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Medical Students Sue Over Residency System

Discussion in 'Pre-Medical - MD' started by scamp, May 7, 2002.

  1. scamp

    scamp Member
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    article on the front page of the NY Times today- a law suit has been filed in Washington claiming that the match system unfairly locks medical students into programs with low pay and long hours.
    "If the suit is successful, the nation's health care system faces enormous financial liability and the prospect of being forced to change the way that generations of doctors have been trained."
     
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  3. A-Phi-A

    A-Phi-A Member
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    Very interesting article scamp. Thanks for the heads up.
     
  4. vyc

    vyc Senior Member
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    does anyone know if this article can be found online? i tried looking and couldn't find it.
     
  5. Papa Smurf

    Papa Smurf Thug 4 Life
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    All I gotta say is HELLZ YEAH!!!! ABOUT FREAKING DAMN TIME!!

    Medical Students Sue Over Residency System

    By ADAM LIPTAK

    Every March, graduating medical school students wait anxiously for Match Day, when a computer tells them where they will spend the next several years as medical residents in teaching hospitals.

    A class-action lawsuit to be filed in Washington today challenges the matching program on antitrust grounds. The suit says the defendants, including seven medical organizations and more than 1,000 private hospitals, have used the program to keep residents' wages low and hours long. Almost all first-year residents make less than $40,000 a year and often work 100-hour weeks.

    If the suit is successful, the nation's health care system faces an enormous financial liability and the prospect of being forced to change the way that generations of doctors have been trained.

    More than 80 percent of first-year residency positions are offered exclusively through the program, known formally as the National Resident Matching Program. The matches are based on ranked lists submitted by hospitals and the 15,000 or so students, and both sides agree in advance to accept the match.

    There is no room for negotiations about wages, hours or other terms of employment. As a consequence, the plaintiffs say, the hospitals, which share detailed salary information with each other, can force residents to accept below-market wages for the three to eight years, depending on specialty, of their residencies.

    "The match basically controls where you are going to spend the first part of your professional life," said Dr. Paul Jung, one of the plaintiffs, who is now a fellow at Johns Hopkins University. Yet, he said, "you're expressly forbidden from having any kind of agreement about any kind of salary or anything."

    Lloyd Constantine, who was New York's top antitrust official for a decade and is not involved in the suit, said the case raised important issues. "If this were coal or steel or autos, it would flat out be a felony and would probably be prosecuted criminally," he said of the matching system.

    Alvin Roth, an economics professor at Harvard, redesigned the system in 1997. He said it merely ensured that medical students obtain the best residencies they could. This fosters competition, he said, which the antitrust laws are meant to protect.

    But James F. Blumstein, an expert in health care regulation at Vanderbilt Law School in Nashville, said that the matching program "does prevent competition in the sense that you can't entertain competing offers."

    "It's not only salaries but also access to opportunities," he said. "It's hard to see what the pro-competitive justification is here."

    Defenders of the matching program say that it is a mistake to think about it in purely commercial terms. They say residencies serve an important social purpose in training doctors and providing care for patients. Whether the antitrust laws should take account of these kinds of arguments is the subject of debate.

    "It's not exactly a job, it's a continuation of a medical education," said Kevin Jon Williams, a professor of medicine at Thomas Jefferson University in Philadelphia, who has written extensively on the matching program.

    Sherman Marek, a Chicago lawyer whose law firm, along with 14 others, represents the plaintiffs, said there was nothing special about jobs that educate. "In any employment, the employee is acquiring skills that can then be taken elsewhere, so there is always an education element," he said. "Nevertheless, market forces are allowed to operate."

    Lawyers for the plaintiffs declined to speculate on how much residents' salaries might change if the matching program were eliminated.

    Representatives of the medical organizations declined to comment on the lawsuit or did not return calls.

    Residents' wages are certainly both low for the profession and uniform. According to the Association of American Medical Colleges, which operates the program and is a defendant in the suit, the average first-year resident, having completed four years of medical school, is paid $37,383. In the Northeast, the average is $39,060; in the South, the average is $35,552.

    Hundred-hour workweeks for residents are common, meaning that they often make less than $10 an hour.

    "They get less money than nurses and physician's assistants," said Michael J. Freed, a lawyer for the plaintiffs.

    The plaintiffs' legal papers say the uniformity of the wages proves that something is wrong.

