Unionization in Residency

[Lawpy]

Worth a read

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

Inflation and worker shortage are two reasons of many motivating residents to unionize.

The article talks about unionization efforts happening at Stanford

Thoughts?

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[Lawpy]

Physicians filed a class-action lawsuit in 2002 alleging that the matching program violated antitrust laws because it allowed for lower-than-competitive wages and exploitative working conditions. The case was dismissed two years later after Congress granted an antitrust exemption to the residency matching program.

 

[Lawpy]

Association Between Resident Labor Union Participation andSurgical Resident Well-being

This survey study evaluates the association of resident physician unions with burnout, suicidality, job satisfaction, duty hour violations, mistreatment, educational environment, salary, and benefits among surgical residents in the US.

jamanetwork.com

 

[Darrow O'Lykos]

The case was dismissed two years later after Congress granted an antitrust exemption to the residency matching program.

I might be cynical, but I don't see congress bothering to even discuss lifting that exemption, especially if GME programs lobby in favor of keeping the exemption in place. I would love to be wrong though.

 

[DarkBluMage]

Anyone want to copy/paste the article?

 

[Green_Goose]

Lol I can't help but not be surprised at all by the typical WSJ Boomer commenters complaining about how 'soft' the current generation is for wanting improved working conditions. "I was treated worse than an animal and was happy about it, and you young whippersnappers should be too!!!"

 

[Rapsidy]

I say this as someone who in many circumstances doesn’t believe in unionization, especially government unionization due to living in a state who’s union pension debt is so high we’re likely to be the first state to declare bankruptcy at the federal level. It’s so bad it has its own Wikipedia Illinois pension crisis - Wikipedia

But because residents are legally not even allowed to engage in free market practices (negotiating salary, hours, vacation, getting a different job with better benefits) I strongly support residency unions mostly because there isn’t a lot of protection for residents in malignant residencies.

Who is actually going to report being worked 120 hours a week and only paid for 80 when the cost of reporting may be the residency being forced to shut down and trying to find a new residency? It hurts the resident just as much as the residency abusing them.

It’s why when I match my number one priority is a residency that cares about their residents.

 

[dpmd]

Did residency at a program that unionized while I was there. We had a residency advisory council who negotiated pay and benefits for the residents before the union. They actually negotiated a better change than the union ended up being able to do so it was basically paying union dues for nothing beyond the free meals served while the union was trying to get residents to unionize.

 

[NeuResurgens]

Lol I can't help but not be surprised at all by the typical WSJ Boomer commenters complaining about how 'soft' the current generation is for wanting improved working conditions. "I was treated worse than an animal and was happy about it, and you young whippersnappers should be too!!!"

These folks are annoying. Never been a fan of the "I had it bad, so you should too" as well as "you have it better than we did, so you have no right to complain about anything" mindsets. Just because things are better than they were doesn't mean they couldn't improve or are even "good." OTOH, you can acknowledge and be grateful for the improvements while still trying to further improve the system.

I feel like the resident union issue is illustrative of a bigger issue: doctors have a way of shooting themselves in the foot with infighting. E.g. Old folks vs. younger, conservatives vs. liberals, specialty vs. specialty and organization vs. organization. And the people benefitting from this infighting are the government, insurance companies and hospital administrators (and to some degree, other allied health professionals). Much easier to defeat a splintered, bickering adversary. It's why the responsibility for billing, coding, finance, all the other paperwork, as well as legal responsibility for patient care are increasingly falling on physicians disproportionately. Like why don't insurance companies bear legal responsibility for the poor outcomes they cause with all this stupid red tape, preauthorizations delaying care, and forcing more of the cost of healthcare onto providers and patients? Partly, because doctors are so disorganized and too busy to fix that and put up a fight. We're having to fight for barely-fair training conditions and our own mentors are often the ones standing in the way. Hard to go to war with the insurance companies when you're working frequent 24s and barely remember your own name half the days, or when you're slogging through progress notes and other paperwork and trying to put the right codes in.

Doctors traditionally are very prideful and I think that ego actually made us easy targets for the current system.

 

[Green_Goose]

These folks are annoying. Never been a fan of the "I had it bad, so you should too" as well as "you have it better than we did, so you have no right to complain about anything" mindsets. Just because things are better than they were doesn't mean they couldn't improve or are even "good." OTOH, you can acknowledge and be grateful for the improvements while still trying to further improve the system.

I feel like the resident union issue is illustrative of a bigger issue: doctors have a way of shooting themselves in the foot with infighting. E.g. Old folks vs. younger, conservatives vs. liberals, specialty vs. specialty and organization vs. organization. And the people benefitting from this infighting are the government, insurance companies and hospital administrators (and to some degree, other allied health professionals). Much easier to defeat a splintered, bickering adversary. It's why the responsibility for billing, coding, finance, all the other paperwork, as well as legal responsibility for patient care are increasingly falling on physicians disproportionately. Like why don't insurance companies bear legal responsibility for the poor outcomes they cause with all this stupid red tape, preauthorizations delaying care, and forcing more of the cost of healthcare onto providers and patients? Partly, because doctors are so disorganized and too busy to fix that and put up a fight. We're having to fight for barely-fair training conditions and our own mentors are often the ones standing in the way. Hard to go to war with the insurance companies when you're working frequent 24s and barely remember your own name half the days, or when you're slogging through progress notes and other paperwork and trying to put the right codes in.

Doctors traditionally are very prideful and I think that ego actually made us easy targets for the current system.

Couldn't have said it better myself

 

[operaman]

Card carrying proud union member here from my past life, but I remain skeptical of residency unions. I have a hard time seeing what they would get me beyond what we were able to negotiate just with our house staff council that met with hospital leaders periodically. We got all the same things the article cites other unions have - better pay, safer conditions, more protections, etc - and I didn’t have to pay a bunch of Union dues out of every check.

I think that without a true willingness to conduct a meaningful strike, the unions don’t really have power. And for any right to work state, there’s no way to mandate every resident join and financially support a union either.

I just don’t see unionization as the ideal path for what are ultimately temp jobs. A good working relationship with leadership can accomplish much of the same, and if leadership is terrible then a union won’t fix that anyhow.

 

[CyrilFiggis]

Card carrying proud union member here from my past life, but I remain skeptical of residency unions. I have a hard time seeing what they would get me beyond what we were able to negotiate just with our house staff council that met with hospital leaders periodically. We got all the same things the article cites other unions have - better pay, safer conditions, more protections, etc - and I didn’t have to pay a bunch of Union dues out of every check.

I think that without a true willingness to conduct a meaningful strike, the unions don’t really have power. And for any right to work state, there’s no way to mandate every resident join and financially support a union either.

I just don’t see unionization as the ideal path for what are ultimately temp jobs. A good working relationship with leadership can accomplish much of the same, and if leadership is terrible then a union won’t fix that anyhow.

Every hospital system is different and you were lucky to be at a hospital that welcomed discussions with a residency council. I’ve seen the positive effects of union bargaining vs the prior option. Like I said, every situation is unique and unionization may not be the best for your institution.