Working conditions Pros and cons of joining a labor union in residency: Is it really worth it? The rate of residents organizing union campaigns has nearly tripled since the beginning of the pandemic. Jan. 3, 2023TuesdayJanuary 2023 issue Resident Notebook Kawther Elsouri, OMS III Student Doctor Elsouri attends the Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine in Fort Lauderdale, Florida. Contact Student Doctor Elsouri
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As an attending surgeon, I find even the concept of unionization for residents to be shameful. Residents should remain focused on continued improvement and appreciate that no matter the investment in time and effort, they will still struggle to learn all they need to successfully practice. Unionization is not only a waste.of resources in time and effort put to much, much better use, but at the end of the day adds yet another layer of cost to an already overburdened educational system. Nurses want to unionize and hold employers hostage for more agreeable employment terms? Let them. Doctors are above that. Jan. 26, 2023, at 10:28 am Reply
Hard disagree. Physician lifestyle has degraded so much in the last 20 years. Tuition and student loan interest rates exploded. Average med school debt without parents paying for it is now 300k not including undergrad loans. Cost of living has gone up, while both resident and attending salaries can barely keep pace. Hospital systems and organization and private equity have snapped up so much clinics that Private practice makes like what, 25-35% of doctors now, and is diminishing with each year. Unionizing is the only way we have to even begin to fight back. I find it shameful that residents are continually abused and younger doctors placed in worse and worse situations. Jan. 26, 2023, at 4:06 pm Reply
If they will struggle to learn all they need to successfully practice regardless, shouldn’t there be an obligation to care for the mental health of residents and prevent burnout/depression? Ignoring those problems is why people in health care suffer or leave the profession altogether. What’s more, more people would JOIN the profession and help the overburdened system if there were better conditions for all healthcare workers Jan. 26, 2023, at 8:24 pm Reply
Hi Dr Blair, I find your perspective very admirable, as I do believe physicians, to a great extent, do embody one of the highest ideals in the provision of medical care. In training, whether directly or indirectly, we learn that patients come first, but that means that something must come second, third and fourth. Does that mean our personal health, sleep, spending time with our families and having “downtime” should never come in first? If so, when can we treat ourselves first? I think this movement really speaks more to the fact that new trainees and attendings want to be taken seriously, versus discounted by the large hospital systems we almost certainly work for. Sometimes that power comes in groups. Is this the right path to be able to come to the boardroom table with hospital executives? Only time will tell, but I can tell you many, many hospital systems and insurance company executives (United Healthcare…) that have made plenty of $ during the pandemic, one of the greatest challenges to our profession in this generation. Maybe physicians and residents are tired of being the sacrificial lamb? This will be interesting to follow. Jan. 27, 2023, at 7:34 am Reply
Dr. Blair’s comments are exactly why union representation in residency is so important. No one is holding hospital systems “hostage” by demanding sane, humane work conditions. Resident unions help ensure residents *can* learn all they need to successfully practice because policies such as duty hour limits can be in place. The current resident system is broken and the onus falls on residents. Hospitals are supposed to be able to run completely without resident support, ensuring that the TRAINING we are actually in is just that, not cheap labor to be exploited. How many hospitals can honestly say they can run without residents if we were to disappear tomorrow? Health corporations won’t simply change because we want them to. We need to force change and unions are one method to do so. Jan. 26, 2023, at 9:31 pm Reply
Unionization of residency programs will not result in stopping physician suicide, reducing student debt or improving the mental health of medical students. Unionization in some cases may result in increased pay and/or an improved work environment. This may also (in some cases) be obtained by interns and residents appointing one of their peers to address the issues with training chiefs and administrators. Unfortunately neither approach may be successful. The difference is that one approach represents trainees as labor and the other as emerging professionals. Whether you approach negotiations as a labor force or a professional force you will begin dialogue which may in time result in positive change. My hope is that you as physicians in training will view yourselves as a professional group instead of presenting as craftspeople, tradespeople or laborers. I loved practicing my profession, hopefully you will also. Jan. 28, 2023, at 4:06 pm Reply