    "Employers pay residents standardized salaries, regardless of such factors as program prestige, medical specialty, geographic location, resident merit and year of employment," the papers argue. "With few exceptions, employers pay salaries very close to the national average and very close to each other. By contrast, post-residency physicians earn widely varying compensations based on these factors, especially geographic location and medical specialty."

    But Professor Roth, the system designer, said the similarities in wages by themselves prove nothing. "If you're looking at prices, both competition and collusion look similar," he said. Moreover, "people would be willing to pay to take these slots," he said, referring to the most desirable positions.

    George L. Priest, a professor at Yale Law School who was a consultant to the plaintiffs, disagreed. "The salary data is highly suspicious," he said. "There is no good reason why doctors after four years of graduate school should make a quarter of what lawyers make."

    The low wages and long hours have serious consequences, Dr. Jung said. "I had to constantly battle fatigue as a factor affecting the quality of my life and the lives of my patients," he said.

    Dr. Jung, 32, said his residency at the MetroHealth Medical Center in Cleveland was dispiriting.

    Hospitals "use residents as cheap labor," he said. "I had the expectation, maybe na?vely, that a lot of time would be spent with patients."

    Instead, Dr. Jung said, he performed many menial and administrative tasks. "It was a lot more hours and a lot less patient care than I expected," he said.

    He added: "Residents want to be treated fairly, and patients want to be treated well. Patient care will improve if you let residents have more say in their working conditions."

    The Justice Department looked into the residency matching program in the mid-1990's. It reached a settlement with an association that administered a separate program for family practice residencies, but did not challenge the main program. Professor Roth said this meant the government had given the hospital matching program "a clean bill of health."

    Mr. Constantine said that the professional training aspect of residents' work made it difficult to predict the outcome of the case. "There is a level of sentimentality" among judges, he said. "They will listen to excuses they would not listen to in the context of a purely commercial situation," he said.

    Professor Blumstein said those excuses should not play a role in antitrust analysis. "The better view and the correct view is that antitrust law does not allow for worthy purposes to offset the anticompetitive actions," he said.

    The closest analogy, Mr. Constantine said, is the civil suit that the federal government brought a decade ago against the eight Ivy League colleges and the Massachusetts Institute of Technology challenging their cooperation in setting student financial aid. The case ended in settlements that limited the amount of information the institutions could share.

    Such information sharing is even more problematic when salaries are involved, he said. "The medical world really is closer to coal, steel and autos than to colleges giving out financial aid," he said.

    Critics compare the residency matching program to early decision programs at colleges. They say that colleges accepting applicants through early decision can offer less attractive financial aid packages because there is no competition for those students, just as hospitals can pay residents low wages because they have nowhere else to go.

    The stakes in the new suit are high. The complaint does not specify how much money the plaintiffs seek, but they claim to represent a class of 200,000 residents. If residents' fair market salaries were determined to be $100,000, say, the sums at issue for a single year would exceed $12 billion, and since this is an antitrust case, the damages would be automatically tripled.

    "It's not obvious that it's in the interests of the plaintiffs to bankrupt every hospital in the country," Professor Priest said. "But it's going to change the nature of medical care. They are going to have to bid for the services of these medical residents, and they won't be able to work them 120 hours a week."
     
  6. Green912

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    I did a search at nytimes.com and came up with this link:

    <a href="http://query.nytimes.com/search/query?query=lawsuit+medical&date=today" target="_blank">ny times article</a>

    however to read the article you have to register (pay?) as a member.
     
  7. scamp

    scamp Member
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    ditto papa smurf! thanx for posting the article!
     
  8. vyc

    vyc Senior Member
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    thanks!!

    (registration is free!)
     
  9. martymcfly

    martymcfly P=MD
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    It's about time.
     
  10. ermonty

    ermonty Senior Member
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    I just heard about this on CNN and I rushed to post about it, but you guys beat me to it. I don't know what to think. I want less hours (less scut more education) and better pay when I get to residency, but I think this class action could do some damage to the healh care system. The plantiffs might get a hefty settlement award and future residents better salaries, but that money has to come from somewhere so something has to give - less residency positions? - longer residencies? :confused:
     
  11. Amy B

    Amy B I miss my son so much
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    This is unfortunetly not the first time residency hours and pay has been disputed by medical students. I can only hope something postive comes out of it, but I doubt it will. The "system" is run by older doctors who went before us and did those long hours for little pay. It is said alot of times that if they could do it, then so can the new doctors.

