The only thing that’s constant in healthcare right now is change. Hospital systems are merging or restructuring, residency programs are downsizing or closing, and our career possibilities post-residency are looking much different than they did just a few years ago.
In New York City, we are seeing a major seismic shift as a giant hospital system takes over a smaller system to become one of the largest teaching hospitals in the country. Mergers mean services are consolidated or downsized, staff are laid off, and in some cases our patients are at a disadvantage because they’re losing their hospital.
CIR is also changing – we’re growing! Within the past few months, 800 residents have joined our ranks in three newly organized chapters, and there are additional organizing efforts underway that will bring hundreds more new voices into our union.
Residents at UC Irvine wanted the clout and expertise of a national union as they went through the legal process of gaining recognitionAfter two years of meetings, hearings, and lobbying elected officials, they became an official CIR bargaining unit in February. This is a huge milestone for the nearly 600 housestaff who will be represented and for their colleagues in other academic medical centers, who face many of the same challenges.
At the same time, residents at Dignity Health’s California Hospital in Los Angeles have begun to bargain their first CIR contract after a unanimous vote in favor of joining CIR in late December.
And most recently, 142 Elmhurst Hospital residents in Queens, New York won a decisive victory, despite arguments by their employer, Mount Sinai Medical School, that residents are “more akin to graduate students” than to employees.
The challenges of growing our union in the midst of mergers, cutbacks and restructuring of healthcare systems are daunting. But the good news is, we have a solid foundation to address the underlying causes of the crisis.
Much of the hospital consolidation we’re seeing is driven by the rising costs of healthcare. CIR is tackling the cost curve, often in collaboration with hospital management. We’re helping residents become more engaged in Quality Improvement and driving initiatives to decrease costs of care while improving patient outcomes and overall patient – and provider – satisfaction.
On another front, CIR members are addressing the root causes of illness with the Healthy Bronx Initiative’s Family Health Challenge, which brings doctors into schools to teach children about nutrition, fitness and barriers to good health. A poster of that project was just presented at the ACGME’s annual education conference and is a national model for resident involvement in the fight against health disparities.
I’m very proud to have been part of CIR these past six years as we’ve shaped the union’s agenda and forged a vision of how we can transform our hospitals and our healthcare system. I’d like to thank everyone for a great year and for being true pioneers. We’ve developed robust QI programs, forums for Women in Medicine discussions, and a legislative agenda that focuses on our members’ and our patients’ needs.
I look forward to the year ahead and hope the articles in this issue of Vitals about residents finding their voice in the midst of these challenges will inspire you to take up the charge and become more involved in the coming year too.