's in Ann Arbor's PGY1 salary is $50,209. Ohio State's PGY1 salary is $49,332. IU has theirs at $51,435. They don't have a union, yet its only $405 less than Michigan's.

None of these are seeing $80,000 salaries for residents.

 

[Prodromo]

Wow. Just wow. You get someone that explains where some of these supposed profits are going, things that cost money, yet you just want more more more. You are looking at just your salary and have blinders to everything else it seems.

But hey, go for it. Get those unions going. They're hurting for members as people are choosing to leave unions across the country. I don't think this will be your answer, though.

Look at University of Michigan. They have a housestaff union. Their PGY1 salary for this year is $51,840. St. Joseph's in Ann Arbor's PGY1 salary is $50,209. Ohio State's PGY1 salary is $49,332. IU has theirs at $51,435. They don't have a union, yet its only $405 less than Michigan's.

None of these are seeing $80,000 salaries for residents.

U of michigan residents get about 4000 a year lump sum around Christmas in addition to their salary. In addition they have a lot more days off throughout the year including all holidays, birthday, etc. benefits there are also excellent. I would say that the union is doing great things for them.

 

[Haybrant]

U of michigan residents get about 4000 a year lump sum around Christmas in addition to their salary. In addition they have a lot more days off throughout the year including all holidays, birthday, etc. benefits there are also excellent. I would say that the union is doing great things for them.

Any response to this thoracicguy? Oh let me guess, people are leaving unions across the country. Get out of this discussion as you have nothing useful to add except cherry picked half facts and half data. You're not even a resident. Seriously, stop trolling here like the resident director above.

 

[VA Hopeful Dr]

U of michigan residents get about 4000 a year lump sum around Christmas in addition to their salary. In addition they have a lot more days off throughout the year including all holidays, birthday, etc. benefits there are also excellent. I would say that the union is doing great things for them.

My FM program paid the highest in the state, excellent benefits, 21 days off plus 5 CME days, and usually a yearly bonus of around 2 grand. We were not in a union. Plus, none of my salary went toward union dues.

I would say that NOT being in a union did great things for us.

 

[RangerBob]

My intern program also treats us well--they give us free food, holidays off when not on wards, ICU, or EM, 3 weeks vacation plus 1 week CME and 2 days for boards, and has been extremely responsive to any resident concerns. We also all get 3 weekdays off at Christmas or New Years every year, regardless of what service we're on. We also get an educational stipend, fitness stipend, and very affordable and good benefits. And I am not in what was considered an extremely competitive program.

I don't see how a union would help me. I also don't see how dismissing the ideas of those who have been in your shoes or know more behind-the-scenes details is beneficial at all--unions were much more critical back when people were getting fired because they called in sick, got pregnant, etc. Union membership has significantly declined over the past few decades--partly because a lot of those jobs went overseas and partly because we have more laws and worker protections that make unions unnecessary. When I was in a union it did absolutely nothing for me except take my money. They weren't able to do anything to help me get my job back when I was laid off.

I could see a union being helpful if you're in a malignant program that treats residents like cannon fodder, but if you're in a program that respects and listens to you, I don't see how it's going to help you. It would likely make things worse--the administration would just say "take it up with the union" if you have concerns or complaints. And managers are often resentful towards unionized workers. I'd rather have a good dialogue with my program than have to go through the union for everything. It's my program director that is going to bat for me when I look for jobs in the future, not the union.

 

[schmitta1573]

Wage contraction is a real issue in many professional areas when you consider debt/income ratio, time spent, etc. Will unions make a difference? That's is debatable considering what has occurred in the last 3o years with wages. Personally, I'd rather have the added protection of a union in place because how else do we get a seat at the table? Do we count on corporations and "non-profits" to pay a fair wage? I don't think anyone is saying residents have it so horrible, but I have a hard time with the argument that we are being paid fairly or that money doesn't exist in the system to pay a bit better. The cannibalistic nature of in medicine, in many ways, seems to be its biggest Achilles' heel. I hate to say it, but it sure seems like "they" are coming for all of us, and as a group of not just residents, but medical professionals, who has our back?

