Buffalo resident’s strike

[nimbus]

'You should be appreciated and not hazed': UB resident physicians go on strike demanding change

Nearly 830 resident physicians at the University at Buffalo walked off the job Tuesday. They're demanding better compensation, benefits and working conditions.

www.wkbw.com

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[toddlasher]

So abuse is obviously not acceptable but in my day the deal was residency sucked but then everything was sweet as an attending. Is this arrangement no longer working out?

 

[JOHNBROCHILL]

Apparently the residents have no 403b/401k. The salary is one of the lowest in NYS. Previously good healthcare benefits were recently taken away.

Keep in mind the government gives roughly 150k per resident for funding to hospitals. The resident gets paid 60k.

At some point the exploitation is too egregious. UB residents have hit that point. Good for them.

 

[mmag]

The whole setup is shady and exploitative. The residents are employed by a shell company and not the university to avoid having to give the same benefits package. Other residency programs in the region have higher pay and benefits. The shell company justifies this by touting the educational value of training is worth $$$.

I'm glad to see the anesthesia residents joining the strike because their value is evident by the cost of CRNA replacement labor.

Buffalo Medical Residents Are Striking for Fair Pay and Better Conditions

The labor action by medical residents in Buffalo is the latest in the medical worker unionization wave sweeping the US.

truthout.org

 

[NightyNight]

If the pay for residents is around 60k with zero benefits, that’s way worse than what I was getting like 10 years ago especially if they working 80 all the time.

I would love to know the “value” of their education compared to other big institutions per specialty. If they have been training the upper quartile of physicians in the general area, then one could argue the clinical training is actually more than a PR statement.

My suspicion is it’s mostly scut and avoiding hiring NPs and PAs. Let’s see if admin willing to make less.

 

[CopaceticOne]

Here's their GME salary & benefit info

 

[aneftp]

Apparently the residents have no 403b/401k. The salary is one of the lowest in NYS. Previously good healthcare benefits were recently taken away.

Keep in mind the government gives roughly 150k per resident for funding to hospitals. The resident gets paid 60k.

At some point the exploitation is too egregious. UB residents have hit that point. Good for them.

That’weird. Usually some type of nominal match

But New York is weird.

So you are saying. The residents can’t put their own money into a 401k with no match?

 

[coffeebythelake]

Is this buffalo general kaleida health?

 

[aneftp]

The crnas in upstate New York including buffalo are having a field day 1099 work from buffalo to Syracuse. It’s quite hilarious. I see a few of the crnas I know posting on Facebook chilling and smiling. One is over 600k 1099 work and it’s not even October yet. And they take a week off each month to fly back down south.

Complete cash cow for crna up there. So if buffalo needs more crnas. They would work for $350/hr. Still cheaper than the $450/hr the docs get up there

 

[coffeebythelake]

The crnas in upstate New York including buffalo are having a field day 1099 work from buffalo to Syracuse. It’s quite hilarious. I see a few of the crnas I know posting on Facebook chilling and smiling. One is over 600k 1099 work and it’s not even October yet. And they take a week off each month to fly back down south.

Complete cash cow for crna up there. So if buffalo needs more crnas. They would work for $350/hr. Still cheaper than the $450/hr the docs get up there

U got any locum contacts for upstate new york with 400-450/hr rates?

 

[ans2021]

Apparently the residents have no 403b/401k. The salary is one of the lowest in NYS. Previously good healthcare benefits were recently taken away.

Keep in mind the government gives roughly 150k per resident for funding to hospitals. The resident gets paid 60k.

At some point the exploitation is too egregious. UB residents have hit that point. Good for them.

I didn't know residents in other places were able to put money into a 403b/401k. I wasn't able to as a resident. Figured that was normal.

 

[MTGas2B]

I didn't know residents in other places were able to put money into a 403b/401k. I wasn't able to as a resident. Figured that was normal.

It was added to my institution in the middle of my training. Mid to late 2000s. No match but access tax deferred 403(b) contributions.

 

[narcotics999]

U got any locum contacts for upstate new york with 400-450/hr rates?

A few months ago my buddy told me Rochester was paying close to 500. Don't know which hospital. You can probably inquire around.

 

[nimbus]

 

[nimbus]

I didn't know residents in other places were able to put money into a 403b/401k. I wasn't able to as a resident. Figured that was normal.

I was able to contribute with a small match in the early 1990s. I came out of residency with about 30k.

 

[nimbus]

Obviously much higher COL but this is what Stanford offers. With all the allowances, it’s $96k for PGY-1.

 

[nimbus]

 

[abolt18]

We got a big raise my 2nd year of residency because we were way below similarly sized programs in the region. (Almost as bad as the buffalo comparisons)

They also considered us 1/2 student 1/2 employee, which was used against us in the sense that you got zero student benefits because you were an employee and got less employee benefits because you were a student: "sorry you can't have a student discount on football/basketball tickets because you're an employee" then in the same breath "sorry you can't have a match on retirement contributions because you're students". We pushed every year to get that BS changed and they FINALLY switched it right after I graduated so residents got the same match as everyone else (mandatory 5% employee contribution, with 10% match!!!). Only saving grace was healthcare was super inexpensive with their HMO plan.

