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COVID-19 Burn Out Causing More Resident Physicians to Unionize, Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

This is part two of a blog series focusing on the effects of COVID burnout in healthcare professionals. Don’t forget to read part one.

The Problem With Residents’ Working Conditions Existed Long Before the Pandemic.

It’s common for resident physicians to work long hours for relatively low pay. They have little or no ability to determine their schedule and are generally locked into positions for up to seven years. Certainly, medical residents have voiced concerns about their work lives long before the pandemic. Some describe years of grueling schedules, sometimes with 24-hour shifts, including 80-hour workweeks. “Residents were always working crazy hours, then the stress of the pandemic hit them really hard,” John August, a director at Cornell University’s School of Industrial and Labor Relations, is quoted as having said.

To learn more about issues that affect residents and fellow physicians, click here to visit the American Medical Association (AMA) Resident and Fellow Section.

Benefits & Drawbacks of Unionizing.

Medical residents looking to unionize often cite such basics as pay and working conditions as top reasons. For reference, first-year residents earned just under $60,000 on average in 2021, according to a survey done by AAMC. At 80 hours a week, one could calculate that residents could very well be earning less than the minimum wage, according to the AAMC data.

Those unionizing typically say wages are too low, especially given residents’ workload, student loan debt, and the rising cost of living.

Additionally, some residents say that unions can have upsides for hospitals and can also help enhance patient care. Patients deserve physicians who aren’t exhausted and preoccupied with the stress of finances. “To take good care of others, we need to be able to care for ourselves. We love being residents and caring for patients. But we can’t do that well if we neglect ourselves,” said a University of Vermont Medical Center resident.

On the other hand, residents unionizing is not without its potential drawbacks. For hospitals, money is an issue. Although federal funding helps pay residents’ salaries, most training expenses come from hospitals. In many instances, because of the pandemic, those funds are now depleted, said Janis Orlowski, MD, AAMC chief health care officer.

Some worry that unionizing can undermine the connections between residents and the physicians who train them. Another primary concern for hospitals is the threat of a strike; although rare, it has been decades since the last one. Many residents also worry that unionizing could undermine patients’ and communities’ trust in them.

Happy Residents, Happy Patients.

For some healthcare workers, the COVID-19 pandemic solidified the importance of a union. Residents have been on the front lines of care but were not always the first to access PPE or lifesaving vaccines. Others are simply looking for acknowledgment of the sacrifices they’ve made while caring for the country’s most vulnerable patients.

However, one thing remains clear; both sides agree that the goal is to become a good physician and get taken care of in the process.

For more information on residency programs, click here to watch one of our video blogs, and make sure to check out our YouTube page.

Contact Experienced Health Law Attorneys Representing Residents, Fellows, and Medical Students.

The Health Law Firm routinely represents resident physicians, fellows and students, including medical students, dental students, nursing students, pharmacy students, and other healthcare professional students, who have legal problems with their schools or programs. We also represent students, residents, and fellows in investigations, academic probation and suspensions, disciplinary hearings, clinical competence committee (CCC) hearings, and appeals of adverse actions taken against them. The Health Law Firm’s attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Weiner, Stacey. “Thousands of medical residents are unionizing. Here’s what that means for doctors, hospitals, and the patients they serve.” AAMC News. (June 7, 2022). Web.

Kwon, Sarah. “Burned out by COVID and 80-hour workweeks, resident physicians unionize.” Kaiser Health News. (May 27, 2022). Web.

Murphy, Brenden. “Why more resident physicians are looking to unionize.” AMA. (June 28, 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

COVID-19 Burn Out Causing More Resident Physicians to Unionize, Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

This is part one in a blog series focusing on the effects of COVID burnout in healthcare professionals. Be sure to check back for part two.

As you know, residents are new physicians who have recently finished medical school and are spending three to seven years obtaining additional training in a medical specialty. Almost all hospitals practice independently; after all, they are doctors already. And in nearly all hospitals where resident physicians practice, they represent the front line of medical care. On duty all the time, on-call all the time, they are usually the first medical professional to see a new patient who can make a diagnosis and order tests or medications. In addition, resident physicians are generally the first to examine, diagnose, and treat a patient.

In most hospitals, in the past, residents were treated almost as indentured servants, required to work long hours without sleep, pull back-to-back shifts, and remain on call for extensive periods. This was considered a right of passage for resident physicians; a “baptism of fire.” If they couldn’t hack it, they did not deserve to be a physician in the specialty.

More than 80 Hours per Week-a Routine Occurrence.

However, recently (let’s say in the last decade or so), it has been recognized that overworked health professionals cannot provide optimum, safe patient care. This led such organizations as the Accreditation Council for Graduate Medical Education (ACGME), which accredits residency programs in the U.S., to require that such programs and hospitals that residents work in must limit the resident physician’s work hours to no more than 80 (yes, 80) hours per week. It got so bad that at least one state, New York, passed a law stating that it was illegal for resident physicians to work more than 80 hours per week.