 

[rokshana]

U of michigan residents get about 4000 a year lump sum around Christmas in addition to their salary. In addition they have a lot more days off throughout the year including all holidays, birthday, etc. benefits there are also excellent. I would say that the union is doing great things for them.

you can have but so many days off..the ACGME will trump a union any day….

 

[ram006]

Yup. For whatever reason people seem to think a strike is some thing the ACGME or RRC will empathize with. Not sure how happy people will be when they realize missing too many days of work delays their graduation from residency.

 

[ThoracicGuy]

Any response to this thoracicguy? Oh let me guess, people are leaving unions across the country. Get out of this discussion as you have nothing useful to add except cherry picked half facts and half data. You're not even a resident. Seriously, stop trolling here like the resident director above.

I mentioned salaries specifically since you called for a salary of $80,000. The lump sum at Michigan was specifically not considered a salary per their housestaff agreement. As for days off, for us, if the OR was shut down for elective cases, we were effectively on holiday hours. Birthdays off? I didn't realize we were in elementary school here. As for the other benefits, they seemed fairly similar to many other programs as far as insurance, etc.

 

[chocomorsel]

To the above Academic Administration, you are specifically talking about ONE program. Yours. Apparently you treat your residents well. However, there are many that don't. And those are the programs that need unions. Clearly, not all do.

For example, I graduated from UNM, which joined the CIR/SIEU in 2007. Before that, the resident were getting paid poorly, many programs offered the bare minimum ($200) for meals, none to minimum book fund; no paternity leave; poor health insurance; unpaid holidays and many more I can't think of. After the Union, PGY1 salaries increased by over $4000 the first year( and kept going up each year to try and keep up with the median in the region) and the Union negotiated for the above mentioned benefits. Resident's finally had a meal plan for call that didn't have **** before, a book fund of at least $4-500 dollars/year, dad's got to take paternity leave if they wanted, a totally free health care plan without co pays if you got your care at the university, and much more.

So where was all this money going to before? To the hospitals pockets because it sure wasn't being given to the residents who were busting their asses. I don't care if it's a finite amount of time, doesn't mean we have to be bent over without vaseline. I call bull**** on that. And that goes to you as well Thoracic Guy. Many programs screw their residents over simply because THEY CAN!!! And many of us residents think it's just a normal part of the process and just want to get through without causing problems.

Well, it's high time residents started to stand up for their rights not as indentured servants, but highly trained, in demand employees who have the right NOT TO BE TAKEN ADVANTAGE OF AND ABUSED if it so applies.

I am all about resident unions. They helped us and me personally immensely and one of the main reasons I attended UNM was because they have a union. Something to really consider for all those applying for residency.

 

[DermViser]

To the above Academic Administration, you are specifically talking about ONE program. Yours. Apparently you treat your residents well. However, there are many that don't. And those are the programs that need unions. Clearly, not all do.

For example, I graduated from UNM, which joined the CIR/SIEU in 2007. Before that, the resident were getting paid poorly, many programs offered the bare minimum ($200) for meals, none to minimum book fund; no paternity leave; poor health insurance; unpaid holidays and many more I can't think of. After the Union, PGY1 salaries increased by over $4000 the first year( and kept going up each year to try and keep up with the median in the region) and the Union negotiated for the above mentioned benefits. Resident's finally had a meal plan for call that didn't have **** before, a book fund of at least $4-500 dollars/year, dad's got to take paternity leave if they wanted, a totally free health care plan without co pays if you got your care at the university, and much more.

So where was all this money going to before? To the hospitals pockets because it sure wasn't being given to the residents who were busting their asses. I don't care if it's a finite amount of time, doesn't mean we have to be bent over without vaseline. I call bullcrap on that. And that goes to you as well Thoracic Guy. Many programs screw their residents over simply because THEY CAN!!! And many of us residents think it's just a normal part of the process and just want to get through without causing problems.

Well, it's high time residents started to stand up for their rights not as indentured servants, but highly trained, in demand employees who have the right NOT TO BE TAKEN ADVANTAGE OF AND ABUSED if it so applies.

I am all about resident unions. They helped us and me personally immensely and one of the main reasons I attended UNM was because they have a union. Something to really consider for all those applying for residency.