    Patient safety is at stake here, and they know it. Let's keep our fingers crossed that the system will change before we get there.
    Amy
     
  12. Green912

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    I certainly wouldn't want to "throw the baby out with the bath water" and bankrupt the whole system, but some changes do need to be made. I mean come on $10/hour after eight years of higher education! That's indentured servitude. And the Hospitals can't cry medical education as if they wern't benefiting from the whole practice. I don't mind working a lot of hours and certianly don't expect to make the high dollar during residency but a resonable middleground would be nice. :)
     
  13. Premed2003

    Premed2003 Senior Member
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    when do you think the changes will be made? in time for us entering med school in 2003? <img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />
     
  14. CANES2006

    CANES2006 Miami chica
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    Thanks Papa for posting this article. Something has got to give in this system. Residents are overworked and underpaid. I think this has a direct effect on the patients because residents often take out their frustrations on their patients. Making the residents happier will make the system run more smoothly. I'm not saying they should pay them $100,000 as a starting salary, but definitely not $39,000. This is highway robbery!!!
     
  15. MiamiMarmot

    MiamiMarmot Senior Member
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    Personally, I agree with Canes. I think that the average wages should be about 50-60k, a middleground between "real" physician wages, and the crappy salary people are being paid now. I don't mind working long hours, because in the end you learn a lot in a *relatively* small amount of time. I also strongly believe that we should be able to compare offers from different hospitals, instead of being locked into one choice. It's a dumb, dumb, dumb system, period.
     
  16. scamp

    scamp Member
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    Although I agree that the pay is too low, I'm most concerned about the hours! I worry that I will be too exhausted all the time... I know I will learn more if I am able to sleep at least a few hours every night!!! I'm also afraid to lose my idealism about medicine as a profession. Has anyone read RESIDENTS by David Ewing something (i forgot his last name). It's kind of terrifying! :rolleyes:
     
  17. cm7b5

    cm7b5 Senior Member
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    I agree.....There is no way a resident should get paid a guaranteed 100K..i think 50-70K depending on location, specialty, etc........but most importantly HOURS!!!!! Why don't they just pay residents by the hour? $15-20 an hour? They can set certain weekly caps for hours (~80)....and minimum and maximum salaries (35-80K....)
     
  18. shorrin

    shorrin the ninth doctor
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    guys,

    I'm afraid that this will be a long hard fought battle. But I believe it is worth it for the sanity of us future md's and the safety and proper care of patients. I really don't think that this suit will come out in our favour because there is so much in our opposition. The system as it stands now makes no good sense at all with the exception of the bottom line.

    So now I'm wondering as an entering MS1, what can we do starting now, to change this system???
     
  19. Ryo-Ohki

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    Write (or email) to your state senators about this issue:
    <a href="http://www.senate.gov/senators/index.cfm" target="_blank">http://www.senate.gov/senators/index.cfm</a>

    Why are apprentice doctors singled out as being "students" and therefore exempt under anti-trust laws?
    It is a sad commentary on the administrators of our healthcare systems that they would exploit young doctors in this fashion.

    Remember, your voice counts! email them! :)
     
  20. nezlab99

    nezlab99 Senior Member
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    Ryo-Ohki-
    good idea! This is awesome that something constructual is being done about this. I think we should all do what we can even if it's just a letter. Hopefully this will end-up affecting us somehow.
     
  21. scamp

    scamp Member
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    I think it's a great idea to get involved now! I've read somewhere that one of the reasons the system hasn't changed is because the residents haven't ever protested in full force- probably because they are too tired and overworked, right?
    I definately think it's time to create a new residency "tradition"- an environment where teaching and learning and healing is the focus (not all scut and paper work), a salary that residents can live comfortably on, and a decent schedule. Although the hospitals may lose their cheap laborers, they'll turn out doctors enthusiastic about medicine and will have better patient care as well. Everyone should really voice their concern to their local senators as suggested above!
     
