From missed weddings and missed birthdays to stories of other resident physicians almost falling asleep at the wheel while driving home after 28-hour long shifts, Philip Sossenheimer, a third-year resident in internal medicine, says the “reality” of completing a medical residency at Stanford is “grueling.”
Sossenheimer said such experiences aren’t uncommon for residents, who are recent medical school graduates training to be board-certified.doctors. When his wife underwent surgery at Stanford Hospital, Sossenheimer half-jokingly said in an interview with The Daily that despite working through most of it, it was more time than he would usually get to see her.
In their second organized action in the past three years, 250 resident and fellow physicians, known as “housestaff,” from Stanford Health Care (SHC) held a unity break outside the Stanford Medical School to demand a fair labor contract at noon on Wednesday.
Chants of “What’s disgusting? Union busting!” and “Patients Over Profit” were joined by honks from passing cars, garbage trucks and Stanford’s Marguerite shuttle buses. Demonstrators claimed that despite successful unionization, Stanford Hospital administration has engaged in “deliberate acts of union busting” and “unfair labor practices” during bargaining, including hiring a corporate employment lawyer and delaying negotiations for a year.
In a statement to The Daily, Associate Dean of Graduate Medical Education (GME) at Stanford Medicine Laurence Katznelson wrote, “Stanford Health Care (SHC) respects the rights of our housestaff to participate in these kinds of activities as part of ongoing union contract negotiations.”
As of May 2022, Stanford housestaff are organized under the Stanford Housestaff Union and represented by the national Committee of Interns and Residents (CIR), the largest housestaff union in the U.S., representing over 27,000 resident physicians and fellows. The Stanford residents’ walkout in December 2020 following Stanford Medicine’s exclusion of residents and interns from the vaccine rollout garnered national media coverage.
Sossenheimer said housestaff face not only financial stressors including minimal pay and student loan debt, but impacts to personal lives. “We spend more time on clinical documentation than we do on our children,” he said at the unity break.
Despite the difficulties, Sossenheimer said the residents always still show up to work.
“If we can show up under these conditions, why can’t [Stanford] show up for us meaningfully? We are here today to send a clear message to Stanford that we refuse to be treated as cheap and disposable labor,” Sossenheimer said.
David Dupee, a second-year resident in psychiatry and member of the bargaining team, said at the unity break that residents work on average 80 hours per week, impacting both their own and their patients’ wellbeing.
“We know that protecting residents is the same thing as protecting patients,” Dupee said. “As residents, it’s our duty to care for every single person that walks through our doors. And yet…we must exhaust ourselves and sacrifice our own physical and emotional health to do so.”
Katznelson, who is also a physician, wrote that the “SHC bargaining team is committed to the negotiation process and reaching an agreement that supports our housestaff and their continued education and clinical training. To date, we have had nine bargaining sessions, provided a total of 48 proposals and counter proposals to the union, while reaching five tentative agreements.”
Katznelson continued, “During our discussions and/or through our proposals, we continue to reinforce our commitment on a number of important topics, including lactation accommodations, ADA accessibility and fatigue mitigation.”
Natasha Abadilla ’14 M.D. ’21, a second-year resident in pediatric neurology and one of the first organizers of the Housestaff Union, said in a statement to The Daily that Katznelson and GME Executive Director Ann Dohn are the administrators responsible for leading “the union busting drive” during unionization efforts in 2022.
“[Katnelson and Dohn] attend every bargaining session and have heard our asks for salaries commensurate to the work we do, safer and more reliable ways home after 24-26 hour overnight shifts, and accommodations for doctors with disabilities or breast feeding doctors…and they’ve either said no or not provided a formal response to our asks,” Abadilla wrote.
Abadilla, who called herself a “Stanford Lifer” after spending more than a decade at the institution, said she has “been disappointed time and time again” with how Stanford responds to “workers who have tried to advocate for more respect and their rights.”
Dupee said that the Stanford Housestaff Union has “faced continual delays and disrespect from management at the bargaining table.” According to Abadilla, the Housestaff Union proposed their economic asks of salaries and benefits in February, and “management has yet to respond formally to these asks or acknowledge them at all,” despite having twice-monthly bargaining meetings.
“A system that runs on caregivers who are not feeling well-equipped to care for ourselves is a failed system, and a prestigious name should not mean that Stanford can continue [to] exploit its workers,” Abadilla said.
The contract negotiations are primarily directed toward Katznelson, Stanford Hospital and Human Resources administration, but Sossenheimer said that “99 percent” of communications are through the hospital’s third party lawyer, Aaron Agenbroad.
Agenbroad is from Jones Day, a large American law firm known for representing companies against labor unions. In the past, Agenbroad has represented corporate clients including McDonald’s and Chevron to defeat class action and labor lawsuits. In 2014, Agenbroad helped Alameda Health System prevail on a grievance filed by anesthesiologists petitioning to unionize.
The Daily has reached out to Agenbroad for comment.
Kelsey Priest, a second-year resident in psychiatry, said at the unity break that like many other peers in her class, she had begun her residency at the peak of the pandemic and faced “unprecedented” expectations. She said at the unity break that their pay and quality of working conditions did not increase to compensate, though Stanford’s profits did.
“It seems like many academic health care health centers, including Stanford, have prioritized profits over people,” Priest said. “The dark underbelly of corporate medicine has become glaringly evident.”
In the fiscal year of 2021, the University’s health care services revenue increased by 8 percent to $1.4 billion, and Stanford Health Care (SHC)’s net revenue from patient services increased 17 percent to $6.2 billion. The Lucile Salter Packard Children’s Hospital received $2.1 billion in revenue.
“Stanford’s reputation is at risk,” said Simranvir Kaur, a fourth-year resident in Obstetrics & Gynecology and member of the residents’ bargaining team.
“Across the country, residents and fellows are treated as unlimited resources. But the idea of a ‘healthcare hero’ is a myth that perpetuates exploitation and abuse,” Kaur said at the unity break.
Several nurses from Crona, the union for Stanford nurses, also attended in support of the resident physicians. Kate Gardiner, a Post Anesthesia Care Unit (PACU) nurse, said she believes that the “hospital would truly crumble without [the residents].”
“The general public may not know how much the hospital depends” on residents, Abadilla said, as resident and fellow doctors “are most often the first doctors patients see when they’re in the hospital” and “always the doctors they see most often.”
Sossenheimer said that successfully negotiating a labor contract would “set the standard” for residency and fellowship for the rest of the profession.
“This is an opportunity for Stanford, one of the wealthiest and most prestigious healthcare systems in the whole world, to invest in its frontline health care workers so we can take care of our community,” Sossenheimer said. “We are fighting for a health care system that values people over profits and we refuse to settle for less.”
An earlier version of this article incorrectly stated that Priest began her residency at Stanford; Priest completed her intern year at another program. The Daily regrets this error.
This article has been updated to reflect the fact that Kate Gardiner is a Post Anesthesia Care Unit (PACU) nurse, not an anesthesia nurse. The Daily regrets this error.
A previous version of this article once referenced the event as a “walkout,” which can imply housestaff left their assignments to attend. However, the union’s “unity break” by law required that housestaff attend on their own time. The Daily regrets this error.
The vaccine rollout which prompted the Stanford residents’ walkout in December 2020 was conducted by Stanford Medicine, not the University. The Daily regrets this error.
Agenbroad was hired by the hospital, not the University. The Daily regrets this error.