Just goes to show, that when hospitals say they don't have money for something, 9 times out of 10 they are lying.

 

[Maybeknot]

I posted a lengthy reply in the original thread. For reference:
http://forums.studentdoctor.net/threads/residents-rise-up.1072702/page-2#post-15271152

I went to a medical school with an academic program and a community program. The academic program was non-unionized while the community program was. Both programs rotated at each other's hospitals.

The academic hospital had individual call rooms, meal plans, food at conferences, etc. The community program had 6-10 people per call room, no meal plan (hell, no cafeteria), and bagels once a week at morning conference. Pay was marginally higher at the community program. Unclear if the extra income would offset the union dues.

I'll repeat: GME funding is tied to Medicare reimbursement as a percentage of Medicare patients taken care of at a program. NYC programs can thus afford to pay their residents more, because they get more $$ from Medicare.

We have bigger fish to fry than complaining that you aren't getting paid enough for 3-7 years of apprenticeship. Hell, next we'll have medical students complaining that they should get paid during their 3rd and 4th year rotations....

 

[rokshana]

Just goes to show, that when hospitals say they don't have money for something, 9 times out of 10 they are lying.

or maybe….positions that may have been filled with someone left were eliminated….of employees had to take furlough days …or the computers don't get upgraded for a another year or 2, or 3…

 

[michaelrack]

or maybe….positions that may have been filled with someone left were eliminated….of employees had to take furlough days …or the computers don't get upgraded for a another year or 2, or 3…

Or maybe the hosptial ceo didn't get his annual cost of living adjustment in his 500k salary....

 

[Staradmiral]

I posted a lengthy reply in the original thread. For reference:
http://forums.studentdoctor.net/threads/residents-rise-up.1072702/page-2#post-15271152

I went to a medical school with an academic program and a community program. The academic program was non-unionized while the community program was. Both programs rotated at each other's hospitals.

The academic hospital had individual call rooms, meal plans, food at conferences, etc. The community program had 6-10 people per call room, no meal plan (hell, no cafeteria), and bagels once a week at morning conference. Pay was marginally higher at the community program. Unclear if the extra income would offset the union dues.

I'll repeat: GME funding is tied to Medicare reimbursement as a percentage of Medicare patients taken care of at a program. NYC programs can thus afford to pay their residents more, because they get more $$ from Medicare.

We have bigger fish to fry than complaining that you aren't getting paid enough for 3-7 years of apprenticeship. Hell, next we'll have medical students complaining that they should get paid during their 3rd and 4th year rotations....

Medical students in Norway do get paid for Sub-Is in last year of medical school. Medical school is also free. AS SHOULD ALL EDUCATION BE. education =/= business.

 

[ThoracicGuy]

Medical students in Norway do get paid for Sub-Is in last year of medical school. Medical school is also free. AS SHOULD ALL EDUCATION BE. education =/= business.

So who exactly should be paying for the educators, facilities, and the rest? Do you think teachers have an obligation to provide their services for free?

 

[ferning]

What percent of tuition can be attributed to instructors salaries? Accounting for what they earn already in grants or clinical billing

Come back to us with that answer and you'll realize education can basically be free. Especially given that 3/4th year students yield income beyond tuition because their pt interview/notes for social history, ROS and collateral can be billed for per medicare rules.

 

[ferning]

Its so beyond collective bargaining when acgme develops arbitrary education requirements so hospital labor staffing needs are prioritized, as well as maximizing labor compartmentalization.

Fear under a dictator like power structure like they have with program directors is intentional. From entrance to the program, evaluations on each block, renewal of yearly contract, whos chief resident, ability to transfer to another program, and future dependence to certify GME transcript. Few workplaces have so hostile, controlling, and marginalizing a set up. Even fast food they don't put the effort in cause they know they can just pull somebody off the streets to work. In graduate medical education they cant do this, so they have to have a controlling power structure of labor. Also it lets your standards for future work conditions decline and you'll put up with alot more garbage as an attending than you would have from your employer.