  22. A-Phi-A

    A-Phi-A Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by scamp:
    <strong>I think it's a great idea to get involved now! I've read somewhere that one of the reasons the system hasn't changed is because the residents haven't ever protested in full force- probably because they are too tired and overworked, right?
    I definately think it's time to create a new residency "tradition"- an environment where teaching and learning and healing is the focus (not all scut and paper work), a salary that residents can live comfortably on, and a decent schedule. Although the hospitals may lose their cheap laborers, they'll turn out doctors enthusiastic about medicine and will have better patient care as well. Everyone should really voice their concern to their local senators as suggested above!</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">My main concern is the crazy hours we will have to work as residents. We will all make money eventually, but I believe that it is irresponsible for hospitals to have overworked and fatigued people making life and death decisions everyday. Luckily my parents both have excellent insurance coverage, but I tell them and my friends that if for some reason they end up at the hospital to ask to see the attending in charge and to not allow a resident to treat them if at all possible. It sounds f*cked up I know, but I will be damned if I allow someone I care about to die because hospitals and old docs are more concerned about the bottom line and tradition.
     
  23. Future_Doc

    Future_Doc Senior Member
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    Long hours = fine with that. :p
    Not being able to make student loan payment on $150k of debt because I only make $37k = not fine with that. :mad:

    How do people make it? Let's see - if I make $37k per year, after taxes I'm bringing home about $24k ($2k per month). My payment just on my student loan will be $1,800 per month - leaving me only $200 a month for ... ??? :confused: Gee, can't do much with only $200 - good thing most of us will virtually be living at the hospital - maybe we can save on a house payment. :D

    I know you can send your loans into repayment after residency, but who wants to accrue interest on $150k for an additional 3-7 years?
     
  24. martymcfly

    martymcfly P=MD
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    This is what I wrote to my senators... feel free to cut/paste/add:

    I would like to bring to your attention a lawsuit filed May 7 in protest of medical residency programs in the US. As a future doctor I am troubled that such a perverse system has survived for so long. Residents are forced to accept the positions they are given without opportunity for negotiation over work hours (which often exceed 100 per week) or salary (which falls in the mid-30s). This is a fantastic opportunity for residents to be heard, an unprecedented event, for these young doctors have little time for anything but work. Please, for the sake of your constituents who may find themselves at the mercy of one of these residents, please support our effort.
     
  25. shorrin

    shorrin the ninth doctor
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Still lurking (Amy Beth) at SDN:
    <strong>...is said alot of times that if they could do it, then so can the new doctors. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I heard that before in other industries as well. However, just because something can be done doesn't mean that it should be done.

    Thanks you guys I'm going to write a letter and have every applicant/medical student/doctor I know sign it. Lets not stop at just us! Our elected representatives need to be overwhelmed before they will look at it seriously!!!
     
  26. shorrin

    shorrin the ninth doctor
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    Here are some responses to the article:

    The Life of a Medical Resident

    To the Editor:

    Re "Medical Students Sue Over Residency System" (front page, May 7): As a medical student and the son of a former surgical resident, I am well aware of the toll that medical training takes on oneself and one's family.

    While the potentially tremendous monetary damages that would be awarded might seem to make ruling for the plaintiffs an impractical option, I, for one, would be willing to forgo the triple damages of the typical antitrust suit.
    Advertisement


    Would ruling in the residents' favor further increase the skyrocketing costs of health care in this country? Most likely, yes, but I'd bet that the patients treated by sleep-deprived residents would argue that it would be well worth it.
    JOSHUA DYM
    Bronx, May 7, 2002
    ??
    To the Editor:

    Re your May 7 front-page article about a lawsuit challenging the medical residents' matching program, which, it says, keeps residents' wages low: Residents are not employees; they are students. They cannot work without supervision; an attending doctor must monitor everything they do and perform the major part of any procedure or operation in which they participate.

    Many training hospitals receive some financial support from the state to support resident education in recognition of the fact that attending doctors must be hired to educate and supervise the residents at all times. Furthermore, new medical school graduates have few, if any, marketable skills and lack the training and experience to provide good medical care on their own.

    The "salary" provided to residents is thus not a salary, but a stipend intended to support them while they complete their education.
    KATHARINE WENSTROM, M.D.
    Birmingham, Ala., May 7, 2002
    ??
    To the Editor:

    How are patients expected to get quality care when the provider of that care is working 16-hour days ("Medical Students Sue Over Residency System," front page, May 7)?

    When a patient is in the care of a teaching hospital, the doctor will spend at most 15 minutes a day with a patient, and even then, he will rely on the work of the hospital's resident doctor. I wouldn't have my car serviced by a mechanic who worked 100-hour weeks for $10 an hour, yet I have no choice but to put my health in the care of a doctor working the same hours. ?
    ANTHONY TORTORELLI
    Westport, Conn., May 7, 2002
    ??
    To the Editor:

    Your May 7 front-page article about the antitrust lawsuit regarding the role of the National Resident Matching Program in perpetuating low resident salaries and strenuous working conditions didn't mention an important driving factor in seeking higher pay. Most residents earning $38,000 salaries face educational debts often greater than $150,000. The need to repay loans, often while trying to start a family, is what makes the salary so difficult to live on.

