Residents union

[Sebastian.]

---

Members don't see this ad.

Why not?

 

[StevenRF]

The residents' union could join up with the nurses' union and we can have one great big walk out.

 

[Faebinder]

NJ has a resident union... i think its a good idea to expand it to other states.

 

[SergeGainsbourg]

The residents' union could join up with the nurses' union and we can have one great big walk out.

A residents walkout? Imagine if hospitals feared such a thing for even a second. They might even have to give some thought to what resident working conditions are like. How terrible that would be.

It would be amusing to see attendings try to cover their own services without their slaves even for one week. I gaurentee that would be the last time they'd give voice to the myth that they had it harder in their day.

What do you mean you don't get a bunch of hours sleep on call?

What, the nurses don't draw blood or put in IV's anytime I ask?

WTF, I'm phlebotomist, patient transport, social worker, secetary, AND doctor?

Hey, wait a minute. THESE hours DON'T add up to 80. What's THAT about?


Seriously, residents are getting shafted every which way. Some kind of representation would help.

 

[treesap]

We've got a doctor's union here in Australia (at the state level). Its pretty strong and fights for everyone, members and non-members. Last year they decided they were working too many hours, so they lobbied for change.

Now I am rostered for a 38 hour work week, anything over that is overtime. Saturdays are time & a half and Sundays and holidays are double time. Since the normal work week is 40 hours (M-F 8-4:30), some departments choose to pay you OT for the extra 2 hours. However, it was set up so that you "accrue" those hours and get an extra day off every month (pre-scheduled of course).

The downside is that you don't make very much for an hourly wage, but if you work any overtime or weekends, its worth it. There are no shifts longer than 14 hours and admitting is similar to the night float system (you leave at 10pm). Training programs take forever, instead of doing medicine in 3 years, you would be looking at 5-6. Surgical ones run even longer and they do much more overtime every week.

I feel the culture sees doctors differently here. Its a job, like any other, and you can easily be replaced. You probably don't get as much respect as a doctor as you might elsewhere. Its a public hospital and sometimes things don't run smoothly (although of course there's lots of inter-hospital variation). I do way more scut than you do in a US hospital, I have to read my own X-rays, take any bloods after 4pm, etc.

I don't know if I can attribute it all to the doctor's union part of it is just socialized medicine. I've worked in the UK and it is much more similar to that than the US. All that being said, I do like the union. Maybe I get paid less, but its certainly less stressful and I get most of my evenings and weekends free.

I haven't heard of any of the doctor's unions going on strike, but I guess they could if they we're ticked off enough. We are government employees!

 

[8744]

Why not?

Because:

1. I'll be done in two years and nothing will change in time to help me. After two years I won't care.

2. You'll always have the zealots who would work for free if their program asked them to.

3. I don't want to be the one to "bell the cat."

 

[Bitsy3221]

The University of Michigan's residents have a union of sorts--don't know how much it helps other than getting more pay if you have to work weekends or your birthday

 

[dutchman]

Yes why not? All the conditions that make it necessary exist i.e poor work conditions and lack of bargaining power. However for such a union to work, it must first offer protection to it's members. They must make it clear that they are ready to fight any form of witch-hunting by hospitals and attendings against it's activist members by dragging both to court consistently. And yes they have to be ready to use labor's nuclear weapon(walkouts/strike).

 

[3dtp]

Because:

1. I'll be done in two years and nothing will change in time to help me. After two years I won't care.

2. You'll always have the zealots who would work for free if their program asked them to.

3. I don't want to be the one to "bell the cat."

A wise and sage man! Well said, sir!

 

[LovelyRita]

I was just thinking along these lines yesterday, except a complete physician union and of course the ramifications if there was a walkout. I fantasize that our public would see the true value of doctors and that in my fantasy world there would never be talk again of a medicare reimbursement cut. Also, what would it be like for people if they couldn't just use the system? Now, granted, I'm at a place that serves lots of medicare/medicaid/"self-pay" ( <---that's an oxymoron if I ever heard one). What if they didn't have us?

There's 47 different sides to this argument, but it's just a thought that floated by yesterday. 🙄

 

[NDMD]

Why? A union is a horrible idea. If you want to reward the lazy, by all means form a union. Forming a union would be a step in the wrong direction.