Just look at the labor standards of european countries and australia. If you dont have national laws like they do then you'll never get anywhere. Labor unions and strikes are so easily overcome by these monopolized healthcare systems. They are totally fine giving 90% of md jobs to PAs, NPs, techs, and social workers. If you think knowledge and proficiency are important to our corporate and consumer healthcare system then you are wrong. They want u to screen/diagnose/treat based on the highest profit margin for all the parties involved (insurance, labs, pharma, hospitals). Supporting science is something they can buy and create, with plenty if increasing real life examples.

The only thing docs have is a marketability to the healthcare consumer. A long reputation in society and media of being smart, caring, and heroic. But the general population is losing faith as docs carry out corporate medicine and live with the side effects of treatments and diagnostic procedures carried out wihout cautious due diligence in the name of algorythmic billing

 

[ferning]

This is all beyond the point though because the fact is that the body is a hell of alot better at taking care of itself than doctors or people ever will be. Its not even a competition nor will it be for our lifetime. Our treatments and procedures so crudely and inaccurately address pathological problems that its like having a caveman bang on a car engine or tear out a part and say he fixed it.

If we treat people that arent blatantly symptomatic to the point of being nonfunctional or within a few minutes of deaths door, then we often are causing more serious pathology. As well as financial disability as our wages are kept low by high healthcare costs and the cost of disability.

But people are somatic, dependent on opiates, and dependent on disability income for basic food/shelter that actual disease prevalance is skewed. Besides people that want a day off from their own hostile work or school environments. But a paying customer is never turned away from a business. If you spend 15 minutes with a patient explaining that they arent sick or don't need a workup/rx then you cant bill health insurance or you get a nominal amount. So profit is prioritized over peoples lives/morbidity.

This doesnt mean physicians have no use or have to be paid less if they arent clinically productive. We could be working less and having better pt outcomes as well as developing an actual science if the profit was taken out of healthcare costs. The investment in training and highly selective process is something desirable to the public in a labor force for such invasive services.

 

[Law2Doc]

Or maybe the hosptial ceo didn't get his annual cost of living adjustment in his 500k salary....

Meh, we all know this wouldn't happen before the layoffs and not upgrading computers/infrastructure. Who are you trying to kid?

 

[BoardingDoc]

This is all beyond the point though because the fact is that the body is a hell of alot better at taking care of itself than doctors or people ever will be. Its not even a competition nor will it be for our lifetime. Our treatments and procedures so crudely and inaccurately address pathological problems that its like having a caveman bang on a car engine or tear out a part and say he fixed it.

CABG. Cardiac stenting. ACLS. Appendectomies. Antibiotics.... I mean, I can keep going here, but I would argue that every single one of these things does a better job of "taking care of the body" than the body will when left to its own devices in each relevant situation.

 

[ram006]

This is all beyond the point though because the fact is that the body is a hell of alot better at taking care of itself than doctors or people ever will be. Its not even a competition nor will it be for our lifetime. Our treatments and procedures so crudely and inaccurately address pathological problems that its like having a caveman bang on a car engine or tear out a part and say he fixed it.

So much crazy in this...

 

[DarknightX]

This is all beyond the point though because the fact is that the body is a hell of alot better at taking care of itself than doctors or people ever will be. Its not even a competition nor will it be for our lifetime. Our treatments and procedures so crudely and inaccurately address pathological problems that its like having a caveman bang on a car engine or tear out a part and say he fixed it.

This is by far the stupidest thing I've ever read on this website, and that's saying quite a bit.

Hey sir, I know you have dead bowel, but your body is a lot better at healing it than I am, so I'm just gonna leave you alone and let things be.

Or hey ma'am, I know your 3 old has meningitis, but we won't give him any antibiotics because, you know, we're just cavemen banging on a car engine.

Going back to the OP, you're not an employee, you're a trainee. You have zero leverage. Maybe attendings could pull this off, but residents? Give me a break.

 

[dozitgetchahi]

This doesnt mean physicians have no use or have to be paid less if they arent clinically productive. We could be working less and having better pt outcomes as well as developing an actual science if the profit was taken out of healthcare costs. The investment in training and highly selective process is something desirable to the public in a labor force for such invasive services.

Seriously, what the **** are you talking about. As if tens of thousands of basic and clinical science researchers and hundreds of billions of dollars worldwide aren't being used to 'develop an actual science'.