    The premise that the National Resident Matching Program is a social good might be defensible in the context of a universal health care system that covered all patients, subsidized the training of all health care providers, and provided access to care throughout the country.

    Just think: instead of abolishing "the Match," we could be consistent and allocate our health care resources as efficiently as we do our medical students.
    DEBORAH J. WEXLER, M.D.
    Boston, May 7, 2002
    ??
    To the Editor:

    As a family doctor who spends four hours a week teaching residents, I find it disheartening to read about a class-action suit that is at least partly about money ("Medical Students Sue Over Residency System, " front page, May 7).

    Despite the huge debt that many medical students accrue, it seems that we no longer consider it a privilege to serve in the role of physician.

    I know a few poets who are also in high debt after their educations.
    JERRY CLEMENTS, M.D.
    New York, May 7, 2002
     
  27. Blazed

    Blazed Senior Member
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    Damn, it is about time. I got the Times yesterday and I was glued to that article.
     
  28. Blazed

    Blazed Senior Member
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    You graduate medical school and your in debt for about 120,000 dollars. On top of that you are trying to start a family. With the salary that these residents are getting and the hours they put in, is just wrong. My brother just graduated law school and is earning a nice salary. I know doctors need to be trained after medical school, but the same goes for lawyers. Lawyers come out of law school only knowing text book facts, and yet while they are being trained they are making three to five times what a resident makes. Come on PA's and Nurses come out of school making more money, and many of them are not half as much in debt as medical students are. Some thing needs to change. Yes the role of being a physician should not be about money, but we are in a world that requires us to have money to live. If doctors should not expect some kind of respectable salary, then why not make a medical education a lot cheaper. When you have a huge loan to pay back and a family to support 35,000 dollars, makes it awfully hard to do so. I personally feel resident are being taken advantaged of, and it is disgusting. Hospitals bidding for cheap labor...
     
  29. psyche

    psyche Member
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    I agree the system is flawed. But I think the relatively low salaries for residents, who are after all in training, is not the most flagrant issue here. That would be the unreasonable number of hours residents are asked to work, along with the elitist, macho, "that's the way it's always been done so suck it up" attitude of older doctors who refuse to budge. Residents should use any leverage they gain from the lawsuit to lobby for better hours. In addition, where is the money for higher salaries supposed to come from? Most academic medical centers are barely making it financially as it is.
     
  30. rpames

    rpames Optometrist
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    I agree with the hours and the pay being an issue, but would anyone else conserned about haveing their name on the lawsuit. It could make getting that job afterwards a little difficult.

    Hospital administration: "Well, he did graduate 3rd in his class from Yale...but he did sue us 3 years ago. NEXT!!!"
    <img border="0" title="" alt="[Eek!]" src="eek.gif" />
     
  31. shorrin

    shorrin the ninth doctor
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by rpames:
    <strong>I agree with the hours and the pay being an issue, but would anyone else conserned about haveing their name on the lawsuit. It could make getting that job afterwards a little difficult.

    Hospital administration: "Well, he did graduate 3rd in his class from Yale...but he did sue us 3 years ago. NEXT!!!"
    <img border="0" title="" alt="[Eek!]" src="eek.gif" /> </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I'm sorry rpames, and this is not an attack on you personally, but this is just exactly the attitude that has kept this system going year after year, while both patients and residents suffer.
    From the very begining of this med-school process we are taught to bow down, suck-up, prance around, jump through hoops and beg for anything that will give us a "leg-up" on the competition for those coveted seats.
    It's shameful that we would be too scared to 'theoretically' upset anyone because they might not hire us. Hell, no one ever made progress with anything without taking a chance that they might get screwed.

    All that being said I have prostrated myself to get ahead and after reading this article I have promised myself that I won't behave that way in the future. It's scary to cross a sacred and eons-old line but sometimes it just has to be done.
     
  32. synite

    synite Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by shorrin:
    I'm sorry rpames, and this is not an attack on you personally, but this is just exactly the attitude that has kept this system going year after year, while both patients and residents suffer.
    From the very begining of this med-school process we are taught to bow down, suck-up, prance around, jump through hoops and beg for anything that will give us a "leg-up" on the competition for those coveted seats.
    It's shameful that we would be too scared to 'theoretically' upset anyone because they might not hire us. Hell, no one ever made progress with anything without taking a chance that they might get screwed.