However, even before the COVID-19 pandemic, there were hospitals and residency programs that would require their residents to work more than 80 hours a week and to turn in false time sheets showing they had worked fewer. We have had many reports that such programs even meet with their residents before an ACGME inspection (or survey) and tell them they must lie to the investigators (or surveyors) and falsely state they did not work more than 80 hours.

COVID-19 Comes on the Scene.

However, in a real crisis like the COVID-19 pandemic, where patients are coming into hospitals dying right and left, it must be acknowledged that resident physicians and other hospital staff will be working above and beyond the maximum, no matter what. The long hours, the lack of relief, the stress of losing patients, and the stress of exposure to a potentially deadly disease have taken their toll on many resident physicians. Those who have contracted the virus and had to rush their recovery and recuperation to get back to work have, perhaps, suffered the most.

Residents Banding Together to Unionize.

Many resident physicians are now banding together to demand higher wages, better benefits, and working conditions due mainly to the “burnout” they experienced during the COVID-19 pandemic. They join nurses, medical assistants, and other health care workers who are unionizing and threatening to strike. In addition, staffing shortages, the rising cost of living, and the lack of personal protective equipment (PPE) and COVID vaccines have pushed them to their limits.

In some places, New York being a familiar example, resident physicians already had unions representing them in many areas. Now, this is expanding.

Check back soon to read part two of this blog series.

Contact Experienced Health Law Attorneys Representing Residents, Fellows, and Medical Students.

The Health Law Firm routinely represents resident physicians, fellows, and students, including medical students, dental students, nursing students, pharmacy students, and other healthcare professional students, who have legal problems with their schools or programs. We also represent students, residents, and fellows in investigations, academic probation and suspensions, disciplinary hearings, clinical competence committee (CCC) hearings, and appeals of adverse actions taken against them. The Health Law Firm’s attorneys include those board-certified by The Florida Bar in Health Law and licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Weiner, Stacey. “Thousands of medical residents are unionizing. Here’s what that means for doctors, hospitals, and the patients they serve.” AAMC News. (June 7, 2022). Web.

Kwon, Sarah. “Burned out by COVID and 80-hour workweeks, resident physicians unionize.” Kaiser Health News. (May 27, 2022). Web.

Murphy, Brenden. “Why more resident physicians are looking to unionize.” AMA. (June 28, 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, is an attorney with The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

By The Health Law Firm|2024-03-14T09:59:17-04:00October 14, 2023|Categories: Medical Education Law Blog|Tags: appeal of termination by residency program attorney, CCC hearing defense attorney, graduate medical education (GME) program appeal attorney, graduate medical education GME program hearing attorney, legal counsel in graduate medical education (GME) dispute, legal counsel in termination by residency program, legal defense attorney for resident CCC hearing, legal representation for residency fellowship program, legal representation for residency program discrimination, legal representation in residency program adverse action, legal representation in residency program contract termination defense counsel, medical school litigation legal counsel, residency fellowship program hearing attorney, residency fellowship program termination hearing lawyer, residency program adverse action appeal attorney, residency program adverse action defense attorney, residency program contract termination defense attorney, residency program grievance attorney, residency program legal dispute attorney, residency program litigation attorney, resident physician defense attorney, resident physician suspension probation defense attorney, reviews of The Health Law Firm attorneys, The Health Law Firm reviews|Comments Off

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

I am writing to break the news to many of you: No, it is not appropriate to touch any of your co-workers in the workplace, nor to hug them, nor to give them back-rubs or massages, nor to pat them on the butt! I know, breaking news, huh?

The reason that I am writing this blog is that most recently, and I am speaking about within the last two months here in September 2023, we have had calls from three different resident physicians and fellows, getting booted out of their graduate medical education (GME) programs for the unwanted touching of other residents or fellows or hospital employees. And they were not all males.

Nothing Learned from the #MeToo Movement?

Despite all the publicity given to the #MeToo Movement, and with the television and social media full of individuals being prosecuted criminally and sued civilly, there still seem to be a large number of residents and fellows who do not understand. No touching means no touching. Weren’t you taught that in elementary school, I mean kindergarten, I mean pre-school, like I was?

Just because someone does not immediately jump up and slap you or punch you when you come up behind him and start giving him a “shoulder rub” or “neck massage” does not mean he has consented to it, wants it or is okay with it. Keep your hands to yourself.

Add to the Things You Learned in Grade School That Are Still Rules to Live by.

