If CU and hospitals appreciate residents, they’d grant collective bargaining rights

In the late fall of my first year of medical school, I stood silent at a candlelight vigil. I remember the tealights on the pavement and the name they spelled out. I remember the candles flickering in the wind and the chill in the evening air. I remember the warmth of the flame as I cupped my hand around my own candle to shield it. I remember this student sat for an exam on Monday, only to be memorialized on Friday after dying by suicide.

Perhaps most of all, I remember the smell of formaldehyde clinging to my clothes from the anatomy lab, which many of us had been working in just before the memorial. Classes were held as normal. Everything was business as usual. The material had to be learned, because our upcoming exam would remain as scheduled. The message, though unsaid, was clear: “No matter what happens, you must not stop working.”

I left the courtyard that evening and went on through second year, clinicals and residency. Though I never again found myself in a courtyard vigil, I found a similar pattern of abuse, a similar feeling created by a system that has little regard for the individuals within it.

A medical student nearly dismissed for having a disability.

Another student who couldn’t get time off after her mother’s death from brain cancer.

A laughable 80-hour work week “restriction.”

A resident whose baby was still in the NICU when she had to go back to work.

The list goes on and on.

Resident physicians (or “housestaff” as we call ourselves) are particularly vulnerable to abuse, as we cannot simply leave a job that treats us unfairly. To “match” to a residency is a binding agreement; to transfer is exceptionally difficult. This abuse takes many forms, from inadequate compensation, to unsafe working conditions and long hours, to lack of sufficient family and medical leave policies. It is a near-universal experience for medical trainees.

These issues are not without impact. They are another step toward burnout, and we see this in the good people leaving healthcare in droves. They create dangerous conditions for patients who receive care from exhausted physicians and overburdened nursing staff, ultimately impacting those we strive to help. They contribute to an epidemic of physician and trainee mental health issues and suicide.

The phrase “just quit” is often thrown around when employees complain about working conditions, but for many residents, quitting isn’t an option. Staying, however, can feel daunting.

We entered this field to care for patients, to be there during their worst moments. But that commitment is often used to justify mistreatment — long hours, low pay, and poor conditions — as if the desire to help should be enough to sustain us. The idea that “it’s not just a job” is used to manipulate residents into tolerating conditions that endanger providers and patients alike. Individually, we stand little chance of changing this system. I truly believe the only way we can fix it is by standing together, for housestaff, patients and coworkers alike.

That’s why today, on the first day of the University of Colorado’s Housestaff Appreciation Week, I want to tell CU and hospital leadership to appreciate us by granting the Housestaff Association of the University of Colorado Hospitals (HSA) full unionization with collective bargaining rights.

I have to believe that a health care system in which physicians, especially resident physicians, have a voice, is a health care system that is better for everyone. The student with a disability I mentioned earlier was not dismissed, due in part to collective action and outrage from her class. There is power in numbers, and there is power in unity. We need to organize to wield that power.

I also believe the experiences that push us into medicine are the most human part of it all. The experiences that we bring with us are our greatest pain and our greatest triumph. They are how we connect with our patients, the driving force behind what we do. They are diminished when we cannot treat our patients the way we want to, when we ourselves are treated as cogs in a machine. I believe something better is possible, and I believe giving HSA a permanent seat at the table is an important step to getting there.

As I stand with my colleagues to work toward this goal, I see myself as a child watching medical mistreatment of my beloved younger sister, as a student shielding a candle from the wind. I see the person who wanted to help and wanted to heal more than anything. I see so many others who had the same hopes and dreams, and, while we chose a career of caring, we didn’t choose not to be cared for ourselves.

It’s time for CU and hospital leadership to prioritize our well-being, just as we prioritize the well-being of our patients, and grant us full unionization with collective bargaining rights.