A union means that we are empowered to use our collective voice to effect necessary change in our workplace. Housestaff are traditionally very vulnerable employees – we sign our contract through the Match before even finding out where we will work; we live in fear of retaliation as we cannot easily change workplaces; and we are only here for a few years meaning that the employer can simply wait us out in order to avoid change. The 500P expansion, the vaccine rollout, the COVID surges, and more have all shown us that there is a pattern of the hospital neglecting and exploiting its housestaff employees. Forming our union will ensure we are at the bargaining table, rather than forgotten.
We are organizing not only for a new economic contract – so that every potential housestaff and their families can live here – but also for a new social contract – so that we’re not treated as cheap labor anymore. We need:
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Better working environments
|When we are cheap labor, our working conditions are not a priority to the hospital – meaning we get overlooked for vaccines, we sleep in hallway stretchers because there’s not enough call rooms, and we’re expected to shoulder the increased census from a new hospital without additional support.|
Better patient care
|It’s not safe or fair to patients that their on-call physician is overworked – and therefore underslept and emotionally exhausted – and has to finish up four other consults before they can even be seen. It’s not fair or safe for us either.|
|Current work conditions are driving people to quit because they are unsustainable – we have to take care of our patients, ourselves, and our families, and often we’re not given the time or resources to do all three. We can’t fix burnout by telling people to be more resilient. We need to fix the root institutional issues.|
And a seat at the table
|We can’t get any of this done unless we stand together and demand it from the hospital. A union gives us sustainable leverage and bargaining power – without this, the hospital will just keep ignoring us until we tire out or graduate.|
While the subjects of bargaining will be determined in negotiation after our union is won, here are a few common themes:
|Current situation||Potential wins|
5 days paid. Stanford makes you combine sick leave, disability leave, and vacation to get 100% of your salary for any additional weeks. If you do not qualify for CA state disability/paid family leave (new employee) or have gotten sick or already taken vacation – you cannot use that for salary support for additional parental leave.
Despite this, Stanford insists it is in compliance with the new ACGME requirements to provide 6 weeks of paid parental/caregiver leave.
UCSF/UCLA have 4 weeks paid parental leave; UC Davis and U Michigan has 6 weeks.
The American Academy of Pediatrics advocates for 12 weeks of parental leave. Stanford should be on the leading edge and meet the guidelines of the doctors that it trains. 6 weeks paid leave + 6 weeks disability/family leave supplemented up to 100% = 12 weeks paid leave. Certain specialty board requirements may limit how much someone can actually take, but this is changing in many fields.
|Stanford does not support caregiver leave, and you must rely on CA state paid family leave (PFL) which pays 60% salary, while using your vacation days to supplement your salary. Again, new hires do not immediately qualify for PFL.||Stanford should supplement caregiver leave to 100% salary for at least 6 weeks, to meet minimum ACGME requirements.|
|After years of receiving no retirement benefits, in 2021 (as a response to the collective action around the vaccine), we were given a 2% basic contribution + 2% matching contribution. Every other SHC employee gets 5% basic + at least 5% matching.||Benefits on par with other SHC employees – 5% basic + 5% match.|
|On call coverage for duty hour violations/sick leave|
Currently there is only punitive feedback for accurately reporting duty hours (being chided that it will catch the attention of the ACGME, or being sent home knowing that someone else is taking on your extra work for no pay). Similarly, residents often experience undeserved guilt for taking a sick day, knowing someone will be called off jeopardy or given extra work.
Additionally, the hospital has historically forbidden paid on-call coverage, and even now does not have consistent policies supporting it, citing ‘a slippery slope’ as a reason to not allow departments to pay their residents.
|On call coverage compensation for covering a sick or over-hours colleague’s call.
Example (NYC H+H): Residents working an additional on-call shift receive $418 for a weeknight and $558 for a weekend or holiday shift. They receive $210 for a short call. The hospital contributes $379,474 annually to pay for these additional shifts.
|Housestaff are the lowest priority for on-site childcare at Stanford, with wait times over a year, hours that don’t work with our schedules, and unsubsidized costs exceeding $2,000/month.||Other unions have won reserved access to a proportion of hospital daycare slots (Jackson), and reimbursements of $3,500/year (NYC H+H).|
|Increased housing stipends|
|We receive $7,200/year (pre-tax) in housing stipends. Our PGY 1-4 salaries still place us in the “low income” bracket for Santa Clara County.||UCLA’s union negotiated a $12,000/year housing stipend, and UCSF’s union negotiated $13,200/year.
Additionally, Harvard offers $30k ($10k/year) in housing assistance for economically disadvantaged residents. Such a program would help improve diversity in recruitment, as currently only people who can afford to live here can come to Stanford.
|Increased meal stipends|
|We receive $10 on our paychecks for each 12 hour inpatient shift logged at SHC on MedHub (outpatient shifts do not count). Now that they have started taxing this, the equivalent is $6.50 for a 12 hour shift, which barely covers a small bowl of soup from the cafeteria.||$75/week worked at Stanford, post-tax ($12.50/day x 6 days).
UCLA negotiated $3000/year for meals, with a $25/day UberEats credit for sites without a meal benefit.
|Parking permits cost $35-$116/month to park a 10-15 minute walk from the hospital. Parking in the 500P garage costs $12/day ($300/month).
SHC will not even give free handicapped parking to residents with physical disabilities (they have no legal obligation as the garages are privately owned by Stanford).
|Free parking for staff and patients/visitors. Someone visiting their family member in the ICU can rack up $400/month in parking fees. Stanford needs to stop extracting money from its employees and patients/community.
UCSF’s union successfully fought back against attempts to take away their free weekend/evening parking.
|We have historically received a ~3% cost of living raise each year. Inflation this past year was 7.9%. This raise is not guaranteed anywhere in our contract and the institution could easily stop offering it.||Guaranteed year-to-year raises in our contract, including a larger raise to account for 8% inflation this year.
UCSD got a 6% raise in the first year of their contract, and UC Davis negotiated a 12% wage increase over the first 2 years.
|Patient care funds|
|SHC patients receive differential access to care (e.g. specialty clinic referral from the ED) based on their insurance. Feeling powerless in our current model of medical care leads to significant moral injury.||Other unions have negotiated patient care funds of millions of dollars to allow housestaff to directly deliver care to their patients and community.|
|Stanford has the nation’s first “Chief Wellness Officer”, but we don’t see these efforts extending to housestaff. Funds promised to the GMEC representatives for housestaff wellness events have never materialized.||We can negotiate funds to hold social events and wellness activities for a chance to interact with each other outside of the hospital/consults/admits, to improve camaraderie and overall morale (Alpine Inn??).
UCLA negotiated a $50k/year housestaff wellness fund, and their union advises the GME on its use.