Resident unionization

[ucladoc2b]

Interesting article from the WSJ.

Medical Residents Unionize Over Pay, Working Conditions

The largest group representing doctors in residency and fellowship programs added chapters at five teaching hospitals last year, up from a prepandemic pace of one a year.

www.wsj.com

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[TeslaCoil]

They are employees and they arent twisting the governments arm, therefore its legal. I support it 100%.

 

[gtb]

American Medicine, as a compendium of independent medical practices is likely finished forever. As anesthesiologists become W2 employees of hospital systems and publicly traded AMCs, I completely support unionization for those physicians. Will be horrible for patients, but it's a completely new world for practicing medicine in the US.

 

[coffeebythelake]

American Medicine, as a compendium of independent medical practices is likely finished forever. As anesthesiologists become W2 employees of hospital systems and publicly traded AMCs, I completely support unionization for those physicians. Will be horrible for patients, but it's a completely new world for practicing medicine in the US.

The corporatization of medicine is the single worst thing for patients in this country. Physicians have been turned into a cog in the wheel, and we are worked faster and harder, to see more patients, to spend more time charting, to face all this production pressure.. with little say and with no personal benefit.. just to enrich a bunch of business people who care about profits.

Look at your pay (after accounting for inflation the pay for physicians have actually declined over time). Compare that to the CEO of your hospital. That says plenty.

The hospital preys on our work ethic and the rite of passage that comes with the intense residency training. We accept the low pay because "it is part of the training". What naivety. Our residents should absolutely unionize and demand better working conditions, benefits and pay. Just think about how much that PA or NP would be paid to do a fraction of what a resident does.

 

[ucladoc2b]

American Medicine, as a compendium of independent medical practices is likely finished forever. As anesthesiologists become W2 employees of hospital systems and publicly traded AMCs, I completely support unionization for those physicians. Will be horrible for patients, but it's a completely new world for practicing medicine in the US.

Can’t imagine it would be any worse that it is now.

I have a hard time imagining how unionizing would improve our lot vs the wide open market we have now.

 

[chessknt]

The corporatization of medicine is the single worst thing for patients in this country. Physicians have been turned into a cog in the wheel, and we are worked faster and harder, to see more patients, to spend more time.. with little say and with no personal benefit.. just to enrich a bunch of business people who care about profits.

Look at your pay (after accounting for inflation the pay for physicians have actually declined over time). Compare that to the CEO of your hospital. That says plenty.

The hospital preys on our work ethic and the rite of passage that comes with the intense residency training. We accept the low pay because "it is part of the training". What naivety. Our residents should absolutely unionize and demand better working conditions, benefits and pay. Just think about how much that PA or NP would be paid to do a fraction of what a resident does.

The CT surgery PAs get paid 500k/yr here (legit, not a rumor, their contracts are paid by the hospital system and public record), better than almost all of the non procedural medical subspecialties and pediatric subspecialties, more than the staff psychiatrists, more than the crnas etc etc. I earn almost 10x more if I intubate and line a 98 year old demented full code aspiration pt than if I spend 25 minutes talking to the family about how I shouldn't do that.

There is more wrong with medicine than just the business people. The entire foundation of the payment FFS system is flawed beyond redemption. No specialty should be able to generate multiples of other specialties in revenue. Me taking care of 14 ICU patients shouldn't be the same as 2 days of primary care work or 2 45 minute hip replacements. We need to burn down and rebuild it with more physician participation this time around. They did it in the 80s, we need to do it again.

 

[interjectionreflection]

The CT surgery PAs get paid 500k/yr here (legit, not a rumor, their contracts are paid by the hospital system and public record), better than almost all of the non procedural medical subspecialties and pediatric subspecialties, more than the staff psychiatrists, more than the crnas etc etc. I earn almost 10x more if I intubate and line a 98 year old demented full code aspiration pt than if I spend 25 minutes talking to the family about how I shouldn't do that.

There is more wrong with medicine than just the business people. The entire foundation of the payment FFS system is flawed beyond redemption. No specialty should be able to generate multiples of other specialties in revenue. Me taking care of 14 ICU patients shouldn't be the same as 2 days of primary care work or 2 45 minute hip replacements. We need to burn down and rebuild it with more physician participation this time around. They did it in the 80s, we need to do it again.

Any links to that 500k I believe you but I'm honestly in shock. What kind of things do they do? Any idea how much would the CT surgeons make in comparison?

 

[chessknt]

Any links to that 500k I believe you but I'm honestly in shock. What kind of things do they do? Any idea how much would the CT surgeons make in comparison?

CT surgeons are clearing north of 1.5 MM. They are the sole source of CT surgery in a huge area and have a functional monopoly so the hospital is raking it in. The PAs do normal PA stuff--write all their notes/consults, assist in surgery etc. I think they are on call q3 or something like that but overnight CT surgery happens here almost never since they are super conservative, rarely offer surgery to borderline let alone very sick candidates. They won't tandem in for complicated aortic repairs with the vascular surgeons (those get shipped). Don't want to dox myself beyond that but suffice to say it is a unique market that is challenging to recruit to.

 

[nimbus]

The corporatization of medicine is the single worst thing for patients in this country. Physicians have been turned into a cog in the wheel, and we are worked faster and harder, to see more patients, to spend more time.. with little say and with no personal benefit.. just to enrich a bunch of business people who care about profits.

Look at your pay (after accounting for inflation the pay for physicians have actually declined over time). Compare that to the CEO of your hospital. That says plenty.

The hospital preys on our work ethic and the rite of passage that comes with the intense residency training. We accept the low pay because "it is part of the training". What naivety. Our residents should absolutely unionize and demand better working conditions, benefits and pay. Just think about how much that PA or NP would be paid to do a fraction of what a resident does.

Nurses, PAs, and attending physicians can easily switch jobs if they don’t like their current job. Residents do not have that option and hospitals take advantage of it. That’s why residents don’t make over $200k/yr. Is a PGY-7 neurosurgery chief resident who’s published over 100 papers while working crazy hours really worth $90k/yr?

 

[coffeebythelake]

There is more wrong with medicine than just the business people. The entire foundation of the payment FFS system is flawed beyond redemption. No specialty should be able to generate multiples of other specialties in revenue. Me taking care of 14 ICU patients shouldn't be the same as 2 days of primary care work or 2 45 minute hip replacements. We need to burn down and rebuild it with more physician participation this time around. They did it in the 80s, we need to do it again.

Hospital and facility fees dwarf all aspects of pay and compensation to physicians. While we can argue over how much one is paid for performing a procedure vs nonprocedural tasks that is squabbling over pennies in the big picture.

 

[chessknt]

Hospital and facility fees dwarf all aspects of pay and compensation to physicians. While we can argue over how much one is paid for performing a procedure vs nonprocedural tasks that is squabbling over pennies in the big picture.

It is a rabbit hole--hospital fees are derived from DRG under the 1983 IPPS rules. These are adjusted using data analysis based on ICD10 codes which are controlled by the AMA which is controlled by surgical subspecialties, cardiologists, and GI. It all comes back to the way they decided to codify medicine in the 80s to control medicare costs and a few subspecialties jumped in and gobbled up most of the pie because they saw the future implications. The fat cat hospital admins came later and definitely share the blame now but the origins of the disparities in healthcare can be traced back to doctors.

The system is so convoluted now you have to essentially dedicate your career to understanding it. It started out as something understandable but is now a poorly differentiated tumor that has metastasized to a third of the GDP. They keep trying to patch it back together but it can't be fixed in it's current iteration IMO.

 

[vector2]

The CT surgery PAs get paid 500k/yr here