Putting maximum pressure on the boss can be difficult when your job involves saving lives, but the resident physicians at the University of Washington have found a way.
This Wednesday at noon, residents and fellows working at hospitals across Seattle will walk off the job for a 15-minute "unity break" to draw attention to the "unacceptable" contract UW is offering its frontline doctors.
Over the phone, University of Washington Housestaff Association (UWHA) president Kellie Satterfield said the union scheduled the strike for lunchtime and advised all residents not to abandon any "obvious emergent medical issues" to ensure that necessary patient care wouldn't be compromised. The residents will strike at the VA, Harborview, University of Washington Medical Center, Seattle Children's Hospital, and the Northgate and Roosevelt clinics.
Residents have been working without a contract since the last one expired on July 1 of this year. The union hopes the demonstration will raise awareness of how vital residents are to the city's hospitals, and to press UW into meeting demands for decent child care coverage, better wages, a housing stipend, and more generous transportation programs.
What Is a Resident?
In case you didn't watch Scrubs—and who could blame you—residents are medical doctors in an apprentice phase. They're the workhorse physicians. Satterfield says residents comprise 20% of the providers in King County, so if you seek care at a clinic or if you see a doctor who isn't "your doctor," chances are good that you're seeing a resident.
The job is hard. Residents work 60 to 80 hours a week with no protected breaks or mealtimes. Many work more than that, opting to take administrative tasks home with them so that they can at least sit next to their dog while they fill out paperwork. According to Satterfield, some hospital shifts go 28 to 36 hours straight depending on call schedules and patient volume. That's an especially troubling number when you consider how little sleep the surgeons must be getting.
The job also comes with constraints. Residents don't get to choose where they live and work for the four to seven years following med school. The "match" system used to pair medical grads with residency programs means an algorithm makes that decision for them. The annual "Match Day" comes in March, leaving residents only three months to find housing and childcare in their new city—two particularly difficult tasks for residents who match at UW.
Rents in Seattle have risen 69% since 2010, and many child care facilities have years-long waitlists. Due to the nature of the job, the university requires some residents to live within 30 minutes of Seattle's major hospitals, which further limits housing and childcare options.
What Do They Want?
UWHA argues that residents receive lower salaries and less vacation compared to peer institutions. Satterfield called resident access to child care "truly horrendous," with the university paying for the equivalent of only two days of child care per year. So they're asking for better raises, at least one month's worth of paid child care, and four weeks vacation. But UW doesn't appear to be budging, and their counterproposals are insulting.
In their last three-year contract, UW agreed to 3% annual raises. This time they're only offering 1% raises for the first two years and then 0% for the third. "They're ultimately proposing a pay cut," said Satterfield.
Resident salary at UW is currently set at $58,200 with another $2,250 in stipends. That number might not bring a tear to your eye, but it's less than $15 per hour on the weeks they work 80 hours. And compared to 50 other large academic programs across the country, the union argues that UW's residents suffer the "lowest rate of compensation proportional to cost of living." Tack on higher housing costs and an average student loan burden of $300-$400 per month, and there's not much in the coffers at the end of the week.
Child care costs directly impact 240 UW residents with children. On average, those residents spend $2,100 on child care, which represents 42% of a first-year resident's monthly salary. Long wait lists mean residents have to luck into slots or else pay nannies, which tend to be more expensive. Satterfield tells a story of one resident couple, both working in surgical specialties, who were suddenly called into work in the middle of the night. They had no one to take care of their newborn and few options at such a late hour, since UW offers no emergency child care services.
UW residents only get four random days off per month and three weeks of vacation per year. So burnout is, as in other industries, a big issue, with some studies showing resident burnout rates as high as 75%.
"Patients suffer for it," Satterfield said, pointing to several other studies showing burnout related to "medical errors and lapses in professionalism."
And the climate change cherry on top of this horrible sundae: in their last proposal UW declined to offer residents a fully subsidized U-PASS and took away bike incentive programs, despite the fact that the university's Campus Master Plan sets the goal of reducing single-occupancy commuters to 12%.
UWHA says this combination of poor compensation and benefits hurts recruiting, which turns top talent away from the program. UW ranks 80th out of 100 large academic medical centers in the country in terms of ability to fill resident spots, according to UWHA's analysis. So if the UW wants to maintain what prestige their program still retains, they'd do well to offer a contract that meets the needs of their doctors.