    All that being said I have prostrated myself to get ahead and after reading this article I have promised myself that I won't behave that way in the future. It's scary to cross a sacred and eons-old line but sometimes it just has to be done.[/QB]</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">i agree completely. i'm shocked by the tacit acceptance so many of you portray. there are serious problems with the system that people have been talking about quietly for decades (low pay, ridiculous hours, shear exploitation, debt management, quality of patient care). this lawsuit, hopefully, finally brings these issues into the national spotlight.

    you dont have to just take it in the a$$, so to speak! if there's one reason this lawsuit will fail and no changes will come about, its if residents and students themselves (the victims) portray indifference. dont worry about hypotheticals like "oh what if i look bad later on, will this mar my record." you're not pansies or trained dogs, you are people with valid concerns and rights.

    the lawsuit is purposefully extreme, claiming to represnt all residents and claiming numbers like $100,000 salaries...this is to get attention. but the goal is not to bankrupt hospitals and ruin the entire system. the goal is to bring positive changes like caps on work hours, higher pay levels, better debt management, etc... if you ignore the issues now, you have no right to complain later on.
     
  33. moo

    moo 1K Member
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    We could do what we do in my country--FORM A DAMN UNION AND GO ON STRIKE!
     
  34. rtk

    rtk Member
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    It'd be easy to jump on the band wagon and cheer this law suit. There are some things to consider however... Don't get me wrong, I'm all for more money and fewer work hours for residents, problem is, where is the money gonna come from? Keep in mind that &gt;80% on an average resident's salary comes from US tax coffers in the form of Medicare dollars. Everyone knows that that money stream is nearly bankrupt. The balanced budget act of 1997 is fully phazed in this year and nearly halves the revenue stream next year. Also, most academic/university training centers are operating in the red, so the money for increased salaries won't come from there. Even private/ community based training programs run a tight ~2% margin on average.

    Also, keep in mind that resident's in their first year of training aren't even liscensed to practice medicine. Most states don't issue a permanent liscense to practice until residents finish their PGY-1 year and in some states after PGY-2. What's that mean? That residents recieve a STIPEND until they have full liscensure and marketability and are able to directly bill 3rd-party payers. After resident's recieve their liscense, many moonlight in their last few years of training.

    Before the advent of Medicare in 1965, interns' and residents' salaries were subsidized by their training hospital. Frequently this pay was below the poverty line and much of the benefits they recieved was in the form of room and board; many residents lived in the hospital: hence the name "resident".

    Believe it or not, the NRMP was created to make matching residents w/ training programs a more equitable situation. It wasn't designed to keep residents from negotiating their benefits. Under the currrent system of resident renumeration, there is only a finite and ever decreasing pool of dollars. Looking across the country, residents are paid approximately the same low salary. As I see it, this suit will do 1 of 2 things... 1) it will cause this small pool of money to be maldistributed with higher salaries at some programs and lower at others -or- 2) things will stay the same with the possible break-up of the NRMP.

    However, under either senario, the lawyers still line their pockets...
     
  35. GATC

    GATC Member
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    I don't know if much is going to come out of this, but I hope some changes do occur. I think that we bust our a$$es during our undergrad years to get accepted to medical school. Then we have to go through the arduous four years of medical school, while paying a large amount of money (and accruing interests). Then we have to go a residency program working over 100 hours a week and getting a meager salary that does not reflect our educational level or responsibility. The fact is that we have been through eight years of schooling. We are in our mid 20s to 30s and we have a salary which cannot sustain a family.

    If anything, I think there needs to be some kind of board that is not directly connected to the medical institutions. Medical students also have to unite and give some pressure to make sure that some changes are enacted.
     
  36. shorrin

    shorrin the ninth doctor
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    rtk,

    You do make some valid points but I believe that it should not be a residents concern as to where the money will come from. Graduating attorneys don't ask where thier salary is coming from, only how much. Still I believe this suit is not so much about money as it is about determining what is fair and what is reasonable.

    What is fair is being treated as equitably as other professions at that same level. CP's go straight to work after school making about 60k, though I think that they have less 'learning' to do. The learning aspect of this argument will be the sticking point and I'm not sure where I stand with that yet.

