Opinion | A Tale of Two Hospitals: Resident Mistreatment and Exploitation

Stanford Health Care

In December 2020, Stanford Health Care rolled out a COVID-19 vaccination plan that excluded nearly all 1,400-plus resident and fellow physicians from eligibility. For the residents and fellows who had been working tirelessly at the frontlines of the pandemic, this was the last straw. In our view, this didn’t appear to be a one-time mistake of some algorithm, but a continued pattern of employer neglect and exploitation of our labor. That’s when we knew we had to start organizing for real power.

A little over a year later, on February 22, 2022, we had gathered supermajority support from our co-workers to unionize with the Committee of Interns and Residents (CIR). However, our request for voluntary recognition from Stanford was denied. In the face of potential anti-union tactics from Stanford, we communicated through our own website and tweetorials, re-centering our mission for a meaningful voice and focusing on widespread support, not only from our own residents, but also from our local elected officials and other labor unions.

The Stanford nurses were some of our biggest supporters — we shared a need for better working conditions to deliver better patient care. They have been unionized for over 50 years, and their collective strength protected them from being stretched even thinner during the pandemic. Is this why Stanford is so afraid of our resident union? Are they so short-sighted as to not realize that bargaining to improve our well-being, our mental health, and the sustainability of our work will pay dividends in improved patient care? We had tried negotiating through the traditional channels, but the system isn’t designed to allow our voice to be heard. Unionizing can give us a structurally empowered voice to have representation in hospital decisions that affect not only us, but our patients too. Despite a tough employer campaign to defeat our union, we won our election 835 to 214 this week.

We’re not alone in this. Following our initial announcement requesting recognition, Keck School of Medicine at University of Southern California and the University of Vermont Medical Center demanded voluntary recognition for their own unions. Both hospitals similarly ignored their residents’ voice by declining the requests for voluntary recognition. While expected, it’s still disappointing to realize the hospital you work for is no different from any other large corporation that tries to suppress the voice of its workers. Resident unions aren’t just about a new economic contract — we need a new social contract. Physicians and other healthcare workers need to have a greater voice in how they’re treated and how patient care is delivered. The brutal nature of medical training often produces a physician who’s been beat down and is just trying to survive, but organizing has reinvigorated our colleagues in a meaningful way. Resident unions are igniting sparks across the country, and it won’t end here — it will create a generation of physicians who feel empowered to change our increasingly corporatized healthcare system.

Greater Lawrence Family Health Center

I can’t say I’m shocked at the many employers who’ve recently denied voluntary union recognition across the country, but I’m still taken aback at how our hospital systems view their workers. Whether a residency program is 40 people or 1,400, our power to have a say in our training and labor is virtually nonexistent. At an institution like mine that professes to support its workers and community, why are simple things like paid parental leave not afforded to all employees? Doesn’t our institution have a responsibility to uphold its values internally rather than just professing progressive values?

This organizing campaign has reminded me why I went into medicine in the first place: To make meaningful changes that improve people’s quality of life. Healthcare workers too deserve a good quality of life. Across our program, we had countless conversations delving into the realities of what it’s like to not have a voice, and we recognized that our individual challenges have been widely felt.

For a small program of 40 residents at a “progressive” institution, we have faced considerable opposition to unionizing. We received pushback from clinic administrators and a surprising number of faculty members who we thought would have been supportive. Several said, “I’m usually pro-union but…” Other faculty members confided they felt afraid to publicly support us after the administration’s negative messaging. But perhaps most discouraging was when our CEO implied we were simply “acting out” rather than taking a moment to ask why we were unionizing or speaking openly about improvements that could be made; at one point he even compared us to “Karens.”

This campaign has been an emotional roller coaster, but it has also been a labor of love. Love for our vocations, our patients, our fellow workers, our communities, and ourselves. We’ve bonded over our jobs and our vision for the future of academic medicine at our institution. The camaraderie that has developed between us, nurses, and other workers in the clinic and hospital who have supported us showed us just how important it is for workers to have power in a healthcare system that fails its employees and patients in so many ways.

On March 15, 2022, we officially won our union. While the hospital’s efforts did manage to turn a few who had initially supported the union, 72% of our unit voted in favor of CIR in an election where every single resident participated. A 100% turnout rate is unprecedented even in a small program. It speaks volumes to how connected we’ve become throughout this process. We are in solidarity with house staff everywhere going public, filing for unionization, and taking the next step toward social progress and justice for academic medicine.

While we don’t know where this new movement in resident unionization will ultimately lead, we know we’re headed in the right direction. Doctors are people too and we must rehumanize medicine for everyone — both our patients and the people who make hospitals run.

Jessie Ge, MD, is a fourth-year urology resident at Stanford Health Care. Rayyan Kamal, MD, is a second-year family medicine resident at Greater Lawrence Family Health Center.