 

[614med]

A few months ago my buddy told me Rochester was paying close to 500. Don't know which hospital. You can probably inquire around.

Likely Rochester General Hospital

 

[Drwine]

'You should be appreciated and not hazed': UB resident physicians go on strike demanding change

Nearly 830 resident physicians at the University at Buffalo walked off the job Tuesday. They're demanding better compensation, benefits and working conditions.

www.wkbw.com

Bad advice given by a CA2 with no ties to the location or program. Anesthesiology is shaping up to be more competetive than ever this year and all applicants need to cast a wide net. A new chair has been appointed and will start October 1.

 

[nimbus]

Bad advice given by a CA2 with no ties to the location or program. Anesthesiology is shaping up to be more competetive than ever this year and all applicants need to cast a wide net. A new chair has been appointed and will start October 1.

I agree. Better to match anywhere than not at all. Seems like union representation and the strike is having some effect too.

 

[psycho-matic]

How can they take away their health insurance?

 

[Ronin2258]

I've looked at the list of benefits. I see the phrases "insurance is *offered* through..." and "coverage *available* through..." and "*can* be purchased..." and no mention of educational benefits. This to me would add a lot of stress, considering the you are living in an expensive and cold (in the winter,) area of the country, the choice the house staff may have to make is rent or healthcare insurance. Scary considering the risk of blood borne pathogens, needle sticks, etc.

Even as a research tech between schools, I had better benefits. All I had to do was sign to what level of coverage for insurance I wanted.

Now questions:
-I read someone mentioned that the residents are employed through a shell company. Does any other program subcontract out their residency training programs like that? That to me alone sounds very shady, instead of direct hospital/university employment. The residency program I trained in was a consortium directly under university control.
-Is there a concern for Medicare fraud, considering the ~150k per resident of Medicare funds are going for education support? If the residents are a shell company employees, that to me reeks of a fraud potential. Makes me wonder if UB has something to hide.

 

[psycho-matic]

I've looked at the list of benefits. I see the phrases "insurance is *offered* through..." and "coverage *available* through..." and "*can* be purchased..." and no mention of educational benefits. This to me would add a lot of stress, considering the you are living in an expensive and cold (in the winter,) area of the country, the choice the house staff may have to make is rent or healthcare insurance. Scary considering the risk of blood borne pathogens, needle sticks, etc.

Even as a research tech between schools, I had better benefits. All I had to do was sign to what level of coverage for insurance I wanted.

Now questions:
-I read someone mentioned that the residents are employed through a shell company. Does any other program subcontract out their residency training programs like that? That to me alone sounds very shady, instead of direct hospital/university employment. The residency program I trained in was a consortium directly under university control.
-Is there a concern for Medicare fraud, considering the ~150k per resident of Medicare funds are going for education support? If the residents are a shell company employees, that to me reeks of a fraud potential. Makes me wonder if UB has something to hide.

University of Hawaii uses a separate company to employ residents. I don't know anything about it other than some folk in the psychiatry forum saying to avoid Hawaii in part due to this issue. Hawaii Residency Programs – Hawaii Residency Programs

 

[CopaceticOne]

Where I did training we also had something like this. If I remember correctly, they were basically the clearing house because training sites involved were like 8+ different health organizations. The GME org took the money provided by those organizations and used it to pay the residents & fellows, who were the only employees. The health insurance was waaaaay better than what the attendings had. But no retirement funding back then.

A bonus was that the GME org had a separate risk management structure that really worked at protecting trainees from being thrown under bus in situations with poor outcomes.

 

[Ashers]

Where I did training we also had something like this. If I remember correctly, they were basically the clearing house because training sites involved were like 8+ different health organizations. The GME org took the money provided by those organizations and used it to pay the residents & fellows, who were the only employees. The health insurance was waaaaay better than what the attendings had. But no retirement funding back then.

A bonus was that the GME org had a separate risk management structure that really worked at protecting trainees from being thrown under bus in situations with poor outcomes.

That sounds like how my residency was organized. And same with no retirement and better health insurance than attendings, but resident health insurance was worse than med student health insurance.

 

[aneftp]

U got any locum contacts for upstate new york with 400-450/hr rates?

The key with any locums contract is to renegotiate

My friend does it in upstate New York which is vast area.

He started at $350/hr 2 years ago Steadily asked for $400 and now gets $450hr with $600/hr after 40 hours.

I think people expect to be handed things in a silver platter. It doesn’t work that way in the private locums world. It’s like negotiating with a car dealer. How you get to a semi agreement. And the car guy says he has to go back to his general manager for approval.

That’s how these deals are worked out.

But a lot also depends what type of coverage you are willing to give them as well. Many people just want to keep their regular job and do prn 1099. Which is fine. But you will be lower on their priority list than the guy who can give 2 weeks at a time.