Everyone learned many, many rules in grade school that are life’s lessons that should be remembered and observed no matter where you are, when you are or how old you are. These include lessons such as: “Don’t lie” (granted, many politicians seem to have forgotten this lesson, but maybe prison will help them remember); and “If you take something out, put it back where you got it.”

These rules are the ones I am writing about here. Common sense? Apparently not for all! These apply regardless of the sex of the parties.

1.It is not okay to give someone a neck or shoulder massage because they “look tense.”

2.It is not okay to give someone a hug because they look sad or “look like they need a hug.”

3.It is not okay to touch someone’s hips or back to show them you want them to move out of your way or just because you are near them.

4.It is not okay to give someone a welcome kiss because you are glad to see them (after all, we are not living in France).

5.It is not okay to slap someone on the butt, despite how big of a jock he is (I would probably grant an exception if this occurs on the football field or rugby pitch while everyone is in uniform, while the game is still in progress, but no place else; and definitely a kiss would be inappropriate!).

6.It is not okay to take the other person’s hand, rub the other person’s back, lay your hand on the other person’s thigh, or rub the other person’s ______ (fill in the blank, anything can go here).

A Battery is a Battery!

Any unwanted touching of any kind is considered a battery. You can be sued for it. You can be prosecuted criminally for it. You can be fired for it. So don’t be surprised when that happens.

How You Can Tell the Other Person Wants the Touching?

How do you know whether the other person wants the touching? That’s easy. They will tell you in no uncertain terms, using very specific language: “I want you to massage my neck” or “I want you to slap my butt” or “I want you to give me a hug.” For example, if you will recall the totally fictional character Hotlips O’Houlihan in the film “Mash,” who stated: “Oh, Frank, my lips are hot! Kiss my hot lips!” But remember, that scene did not take place in the workplace.

Also, this won’t be a request which the other person makes nonverbally or by “a look” or by an indirect comment or insinuation or by “flirting.” Just because you believe you are God’s gift to the other sex or other person does not mean you really are. Just because you believe that you can tell when the other person really wants to have some romance with you without them even having to say it, does not mean that you are correct. “No” means “no,” especially when it is not a specific “Yes.”

Direct and specific. Otherwise, JUST ASSUME THAT THEY DO NOT WANT IT and you will be okay. Also, just because that might happen one time (miracles being miracles) does not grant you an unlimited license to hug, kiss, rub or slap a butt all the time, anytime, anywhere, and especially not at work.

You won’t get sued because you failed to give someone a hug that needed it (Heimlich maneuvers excepted). You won’t get prosecuted criminally because you failed to give someone a hug who needed it. You won’t have a Title IX complaint or sexual harassment complaint filed against you because you failed to give someone a hug who needed it. You won’t get fired because you failed to give someone a hug who needed it.

Especially Keep Up Boundaries with Subordinates.

If the other person is a subordinate, then you must still make sure you create, maintain and keep your professional boundaries. Just because your junior resident says he needs you to kiss his lips, does not mean you should do this; in fact, you shouldn’t. Just because your ultrasound technician tells you she needs you to give her a hug, does not mean you should do this; in fact, you shouldn’t. Just because your favorite nurse tells you that he is your favorite nurse and to “kiss me you fool,” does not mean you should do this; in fact, you should not. And again, the foregoing goes triple in the workplace.

So, Just Keep Your Hands to Yourself!

So, just keep your hands (as well as other body parts for you pervs out there who may interpret this warning too literally) to yourself, especially in the workplace!

If you are unable to keep your hands to yourself, then you have some serious impulse control issues and you need some heavy duty psychiatric or psychological treatment to cure this.

If you are unable to distinguish the boundaries between workplace and social settings, then you have some serious professional boundary issues, and you need some deep education, counseling and behavior modification therapy.

If you believe you can read the other person’s mind and can receive those secret brain signals that tell you that he or she really, really wants you badly, man (or woman) you need some help.

If you are unable to control yourself to the extent that you violate the warnings I am providing in this article (though they be written with a certain degree of humor and sarcasm), then you are in for a very rude awakening. It is just a matter of time.

Don’t allow your professional career to be ruined by a lack of self-control. Control yourself. No one else can.

We are here if you need us.

However, if you get into trouble with your graduate medical education program, medical school, hospital or employer because of being a little too “handsy” or because of unprofessional conduct or boundary issues, contact us right away. We are familiar with such problems and may be able to help, if it’s not already too late.

To read one of my prior blogs, including 16 helpful tips to avoid sexual harassment complaints and allegations, click here.

Contact Experienced Health Law Attorneys Representing Medical Students, Residents, and Fellows.

The Health Law Firm routinely represents students, including medical students, dental students, nursing students, pharmacy students, resident physicians, and fellows, who have legal problems with their schools or programs. We also represent students, residents, and fellows in investigations, academic probation and suspensions, disciplinary hearings, clinical competence committee (CCC) hearings, and appeals of adverse actions taken against them. The Health Law Firm’s attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.