    Money aside though, the real neccessity for changing the system here is time and safety. I could handle 37k if only I worked ~40hours. I'm not certain that I would trust anyone to even take a history after 30hrs of no sleep.

    The system as it stands is not safe, not reasonable and not fair. Older Doc's who counter this argument with the 'it's a priveledge to be a doctor argument and we are just awful to ask for more' didn't come from the highly competive and highly expensive background that we come from. In many aspects it's a matter of surviving nevermind being comfortable.
     
  37. Ryo-Ohki

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    What other job in the economy makes a person work over 24-48 hours straight?

    I like the "student" argument. How much are you learning after your 35th consecutive hour?

    It is exploitation. Unfortunately, the victims are probably sleeping after working 24 hours straight and are too tired to make any political protest. It is up to us.
     
  38. Grumpy

    Grumpy Junior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by moo:
    <strong>We could do what we do in my country--FORM A DAMN UNION AND GO ON STRIKE!</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Moo, this is EXACTLY what doctors need to do, sweet and simple.

    Nurses have been successfully forming unions and they don't have nearly as much leverage as doctors have. I think doctors are still getting used to the idea of being employees, rather than employers. We, as future doctors (and I say this hesitantly since I am still waiting for an acceptance) need to start organising as early as possible (and I mean while in medical school) if we want to secure our future, as well as a powerful voice in health care reform.

    -Grumpy
     
  39. MacGyver

    MacGyver Membership Revoked
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    Some of you dont understand that the MONEY IS ALREADY THERE TO INCREASE SALARIES.

    Thats right, as of RIGHT NOW, hospitals have more than enough money given to them by Medicare to afford a pay increase.

    Each residency position that is filled by an American medical graduate is $200,000 per year. Of that amount, about 40k goes to resident salary and about 20k goes to malpractive insurance. That leaves 140k in pure profit per each resident position per year.

    So, the money is already there folks. I dont buy this argument about "wheres the money going to come from." Its already there. Hospitals siphon off the profits from these funds that are specifically earmarked for resident education and spend them on other things or keep it as profit.
     
  40. shorrin

    shorrin the ninth doctor
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    hey all,

    This is a link to the full text class action document:

    <a href="http://www.usatoday.com/news/nation/2002/05/07/residents-brief.htm" target="_blank">http://www.usatoday.com/news/nation/2002/05/07/residents-brief.htm</a>
     
  41. Blazed

    Blazed Senior Member
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    Shorrin I second everything that you have said. This is wrong and needs to be addressed. If residents are to frightened to express their problems with the system, then they will continue to be taken advantage of. You can't sit around and be exploited with out doing anthing about it. It is fine if they leave the salary alone, but don't work me like a Fu**ing dog. This is bull****. You bust your ass in med school for 4 years and then you leave there with a huge debt and on top of that you are going to have a set low salary with ridiculously long hours. ****, I put my name on that suit also if I were a resident. The worst thing is being taken advantaged of, and know that this is going on, meantime you sitting down with your thumb up ur ass. Hopefully this suit is successfu, residents deserve to be treated better than this..
     
  42. Hallm_7

    Hallm_7 Senior Member
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    Did anyone else notice that none of the three named plaintiffs filed suit against their resptive hosptials or universities? Why would this be? It seems that they would sue the place they were working at unless they're intimidated somehow.

    Oh well, may not mean anything at all,
    just curious.
     
  43. USeF

    USeF sunny L.A.
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    First and foremost: THANK YOU! There are too many pre-meds at my school that have no minimal concept of the current status or any inkling of the prospect for change in health care delivery. Glad to read all this stuff (and in the other forums)

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by shorrin:
    <strong>rtk,

    You do make some valid points but I believe that it should not be a residents concern as to where the money will come from. Graduating attorneys don't ask where thier salary is coming from, only how much. Still I believe this suit is not so much about money as it is about determining what is fair and what is reasonable. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">One difference: we are socially responsible and held to be ethical. Remember all those secondary ethical questions and a certain little 'oath'? We in general put the helping of patients above ourselves. Unless it becomes extreme of course as in the case of...

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"><strong>Money aside though, the real neccessity for changing the system here is time and safety. I could handle 37k if only I worked ~40hours. I'm not certain that I would trust anyone to even take a history after 30hrs of no sleep.

