Over a Thousand Doctors at a Bronx Hospital Are Unionizing
A mural honoring health care workers at Montefiore Medical Center in the Bronx is seen on the side of a building in Midtown Manhattan, May 11, 2020. (Timothy A. Clary / AFP via Getty Images)
Medical residents and fellows at Montefiore Medical Center in the Bronx are trying to form a union, citing the need to fight overwork and understaffing that’s endangering patients. Jacobin spoke with unionizing doctors about their organizing drive.
by NOA NESSIM and AUBREY VINH
In early November, medical residents and fellows at Montefiore Medical Center in the Bronx announced that they were seeking to unionize with the Service Employees International Union Committee of Interns and Residents (SEIU CIR). Montefiore is a safety-net hospital, serving lower-income residents of the Bronx; it is also one of the country’s premier training hospitals for new doctors. If the organizing drive is successful, the Montefiore bargaining unit will represent over one thousand doctors.
The doctors who are attempting to unionize Montefiore complain of dangerous overwork and understaffing that is undermining patient care; the hospital has refused to voluntarily recognize the union. Jacobin’s Sara Wexler interviewed Montefiore family medicine resident Noa Nessim and psychiatry resident Aubrey Vinh on Friday, November 18, about why doctors are pushing for unionization and what organizing efforts have been like so far.
SARA WEXLER What made you all decide to unionize?
NOA NESSIM It’s been a long time coming. There’s a very clear need for health care workers who are on the ground every day, seeing how awfully health care can be delivered in this current health care system, to have more power in the decisions that are made about how health care gets delivered and how resources get distributed. That’s at the core of what’s driving a lot of us to unionize — feeling like we need to have more say in our workplace.
AUBREY VINH Something I noticed when I was on the interview trail was that programs that are unionized are so proud of it and have really substantive infrastructure to back what unions bring, not just to residents but also to patient populations and your ability to advocate for patients. So, I had already come to Montefiore knowing that I wanted to be part of the unionizing effort, which I had heard whispers about from talking to current residents.
We’re seeing a lot of labor organization right now and seeing that unionizing is a very powerful tool for advocating within these capitalist [health care] systems.
SARA WEXLER Before you got here, there was already talk of unionizing. It’s been going on for a bit?
NOA NESSIM Yeah. Aubrey started in July of this year; I started my residency in July 2020. At that time, there had already been conversations about it among residents. It was that year, 2020 to 2021, that we started seriously trying to organize a union. And the Committee of Interns and Residents (CIR) came on board to support our efforts around January 2021.
SARA WEXLER What were the main drivers that convinced you and other residents to take on this battle? Was it the hours, pay, and working conditions in general or seeing other residency programs having a union?
AUBREY VINH It was a combination of all those things. Something that I heard of prior to arriving at Montefiore was that the inequities and lack of support for residents revealed by the pandemic got the ball rolling. In terms of an organizing effort, people were speaking out about personal protective equipment (PPE) and about access to vaccinations. That was a tipping point
It’s known among the residents that you have to put in a lot of extra effort to make sure that patient care gets done. It’s a pretty easy starting point when somebody has been on the phone trying to get a patient down for imaging for the better half of a day. You can turn to them and say, “If we had more staffing, this would be different. And that’s something that we would advocate for if we had a union.” Everybody is on board with that.
Also, residency is an inherently coercive system: we all sign a contract that we’re matched to without much chance to advocate for better benefits. Knowing that as a baseline about the residency system, unionizing is pretty intuitive to most people in residency and fellowship programs.
NOA NESSIM Having had conversations across different departments at Montefiore, one of the main problems that comes up over and over again is staffing. It’s not even staffing of residents and fellows, although that is also a problem; it’s staffing of phlebotomists, nurses, CNAs, EKG techs, transport — all of the support systems and all of the workers in the hospital that get things done and carry out the care that we are, in some ways, dictating as doctors.
Without enough staffing of folks that actually make the care happen, it becomes incredibly frustrating and labor-intensive to do our jobs. That’s been, I think, the number-one issue that comes up most consistently. And while I agree that it can be intuitive for a lot of people once the question is asked, I do think that, for a lot of people, the question has not yet been asked.
The way capitalism makes so many workers believe that the way that their job is defined and carried out is normal and ok . . . residents think that working eighty hours a week is normal and not having breaks is normal. But once you raise the question, “Do you think it really has to be like this? What if we could say, ‘We need x number of staff’? What if we say we need to get paid when we get called in to work a shift that someone else was supposed to work but they got sick?” Once you ask that question, it can become very, very clear.
SARA WEXLER How has organizing been so far?