Don’t Get Labeled as a “Problem Resident” for Disputes With Your Medical Education Program: Prepare to Identify and Address Problems

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A resident physician has a tough life while working to become specialized in a medical specialty, especially in the more complex ones. Try to make it less complicated instead of more complicated.

Residents are In Two Different Positions: An Academic Position and an Employee Position.

Residents actually serve in two different positions. One position is as a learner in an academic situation, similar to a student, pursuing post-graduate training and education in an accredited graduate medical education (GME) program. The second position is as a full-time employee, paid to take care of patients in hospitals and other institutions, with a workweek often approaching or exceeding 80 hours a week. Residency training programs may range from three years to six years in length, depending on the medical specialty.

Because of the difficulty of balancing full-time work and full-time academic learning, often while dealing with family, health, and other outside problems, residents often run into difficulties with their GME programs. This may be due to personality conflicts with a program director or attending physician, cultural or religious differences, learning disabilities or other health or physical problems, outside family obligations, a bad fit with the particular program, differences in medical school training, or many other reasons.

The potential resident should attempt to identify what these might be before starting a program and seek to avoid these at any cost. This may be easier said than done, but you must identify the problem before you can fix it.

It Is Important to Know Your Rights and Take Appropriate Actions.

Understanding your due process rights and other legal rights, as well as your program’s grievance and complaint procedures, is crucial in handling serious problems after you are in a program. However, you should always seek to work out your problems informally, seeking advice from and using the resources made available for residents. These resources may include Employee Assistance Programs (EAPs), psychological and mental health counseling, the availability of mentors and tutors, the institution’s office for equity, inclusion, and diversity (which may go under different names at different institutions). Request extra tutoring and specialty courses that may be available to help you cope. Seek to eliminate areas of contention or disagreement and to increase areas of commonality and agreement. Seek at all costs to get along with others and work up to expectations.

However, if all efforts fail, then you do have abundant legal rights to protect yourself no matter what program you are in. The Accreditation Commission for Graduate Medical Education (ACGME) requires that all accredited GME programs have written policies and procedures in place that provide various rights to residents. These include, for example, the right to file grievances (complaints) when the resident is wronged and these must be formally investigated by the institutions. You will have what the ACGME calls “Due Process” rights (e.g., the right to legal representation, the right to adequate notice, the right to have a fair hearing, etc.) in connection with any type of adverse action taken against you. You will also have the right to appeal adverse decisions, the right to be free of discrimination and harassment, and other valuable rights all ACGME accredited programs must-have.

Obtain and Review All Program Manuals and Handbooks.

The resident should always obtain and review the documents that govern their programs. These are often only mentioned or reviewed in passing during orientation. You should obtain copies of these, review them and save them on your computer. You may not be able to freely access these at the time you actually need them.

Such documents may “GME Handbook,” “Residency Program Manual,” “House Staff Manual,” “Resident Policies and Procedures,” or variations on these names. Your actual resident contract or house staff contract may also have certain rights spelled out in it.

But, as an employee of the hospital or institution, you also have all of the same rights as an employee of any large organization. These may be spelled out in an Employee Handbook. But they will definitely be spelled out in your state’s employment laws. The right to work free of discrimination based on race, national origin, religion, gender, and disability, will be among these.

Take Action to Protect Your Rights and Your Career.

Seek the advice of experienced health care legal counsel at the earliest possible time, even if only to review your options and help decide on a course of action. If you receive a written counseling, remediation, performance improvement plan (PIP) corrective action plan (CAP), suspension, or probation, seek legal advice from an attorney experience with graduate medical education programs. At the very least, consult on how to respond and what to do next to be prepared.

These problems and issues are ones for a board-certified healthcare lawyer familiar with such programs, not an employment lawyer, contract lawyer, trial lawyer, or criminal defense lawyer. Know the difference.

Click here to read about the qualifications of a board-certified healthcare lawyer.

For more information, visit our YouTube page and watch our latest video on residency program disputes.

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent other health providers in investigations, regulatory matters, licensing issues, litigation, inspections, and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies. Its attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Our attorneys can represent you anywhere in the U.S. and anywhere in Florida.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Call (407) 331-6620 or Toll-free (888) 331-6620

graduate medical education GME program hearing attorney

COVID-19 Burn Out Causing More Resident Physicians to Unionize, Part 2

COVID-19 Burn Out Causing More Resident Physicians to Unionize, Part 1

Resident Physicians and Fellows: No, it Is Not Alright to Hug or Touch Others! Important Lessons Regarding Boundaries in the Workplace

Don’t Get Labeled as a “Problem Resident” for Disputes With Your Medical Education Program: Prepare to Identify and Address Problems