 

[Faebinder]

A lot of the major loss of control by the physicians is mainly due to their dependance on a hospital. The private docs outside the hospitals are the reason we haven't gone down on our knees. They make the hospitals want to compete for our services (yes... we are providing a service.. not the other way around...)

That's why private practice makes a lot more money.

But the trend now a days is to become more hospital involved... more hospitalists and specialties that are hospital intensive.

I'm predicting this will stop soon as the private sector will simply take the insured and toss the uninsured over to the hospitals, where hospitals will bill medicare/medicaid. Primary care is more capable of doing this than specialties since they can be more independant that specialties... so in the future we'll see the damage creep over to hospital based specialties (yes dermatologists will escape the damage probably).

 

[dutchman]

Why? A union is a horrible idea. If you want to reward the lazy, by all means form a union. Forming a union would be a step in the wrong direction.

I'll tell you why--because in life if people are allowed to screw you without consequence, they will keep screwing you.

 

[NDMD]

I'll tell you why--because in life if people are allowed to screw you without consequence, they will keep screwing you.

A union is not the answer. It's called standing up for yourself. There's no need to hide behind a union.

 

[nocallaochicas]

A union is not the answer. It's called standing up for yourself. There's no need to hide behind a union.

Please provide two ways that you have 'stood up for yourself' regarding the current discussion topic...and please describe the changes that resulted from your action.
ncc

 

[dutchman]

A union is not the answer. It's called standing up for yourself. There's no need to hide behind a union.

Who are you going to stand up against as a resident doctor? Even nurses will defeat you as it stands today.

 

[8744]

Who are you going to stand up against as a resident doctor? Even nurses will defeat you as it stands today.

This is so true. As a resident you have absolutely no contol at all over your work conditions, your hours, your pay, or anything else. They can dress up the pig and slather it with lipstick (like they did at a certain hospital I will just call "Earl" to avoid the Death From a Thousand Flames) but it is still a pig. You can't even quit and find a better job except through an almost heroic effort. (See my blog, March 2006) Like I said, even the worthy cafeteria lady and the janitor pushing the broom not only make more on an hourly basis but have some protections against abuse.

You'd laugh and quit any other job that treated you so poorly.

About all you can do is try to get into a non-malignant program. My program is pretty cool but even they can't do too much to increase pay, for example.

 

[Colinator]

As an interviewee I pay a great deal of attention to the benefits/perks at different programs. Rush in Chicago has a resident's union, ensuring the best pay in the city. UMich has a resident's union (house staff organization) as well which works out an ensured 3% pay increase each year, works out deals with local realtors for discounts on fees when purchasing a house/condo, deals on dry cleaning, etc. These are only two examples, I'm sure there are more. Every little bit helps. Part of the reason residents feel used and abused is the result of passively accepting the system as is. If you're going to complain, why not make an effort to do something when you can. Command some respect or quit whining.

 

[NDMD]

You open up a totally different bag of worms by bringing a union aboard. Just look at what's happening to GM, Ford, the airline industry, etc. The unions are killing them. Unions were a necessary evil 50 years ago. They aren't needed today. Unions are a dying breed and membership is dropping yearly.

 

[NDMD]

About all you can do is try to get into a non-malignant program. My program is pretty cool but even they can't do too much to increase pay, for example.

I agree. That's the key. A little research means a lot.

 

[oompaloompa]

Because:

1. I'll be done in two years and nothing will change in time to help me. After two years I won't care.

2. You'll always have the zealots who would work for free if their program asked them to.

3. I don't want to be the one to "bell the cat."

I agree with this completely. I was thinking about my whole academic career the other day and you really have to admire how they have systematically broken our spirit. They start out with us jumping through hoops, but once they see how eager we are to do that, then they add the lava pit and the tiger trap. Some examples if I may.....

Required Physics and Calculus - WTF? I don't even trust myself with mental math these days.

The MCAT - many actually believe that most of the knowledge tested is indeed useful for med school. Seriously.

Basic science - the amount of "basic" medical knowledge has increased exponentially in the past 30 thirty years, but its still 2 years of classes. Despite this, you will be derided and called slackers compared to the "good old days."

Clinic years - part observation and scut, part dancing dog show. What more can I say.

