Physician unions have been active in the last year, as resident physicians face a convergence of financial and work-life-related pressures.
Several medical residents involved with union organizing spoke to Medscape Medical News in an Oct. 7 report. Here are three insights about what resident physicians are hoping to get most out of unionization:
1. Parental leave: According to one 2019 study published in the National Library of Medicine, the average paid parental leave for physicians in the top 50 residency programs in the U.S. was 5.1 weeks.
Most physician residents are in their 20s and 30s — years that many consider starting a family — sparking calls for enhanced parental-leave policies in union contracts. The resident physician union at California Pacific Medical Center, for example, hopes to secure eight weeks of paid parental leave in its contract negotiations. The union also hopes to include access to fertility benefits and reproductive care in the next agreement.
"Our reproductive futures are really hindered by what care we have access to and what care is covered," said A. Taylor Walker, MD, family medicine chief physician at Tufts University School Medicine/Cambridge Health Alliance in Boston. Dr. Taylor is also the national president of the Committee of Interns and Residents, which is a part of the Service Employees International Union.
"We don't make enough money to pay for reproductive care out of pocket."
2. Healthcare: Inadequate health insurance has been a central issue for physician unions, particularly access to mental healthcare that extends beyond the same institution they work for.
"If you can only go to a therapist at your own institution, there is a hesitation to utilize that specialist if that's even offered," Dr. Walker said. "Do you want to go to therapy with a colleague? Probably not."
Expanded primary care coverage is another goal of physician unions. "At my hospital, they're telling us to get Amazon One Medical for health insurance," said Madison Masters, MD, a resident in internal medicine at Mass General Brigham in Boston. "They're saying it's hard for anyone to get primary care coverage here."
3. Compensation: Salary remains a top issue for resident physicians forming unions. Dr. Masters told Medscape that starting salaries at Mass General Brigham are $78,500 plus a $10,000 stipend for housing. At the University of Vermont Medical Center in Burlington, first-year residents recently won a raise in contract negotiations and are paid $71,000 per year instead of $61,000, in addition to a $1,800 stipend for food and another $1,800 to help pay for board exams.
Prior to unionization, Jesse Mostoller, DO, now a third-year pathology resident, recalled hearing about another resident moonlighting as an Uber driver to make ends meet.
"When we were negotiating, the biggest item on our list of demands was to help alleviate the financial pressure residents have been facing for years," he said.