While I agree that the body sometimes needs to be left the hell alone etc, giving insulin to a Type 1 diabetic is worlds away from 'cavemen banging on a car' or whatever your asinine analogy is.

 

[AStark]

All Canadian residents are unionized and represented by provincial associations that bargain directly with provincial ministries/departments of health. This has nothing to do with individual programs or - in larger provinces - even individual schools (all Canadian programs are organized through a university medical school). I don't know that our salaries are always that impressive (generally at least $50k for PGY1s; it was $53k for me), but we have benefits (drugs, dental, other extended health), exam reimbursement, CMPA dues reimbursement, and guaranteed vacation time and other leave. Certainly there are no "managers" who are "resentful" of this arrangement, nor does unionization have a lot of practical consequences apart from the contract and a few social events each year. We don't have any kind of "infrastructure" of "union reps", except for a representative from each program that sits on the provincial association board. Some of the rhetoric employed here is ridiculous.

It's all well and good to say that residency is temporary and we ought not be paid more because it's an "apprenticeship". However, I spent almost a quarter of my after-tax income on bank LOC interest and student loan principal payments in PGY1. So, forgive me, but this is about money, and I'd sooner seek a better contract through a formal process, possibly leading to arbitration, than rely on the beneficence of hospital and university administrations.

 

[TooMuchResearch]

Are other residency programs forming collective bargaining organizations like the Seattle kids did? If not, why not? It is time for us to do this. If you are a resident reading this post, you must consider starting this at your hosptial. I am at an organization that nets >200 million dollars a year (net!). And does what with that exactly? Remember, as medical school graduates your average starting salaries in a job should be around $80,000/year. Instead you are getting paid at some programs in the mid 40's. You are getting hosed, everyone knows it. (Hospitals claim that resident's cost them money; Im calling BS on that. It would be good to hear some thoughts on this.)

It is time to start collective bargaining organizations at all residency programs around the country. Consider starting this conversation at your housestaff meetings (or w a few coresidents) asap. Yes, different specialties are different, but we must come together as a unit now, doesn't matter if you are medicine or surgery. As physicians we are a unit, united to do the best that we can for our patients.

No thanks. We're all happy at my program.

 

[Law2Doc]

So much crazy in this...

Agreed. I think that poster doesn't appreciate that before the advent of "modern medicine" living to 40 was a big deal. The human body does a fine jobs with the milder things that probably shouldnt be treated in the first place (the common cold, many viruses) but a Pretty crappy job of curing many of the things that actually kill us (neoplasms, trauma, diabetes, heart disease, lung disease). To ignore that fact that medicine has more than doubled the average lifespan since the 18th century is naive.

 

[Raryn]

Agreed. I think that poster doesn't appreciate that before the advent of "modern medicine" living to 40 was a big deal. The human body does a fine jobs with the milder things that probably shouldnt be treated in the first place (the common cold, many viruses) but a Pretty crappy job of curing many of the things that actually kill us (neoplasms, trauma, diabetes, heart disease, lung disease). To ignore that fact that medicine has more than doubled the average lifespan since the 18th century is naive.

I think medicine has done a hell of a lot of good, but to claim that it is responsible for the doubling of the average lifespan is also naive. Public health measures like improved sanitation were responsible for the lions share of those gains. Those and vaccinations (though mostly the public health measures) are why we actually die of neoplasms, trauma, diabetes, heart disease, lung disease rather than dying of acute infectious causes.

Edit: silly typo

 

[Law2Doc]

I think medicine has done a hell of a lot of good, but to claim that it is responsible for the doubling of the average lifespan is also naive. Public health measures like improved sanitation were responsible for the lions share of those gains. Those and vaccinations (though mostly the public health measures) are why we actually die of neoplasms, trauma, diabetes, heart disease, lung disease rather than dying of acute infectious causes.

Edit: silly typo

Much of the understanding behind public health and all of the knowledge regarding vaccines stems from MEDICAL knowledge and research, so yeah, I'm giving doctors credit for that too. People didn't stop drinking sewage because of the taste -- they did it because a doctor decided it was making people sick.

Point is, the human body wasn't "fixing itself" of any of this until somebody with some healthcare knowledge got involved.