I could go on, but I guess my point is that we have been highly trained to accept often ridiculous and completely unconditional assignments for some years now. There is no incentive for the administration to change, and no reason to suspect we have any freewill left to stop them.

Also, like Panda said, what's getting us through the day is the thought that one can tolerate just about anything if you know there's an ending.
Unions are for people who will have a certain role for a lifetime, and therefore a vested interest in making sure said lifetime does not seriously blow. Most people in our situation are more than willing to focus on the light at the end of the tunnel.

Anyway, sorry about all the doom & gloom. Consider it your daily allowence of cynicism.

 

[sirus_virus]

I agree with this completely. I was thinking about my whole academic career the other day and you really have to admire how they have systematically broken our spirit. They start out with us jumping through hoops, but once they see how eager we are to do that, then they add the lava pit and the tiger trap. Some examples if I may.....

Required Physics and Calculus - WTF? I don't even trust myself with mental math these days.

The MCAT - many actually believe that most of the knowledge tested is indeed useful for med school. Seriously.

Basic science - the amount of "basic" medical knowledge has increased exponentially in the past 30 thirty years, but its still 2 years of classes. Despite this, you will be derided and called slackers compared to the "good old days."

Clinic years - part observation and scut, part dancing dog show. What more can I say.

I could go on, but I guess my point is that we have been highly trained to accept often ridiculous and completely unconditional assignments for some years now. There is no incentive for the administration to change, and no reason to suspect we have any freewill left to stop them.

Also, like Panda said, what's getting us through the day is the thought that one can tolerate just about anything if you know there's an ending.
Unions are for people who will have a certain role for a lifetime, and therefore a vested interest in making sure said lifetime does not seriously blow. Most people in our situation are more than willing to focus on the light at the end of the tunnel.

Anyway, sorry about all the doom & gloom. Consider it your daily allowence of cynicism.

The only problem with the sadistic approach to medical education is that it is producing what i call "angry doctors". Anything to change that(and I am not talking about sensitivity training) will help. After ten years of maltreatment, you are probably not going to be the most approachable doctor, and evidence of this can be seen in our hospitals today.

 

[3dtp]

We've got a doctor's union here in Australia (at the state level). Its pretty strong and fights for everyone, members and non-members. Last year they decided they were working too many hours, so they lobbied for change.

Now I am rostered for a 38 hour work week, anything over that is overtime. Saturdays are time & a half and Sundays and holidays are double time. Since the normal work week is 40 hours (M-F 8-4:30), some departments choose to pay you OT for the extra 2 hours. However, it was set up so that you "accrue" those hours and get an extra day off every month (pre-scheduled of course).

The downside is that you don't make very much for an hourly wage, but if you work any overtime or weekends, its worth it. There are no shifts longer than 14 hours and admitting is similar to the night float system (you leave at 10pm). Training programs take forever, instead of doing medicine in 3 years, you would be looking at 5-6. Surgical ones run even longer and they do much more overtime every week.

I feel the culture sees doctors differently here. Its a job, like any other, and you can easily be replaced. You probably don't get as much respect as a doctor as you might elsewhere. Its a public hospital and sometimes things don't run smoothly (although of course there's lots of inter-hospital variation). I do way more scut than you do in a US hospital, I have to read my own X-rays, take any bloods after 4pm, etc.

I don't know if I can attribute it all to the doctor's union part of it is just socialized medicine. I've worked in the UK and it is much more similar to that than the US. All that being said, I do like the union. Maybe I get paid less, but its certainly less stressful and I get most of my evenings and weekends free.

I haven't heard of any of the doctor's unions going on strike, but I guess they could if they we're ticked off enough. We are government employees!

Michigan's residents did in the 80s. They were clever. They saw patients, they went to work, the off duty residents picketed outside and got on TV getting lots of PR, and the guys inside in the clinics, quietly dropped the billing/charge sheets in the trash, leaving the U without billing sheets for a day.

 

[3dtp]

The only problem with the sadistic approach to medical education is that it is producing what i call "angry doctors". Anything to change that(and I am not talking about sensitivity training) will help. After ten years of maltreatment, you are probably not going to be the most approachable doctor, and evidence of this can be seen in our hospitals today.

