Buffalo residents striking

[notEinstein]

UB medical school residents begin 4-day strike

The residents say this comes after a year of collective bargaining with University Medical Resident Services has not resulted in a new deal.

spectrumlocalnews.com

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[Stellar Mudd]

This should be fun

 

[ThoracicGuy]

They want retirement benefits? I never had retirement benefits in my training. Lowest salary in NY, but they aren't in NYC.

Now I wonder how they are going to explain this to their respective boards when it comes time to submitting their days in training to sit for their exam...

 

[Stellar Mudd]

One of their issues is health care benefits. And being the only in the region without retirement benefits - depending on the length of training it’s not inconsequential given most physicians start paying in late as it is. The organization sounds genuinely abusive. Which is what you hear about NY programs. It’s only a 4 day strike to make a point anyway. Probably not long enough to really affect BE but long enough to send a message of suck to the admin.

My friends all had great medical and retirement and other benefits through their residencies. This program may be an outlier.

 

[Saddleshoes]

Retirement Benefits????

I guess they want a 401k with a match?
(The residents at my place get a 401K with a 5% match.)

 

[Stellar Mudd]

Retirement Benefits????

I guess they want a 401k with a match?
(The residents at my place get a 401K with a 5% match.)

Wait, you’re surprised the residents are making a big deal over it, or that the program isn’t budging on the issue?

I mean the thing that was mentioned first was health insurance benefits and that’s very much relevant to trainees for many reasons, not the least of which is starting a family at that time which many do.

 

[GoSpursGo]

Wait, you’re surprised the residents are making a big deal over it, or that the program isn’t budging on the issue?

I mean the thing that was mentioned first was health insurance benefits and that’s very much relevant to trainees for many reasons, not the least of which is starting a family at that time which many do.

Hard to comment on healthcare benefits without specifics. It does suck to not have retirement benefits, but is in line with what other academic institutions have done (including my fellowship training).

They are unionized, so it is their right to strike. I guess they’re about to find out how much leverage they really have. Honestly I think it’s pretty variable how much any hospital relies on their housestaff.

 

[NotAProgDirector]

Full disclosure: I have nothing to do with UB. Don't work there. Didn't train there.

It is a very interesting situation. Residents are definitely employees, and hence have the right to organize and strike if they wish. One could argue that they knew the salary/benefits when they chose to match to this site, but plenty of employee strikes are based upon current employees wanting better working conditions or benefits.

As is common, it's hard to separate the facts from the spin. There's reporting that UB was recruiting residents telling them that although salaries were lower, their health benefits were completely covered. Now residents are reporting that there were changes and there's now large deductibles, etc. But unclear if this is because residents were offered the choice of a HDHC plan with an HSA - which ends up being a great deal if you don't get sick but a huge money loser if you do.

Also mentioned in current reporting is that the union tanked negotiations by demanding a big salary increase in the last 24 hours prior to the strike. But it appears what happened is that GME refused to meet their benefit demands, so the union calc'ed what those benefits were financially worth and added it to salary demands. Not surprising that GME refused that, but not exactly a "last minute bait-and-swap" either.

Regarding board certification, most boards have flexibility where 4 days won't matter. But it may matter for some. IM allows quite a bit of missed time without extension, but every year we have someone who uses it all (usually for a pregnancy leave or an extended medical leave) -- and anyone at the limit will get extended further.

As mentioned in all of the reporting on this, the situation is complicated by the fact that the residents are hired by a separate company. Whether this is "a shell corp to shield the hospitals from responsibility" vs "the best way to manage residents who rotate at a large number of institutions" is debatable. But it definitely makes the situation more complicated and likely slower to resolve.

The really interesting situation is the power of this short strike. If a 4 day strike forces a compromise, then it's a win for the union for sure. if not, then what comes next? My (albeit very limited and likely incorrect) understanding of labor law is that intermittent short strikes are not allowed. Either employees go out on strike and don't return until they have a contract, or they work. So if this is not effective, then what can the union do? A long term strike would definitely cause problems for residents with certifications, not to mention that if the strike is long enough, contracts may expire and it's unclear what happens then. programs can't afford to extend large swaths of residents to complete training -- both financially and with enough cases / patients.

 

[comp1]

Even considering compounding interest, I just can't see retirement benefits being that much of a deal, unless the residents are independently wealthy. It would not be prudent to go into debt on living expenses to make enough of a contribution to get a significant match. It seems more like a talking point than an actual concern. I always want more details in these cases, but retirement benefits is one thing that really seems weird to me. Of course I'm a bitter old guy who certainly didn't get retirement benefits or a capped 80 hour workweek (averaged, I know). Also, I do agree that they probably should be the lowest paid residents in the region? At least compared to Pittsburgh and NYC, just based on cost of living. Someone has to be, after all. That seems like another weird argument to make. The "shell company" seems like a red herring. I don't think it matters if the hospital in specific is doing the negotiating. I also am unclear on the benefit of a single 4 day strike (the poster above is correct that repeated short term strikes are illegal), but I can clearly see the harm for the trainees in a prolonged strike. This was always something that I found off about a resident union. Strikes have the potential to harm resident "workers" much more than average union member and the potential benefit is quite low relative to the eventual earning power of the resident if that harm did not come to pass.

 

[LucidSplash]

I think I was permitted to invest in the hospital retirement plan as both a resident and a fellow (one in TN, one in NY). However in both situations, for the purposes of the retirement plan the hospital didn’t consider us employees that were eligible for the matching funds that other W2 employees (attendings, nurses, techs, administration, etc) were eligible for. It was one of those situations when residents were considered learners when convenient for the hospital.