 

[ryanjmy]

I’ll be that guy…

Was there a bait and switch? If not I don’t get what the big deal is. If you’re at a bad program it’s most likely that you’re there because you couldn’t match somewhere better. There’s always someone willing to grind at a bad program for a few years to be their desired specialty. If you signed up for that you shouldn’t complain

 

[Drwine]

I've looked at the list of benefits. I see the phrases "insurance is *offered* through..." and "coverage *available* through..." and "*can* be purchased..." and no mention of educational benefits. This to me would add a lot of stress, considering the you are living in an expensive and cold (in the winter,) area of the country, the choice the house staff may have to make is rent or healthcare insurance. Scary considering the risk of blood borne pathogens, needle sticks, etc.

Even as a research tech between schools, I had better benefits. All I had to do was sign to what level of coverage for insurance I wanted.

Now questions:
-I read someone mentioned that the residents are employed through a shell company. Does any other program subcontract out their residency training programs like that? That to me alone sounds very shady, instead of direct hospital/university employment. The residency program I trained in was a consortium directly under university control.
-Is there a concern for Medicare fraud, considering the ~150k per resident of Medicare funds are going for education support? If the residents are a shell company employees, that to me reeks of a fraud potential. Makes me wonder if UB has something to hide.

"The residency program I trained in was a consortium directly under university control." No different in Buffalo. Before the creation of the current corporation residents were randomly assigned to be paid by individual hospitals in the consortium. Since consortium menbers are a mix of public and private hospitals there was a difference in pay and benefits.
One thing not mentioned is the Buffalo faculty do substantially better than their counterparts in the region. The highest paid NY state employees work in public hospitals in Buffalo.

SeeThroughNY :: Payrolls

The Payrolls section provides a database of names, positions, salaries and/or total earnings for individuals who have been employed by New York State, New York City, state and regional public authorities, public school districts, and New York's county, city, town and village governments.

www.seethroughny.net

 

[nimbus]

"The residency program I trained in was a consortium directly under university control." No different in Buffalo. Before the creation of the current corporation residents were randomly assigned to be paid by individual hospitals in the consortium. Since consortium menbers are a mix of public and private hospitals there was a difference in pay and benefits.
One thing not mentioned is the Buffalo faculty do substantially better than their counterparts in the region. The highest paid NY state employees work in public hospitals in Buffalo.

SeeThroughNY :: Payrolls

The Payrolls section provides a database of names, positions, salaries and/or total earnings for individuals who have been employed by New York State, New York City, state and regional public authorities, public school districts, and New York's county, city, town and village governments.

www.seethroughny.net

Guess they don’t have big division 1 football and basketball programs with coaches to pay.


I found this interesting.

 

[aneftp]

Guess they don’t have big division 1 football and basketball programs with coaches to pay.


I found this interesting.

View attachment 392021

Teachers get paid very well in upstate New York as well.

I think non medical people do better in high state income rates like New York and California despite the cost of living. Though upstate is cheaper cost of living. Places like Rochester is outrageous high property taxes (equivalent of 3% of your true home value). Worst than Texas 2% true home value

 

[aneftp]

I made around 35k I think in early 2000s are major northeast city in residency. Because of a glitch in how they assigned cities funding. .

I also paid 11% city and state income taxes. I did get subsidized housing (400 sq foot efficiency) which helped.

Just suck it up buffalo. It’s a short time in your life.

It was actually a great growing experience You make friends for life. We were all the same age give or take 2 years apart. To be 26/28 years old with no commitments was great. I know some people do have families etc so they have different perspective on cost of living vs a single guy in the city.

 

[Maz777]

The government needs to stop GME funding entirely. Only then will hospitals have to pony up and compete for residents like they should.

 

[pgg]

The government needs to stop GME funding entirely. Only then will hospitals have to pony up and compete for residents like they should.

That makes no sense.

Hospitals can already pay more or offer better benefits to compete for residents.

But they don't, because they understand that people don't rank residency programs based on the paycheck.

 

[Maz777]

That makes no sense.

Hospitals can already pay more or offer better benefits to compete for residents.

But they don't, because they understand that people don't rank residency programs based on the paycheck.

Residents continue to be exploited for cheap labor given that hospitals are subsidized. There is very little incentive for hospitals to pay them more under the current structure. Hospitals know that residency spots are a premium and will continue to use the excuse that GME funding dictates how much they should be paid. Let the free market dictate how much resident physicians should be paid. How much would it cost for a hospital to substitute the work of a neurosurgery resident? Over 500k at least.

 

[pgg]

Residents continue to be exploited for cheap labor given that hospitals are subsidized. There is very little incentive for hospitals to pay them more under the current structure. Hospitals know that residency spots are a premium and will continue to use the excuse that GME funding dictates how much they should be paid. Let the free market dictate how much resident physicians should be paid. How much would it cost for a hospital to substitute the work of a neurosurgery resident? Over 500k at least.

You're missing the point

People rank programs based on the quality of the training they perceive, the reputation of the program, and geographic considerations.

Pay is an afterthought.

I agree residents should be paid far more. Shuffling around where the dollars come from won't change the above factors.

The invisible hand of the market can't fix an issue where the money is not a significant factor in ranking choices.