Agreed, and the cycle of violence, abuse and school yard bullyisms will continue to repeat.

 

[cchoukal]

As an interviewee I pay a great deal of attention to the benefits/perks at different programs. Rush in Chicago has a resident's union, ensuring the best pay in the city. UMich has a resident's union (house staff organization) as well which works out an ensured 3% pay increase each year, works out deals with local realtors for discounts on fees when purchasing a house/condo, deals on dry cleaning, etc. These are only two examples, I'm sure there are more. Every little bit helps. Part of the reason residents feel used and abused is the result of passively accepting the system as is. If you're going to complain, why not make an effort to do something when you can. Command some respect or quit whining.

I can tell you with 100% certainty that Rush's union does not ensure the best pay in the city. I sit on the GMEC at another chicago hospital and, believe it or not, administrators know what everyone else pays their residents, even down to the amount of on-call food dollars and rec center and parking benefits. Northwestern has been ahead of the rest for decades. It's a fine point, to be sure, because most of the Chicago programs are within a few percentage points of each other.

 

[southerndoc]

I do way more scut than you do in a US hospital, I have to read my own X-rays, take any bloods after 4pm, etc.

Reading your own x-rays is scutwork? Good grief, what's next? Will physical exams be scutwork?

 

[southerndoc]

I was just thinking along these lines yesterday, except a complete physician union and of course the ramifications if there was a walkout. I fantasize that our public would see the true value of doctors and that in my fantasy world there would never be talk again of a medicare reimbursement cut.

Yea, stage a walkout. I guarantee you the nurse practitioners will take advantage of this.

 

[gutonc]

Yea, stage a walkout. I guarantee you the nurse practitioners will take advantage of this.

Only if they can work 9-5 w/ double-time for >36h a week or weekend/holiday time. When was the last time you saw an NP or PA in the hopital on the weekend or a holiday?

 

[justwondering]

a union sounds like a good idea

but a walk out is not really feasible. if a system is set up so that they need residents there, the attendings wouldnt be able to cover the icu's, er's, floors and acute visits to the clinic without residents. so it would really be the pts who would suffer and its not their fault.

 

[8744]

a union sounds like a good idea

but a walk out is not really feasible. if a system is set up so that they need residents there, the attendings wouldnt be able to cover the icu's, er's, floors and acute visits to the clinic without residents. so it would really be the pts who would suffer and its not their fault.

Look, I agree with you. I don't think Doctors, police officers, firemen, or air traffic controllers should be allowed to strike. On the other hand, "Patient Care Comes First" is often used as blunt weapon to shut down the debate on work hours, pay, and other resident quality of life issues as in, "We'd like to give you a few weekends off but Patient Care Comes First."

Well, mother-****er, if Patient Care Comes First then I guess my attendings won't mind doing a little more call or covering some of the scut work.

When they say "Patient Care Comes First" what they really mean is "We Have You By The Gonads and By God patient Care Comes Firat As Long As It's Your Sorry, Low-Payed Ass."

I believe that we should work longer hours than most folks and it is important to training. MAybe we don't deserve to be payed better than we are. But quit blowing smoke up my ass. If patient Care Came First nobody would ever get a day off or a vacation and everybody would either live at the hospital full time or take a few patients home with them.

 

[nradsoit3]

If patient Care Came First nobody would ever get a day off or a vacation and everybody would either live at the hospital full time or take a few patients home with them.

Except that I have no room in my 1000 a month shack size studio!!!😱

 

[1bloodyred]

union is a great idea. it should be extended to a doctors union not just resident.

it has nothing to do with lazy people, or finishing your residency. It has to do with ORGANIZED POWER to fight the big institutional power.

You do have to fight for yourself, but one person without backing rarely gets anywhere.

There needs to be an all out physicians union. The pilots have it, the nurses have it, doctors need to have it.

 

[Miami_med]

What is needed is a complete overhaul of the system. A union just further cements the same stupid system. In ANY other profession, there are no rules mandating many years of forced service at controlled wages. Lawyers and engineers and architects don't graduate into special residency programs. Forget unions, just institute free market competition. Let people train in private settings and tear down the ridiculous specter of board certification as a barrier to even the most basic practice of medicine. Why can't doctors work their way up and split when they are ready like any other type of professional doing any other sort of work?