    The system as it stands is not safe, not reasonable and not fair. Older Doc's who counter this argument with the 'it's a priveledge to be a doctor argument and we are just awful to ask for more' didn't come from the highly competive and highly expensive background that we come from. In many aspects it's a matter of surviving nevermind being comfortable.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">exactly! nothing more to add to that except an 'amen' :)
     
  44. Hallm_7

    Hallm_7 Senior Member
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    Does anyone else think that if this suit wins, and hospitals start paying residents what they're worth, that they'll pass this cost on to the patients? Or is raising patient costs not an option as a possible solution?
     
  45. Street Philosopher

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    I dunno but 48 billion is a lot of money. Maybe William Gates III will pay it off as a gesture of goodwill? hehehe
     
  46. PelicanMan

    PelicanMan Senior Member
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    They need to reduce the hours purely because it effects patients health. To me its not so much the money but the hours. If you haven't slept you are not on top of your game.

    It doesn't make any ****ing sense.
     
  47. brandonite

    Moderator Emeritus 7+ Year Member

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    I agree completely with what they are doing...

    Is there anything us premeds/soon-to-be-Med-1's can do to help?? I mean, the people behind the lawsuit are residents, with limited time and money. Perhaps we could start some sort of legal defence fund. I realize that none of us have any money either, but if we were to just put in $10... This system has to change. It is putting patients in danger, it is extracting basically slave labour from us, and all because the doctors that run it want to put us through exactly what they had to go through... Some sort of hazing ritual that is probably responsible for the deaths of more than a few patients because the resident that was taking care of them hadn't slept in 48 hours...
     
  48. shorrin

    shorrin the ninth doctor
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    nova has done a section on the hippocratic oath. One med-students comments are particularly appropriate for this debate:

    <a href="http://www.pbs.org/wgbh/nova/doctors/oath_010330.html" target="_blank">http://www.pbs.org/wgbh/nova/doctors/oath_010330.html</a>

    I wonder why the allo forum isn't up as up in arms about this as we are? hmmm. doesn't bode well... <img border="0" title="" alt="[Frown]" src="frown.gif" />
     
  49. deva

    deva Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by shorrin:
    <strong>nova has done a section on the hippocratic oath. One med-students comments are particularly appropriate for this debate:

    <a href="http://www.pbs.org/wgbh/nova/doctors/oath_010330.html" target="_blank">http://www.pbs.org/wgbh/nova/doctors/oath_010330.html</a>

    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Make sure you read the physician's comments that are after the med student's. This is what we are up against. This guy claims that doctors who value their quality of life must not care about their patients. He criticizes "New Age" doctors who question the practices of their elders. Basically, it's the suck-it-up-and-shut-up argument - with the pretext of being about the best care for patients.
     
  50. DarksideAllstar

    DarksideAllstar you can pay me in bud
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by devastator:
    <strong> </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by shorrin:
    <strong>nova has done a section on the hippocratic oath. One med-students comments are particularly appropriate for this debate:

    <a href="http://www.pbs.org/wgbh/nova/doctors/oath_010330.html" target="_blank">http://www.pbs.org/wgbh/nova/doctors/oath_010330.html</a>

    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Make sure you read the physician's comments that are after the med student's. This is what we are up against. This guy claims that doctors who value their quality of life must not care about their patients. He criticizes "New Age" doctors who question the practices of their elders. Basically, it's the suck-it-up-and-shut-up argument - with the pretext of being about the best care for patients.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Of course I am concerned about my lifestyle! On every interview I went on, my interviewers all said " We want everyone to have a life outide of medicine here", etc. What happened to this idea? throw it out the window as soon as we get you doing work we can bill for?!!?

    Its not so much the residents' pay that bothers me. If I wanted a fat bank account I wouldn't have wanted to become a physician, I would have went into engineering, CS, or business. Why would I put myself through 8 years of hell, if all I wanted was a fat check?

    What gets me is the huge amount of hours. Thats why a lot of people are choosing anesthesia, pathology, etc. A lot of those fields have a "set schedule" of 40-50hrs/wk. How can anyone not see the logic in the argument that a huge amount of hours w/ no sleep affects patient care?

    I just don't get it. :mad:
     
  51. LBJeffries

    LBJeffries Senior Member
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    I think that the passion and will to change the system is within all of us, especially as a collective group. It will change eventually, I don't think many of us doubt that, its just a matter of when. 50 years from now? 20 years from now? Now? Why can't WE change it? Let's pledge to support this lawsuit in any way we can while medical students, and continue the fight through residency.
     

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