Residents at New York City hospitals seek union recognition

https://mailchi.mp/cfd0577540a3/the-weekly-gist-november-11-2022?e=d1e747d2d8

 Last week, over 1,200 resident physicians and interns at Montefiore Medical Center, one of the largest employers in New York City, with four hospitals in the Bronx, held an organizing vote and requested voluntary recognition of their bargaining unit. The residents organized under the Committee of Interns and Residents, a unit of the Service Employees International Union that claims 22K members and has established unions at five hospitals this year. Roughly seven percent of practicing doctors were unionized as of 2019; that number has grown in the wake of pandemic-induced burnout and industry consolidation. Montefiore Medical Center declined to voluntarily recognize the union and has requested that the union re-form via a secret ballot election.

The Gist: Health system executives may see the possibility of resident unions as another headache amid the ongoing labor crisis, but the drivers of the crisis—burnout, workplace safety concerns, work-life balance, and real-wage erosion—are responsible for the growing appeal of unions for physicians. Fueled by economy-wide stressors, unionization has been growing in nontraditional labor sectors, including among baristas and tech workers, and medical residents may be the next to join that wave.

Health systems worried about resident unionization should address residents’ concerns about working conditions proactively, which may involve reevaluating wages in light of residents’ significant contributions to operational and financial success.  

Physician residents and fellows unionize at two major California health systems

Seeking stronger workplace protections, physician residents and fellows at both Stanford Health Care and the University of Southern California’s (USC) Keck School of Medicine have voted to join the Committee of Interns and Residents, a chapter of the Service Employees International Union (SEIU).

Despite being frontline healthcare workers, most Stanford residents were excluded from the first round of the health system’s COVID vaccine rollout in December 2020. The system ultimately revised its plan to include residents, but the delay damaged Stanford’s relationship with residents, adding momentum to the unionization movement. Meanwhile, Keck’s residents unanimously voted in favor of joining the union, aiming for higher compensation and greater workplace representation.

The Gist: While nurses and other healthcare workers in California, as in many other parts of the country, have been increasingly banding together for higher pay and better working conditions, physician residents and fellows contemplating unionization is a newer trend. 

Physicians-in-training have historically accepted long work hours and low pay as a rite of passage, and have shied away from organizing. But pandemic working conditions, the growing trend of physician employment, and generational shifts in the physician workforce have changed the profession in a multitude of ways. 

Health systems and training programs must actively engage in understanding and supporting the needs of younger doctors, who will soon comprise a majority of the physician workforce.

Medicare overpays hospitals $1B each year for graduate medical education, study finds

https://www.beckershospitalreview.com/payer-issues/medicare-overpays-hospitals-1b-each-year-for-graduate-medical-education-study-finds.html?oly_enc_id=2893H2397267F7G

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Medicare overpaid hospitals about $1.3 billion in 2015 for the government’s Teaching Health Center Graduate Medical Education program, according to a study published in JAMA Internal Medicine.

The Graduate Medical Education rate is $150,000 per resident. While 25 percent of hospitals received less than $106,000 per resident in 2015, 25 percent received more than $182,000 per resident. That same year, nearly half of teaching hospitals got more than $150,000 per resident.

If Medicare GME payments were capped at the $150,000 rate, researchers predict Medicare would save more than $1 billion every year.

“Our study suggests Medicare GME may be overpaying some hospitals up to $1.28 billion annually,” said Candice Chen, MD, lead study author and associate professor of health policy and management at the George Washington University Milken Institute School of Public Health in Washington, D.C. “Those funds could be redirected and used to strengthen the physician workforce, especially in underserved areas.”