So for my own reasons I didn’t contribute because I felt I needed that money more as a resident. If there had been a match, I would likely have contributed the minimum amount so as not to “lose” money.

I wonder if that is at play here when they are discussing the retirement plan.

 

[DocWinter]

I interviewed at UB years ago and I'm familiar with the situation . UB was transparent that although they paid less, their benefits were above average and the package overall was reasonable.

All the university/hospital needs to do is stand pat and the union will fold because the residents cannot afford to miss much time.
It will be expensive in the short run but imagine the cost if they give in and then year after year.

Not that I agree with it and I am certainly on the side of the residents in the what we put in to the 3-7 years of residency is in no way equal to the pay, but at least the way that I had seen it when I was a resident, and you put put in your dues and reap the benefits later.

 

[annoyedpsychiatrist]

in residency i had no retirement benefits and pretty crappy pay for pretty crappy hours. I could emphatize more if they were on strike because of poor working conditions, malignant faculty, etc but their reasons seem pretty on par for most residency programs..

 

[VA Hopeful Dr]

We had a 401k match and decent health benefits when I was in residency. Given how poorly most hospital employees are paid, high deductible plans shouldn't be the only option. I feel less strongly about the retirement part.

 

[NotAProgDirector]

Salary, Benefits and Support

Your total compensation includes your salary, as well as indirect compensation, such as the benefits provided to you.

medicine.buffalo.edu

Looking at these, they forced all new residents into a HDHC plan, with no contribution to their HSA. And the payroll deduction was only $10-20 per pay period less. This is really crappy and completely unacceptable IMHO.

 

[Dantes]

When I interviewed almost all academic programs offered a retirement match and decent healthcare. I ranked Buffalo low and this was one of a few reasons. Residents are employees and should have the same benefits. Buffalo also pays significantly less than Rochester an hour away. I'm all for the residents striking.

 

[RangerBob]

Salary, Benefits and Support

Your total compensation includes your salary, as well as indirect compensation, such as the benefits provided to you.

medicine.buffalo.edu

Looking at these, they forced all new residents into a HDHC plan, with no contribution to their HSA. And the payroll deduction was only $10-20 per pay period less. This is really crappy and completely unacceptable IMHO.

We had Cadillac plans at all three programs I was at (TY, residency, fellowship). It really helped lower our stress.

Our residency program had the best plan. $250 out of pocket max (I believe increased to $500 my last year). So it cost $250 to have a baby, regardless of complications, etc. and the women were ecstatic that breast pumps were covered.

Monthly premiums were low at all three programs. We felt well taken care of.

Yes, I would be upset too if I was forced onto a HDHP. Especially if the monthly premium didn’t go down much, and if the program wasn’t filling up the HSA fund for us.

My TY did have a retirement plan—unfortunately we weren’t vested until PGY4, so I didn’t get to keep any of the employer contributions (they put money in even if we didn’t)

I think one bottom line here is don’t do residency in NY…

 

[dozitgetchahi]

We had Cadillac plans at all three programs I was at (TY, residency, fellowship). It really helped lower our stress.

Our residency program had the best plan. $250 out of pocket max (I believe increased to $500 my last year). So it cost $250 to have a baby, regardless of complications, etc. and the women were ecstatic that breast pumps were covered.

Monthly premiums were low at all three programs. We felt well taken care of.

Yes, I would be upset too if I was forced onto a HDHP. Especially if the monthly premium didn’t go down much, and if the program wasn’t filling up the HSA fund for us.

My TY did have a retirement plan—unfortunately we weren’t vested until PGY4, so I didn’t get to keep any of the employer contributions (they put money in even if we didn’t)

I think one bottom line here is don’t do residency in NY…

Both my residency and fellowship programs had very good insurance, as well as 401k matches. Between residency and fellowship, I picked up a total of about $15k in 401k contributions/matching from my programs.

Would I strike over not getting this stuff? I’m not sure, but I do support the residents here. GME in America flatly sucks, and everyone works way too hard for way too little compensation those years.

(That said, I think the insurance issue is way more of a big deal for a resident than the retirement matching. You can totally save for retirement once you start making doctor money, but having crappy health insurance when you’re on a resident salary is brutal. Both my residency and fellowship basically offered 100% insurance coverage as long as you were going to the covering institution for care, and I think that’s only fair. If they’re going to pay you peanuts and work you like a pack mule, they should at least have the decency to cover your health expenses *at the same institution*.)

 

[elleE23]

Salary, Benefits and Support

Your total compensation includes your salary, as well as indirect compensation, such as the benefits provided to you.

medicine.buffalo.edu

Looking at these, they forced all new residents into a HDHC plan, with no contribution to their HSA. And the payroll deduction was only $10-20 per pay period less. This is really crappy and completely unacceptable IMHO.

This is correct. Additionally, incoming residents were unaware of the healthcare plan changes and were recruited on the premise that they would have the old plan.

For those questioning the strike and benefits, this table helps clarify things. Rochester is 40 min away:

https://ubhousestaff.org/wp-content/uploads/2024/08/Screen-Shot-2024-08-31-at-11.12.32-AM.png

 

[NotAProgDirector]

I assume the strike is over now. So now what? The strike generated some press, but doesn't appear to be enough to change anything. And unclear if repeated short strikes are legal -- they often are not.