Medical residents have fewer labor protections than Chinese factory workers. While labor abuses at Apple’s factories make headlines, few people are as concerned about the lack of protections for doctors and medical students here in the United States. As a resident, I was subject to some of the worst abuses – intentionally misreported time sheets and gender-based discrimination – and after I complained, I was fired, so I sued the hospital and won. Through this experience, I learned that there are very few laws protecting medical residents, and that for all of the regulation pertaining to healthcare itself, there is little effort to protect the medical workers themselves. If medical reform is going to happen now, then there needs to be reform for medical education as well and laws to protect medical residents.
It should surprise no one that there is a lack of outrage about the abuses inherent in the medical residency system. Doctors have job security, earn a hefty salary, and frequently come from more well-to-do families. Furthermore, doctors are frequently criticized for not listening and keeping patients waiting too long. Truth be told, patients who express these complaints are not entirely wrong; however, much of the blame should not be placed on the physician, but rather on our medical system and training. Our current residency system is not designed to produce humane physicians; instead, doctors simply reflect the culture in which they have been educated.
The contrast between labor laws that pertain to medical residents and Chinese factory workers is stark. In 2003, the first regulations (for most states) — as opposed to laws with actual enforcement – went into effect, stating that residents could not work more than 80 hours per week. I began my internship that year and worked up to 160 hours per week, though I only reported 80 hours of my time due to the pressure by hospital administration and fellow residents. That year, a fellow intern, Tony, a compassionate doctor, was killed in a single car accident when he fell asleep at the wheel after working too many consecutive hours without sleep. I too have fallen asleep post-call at the wheel when paused at a stop light, only to be startled awake by blaring horns indicating the light change.
Meanwhile, just last month the Fair Labor Association published their recommendations for Foxconn, Apple’s major supplier in China, to address their current production practices. Included in this list was excessive overtime, which had been peaking at 60-70 hours per week, and is now capped at 49 hours per week total including overtime. Another problem cited was the 1.2 million Chinese workers who were not given all of their overtime pay. Complaining about this in residency would be laughable because there is no such thing as overtime pay for a resident.
My internship year was a particularly difficult one, and culminated in my being fired and successfully suing the hospital for labor abuses. Unwilling to be treated like an indentured servant, I complained to my administrators about the work abuses inherent in the program: excessive hours, falsified time sheets, and working too many consecutive hours without sleep. Additionally, as the only female in an internship class of 8, I was on the receiving end of exceedingly hostile abuse, because of my gender, from two male residents as egregious as it was relentless. Because I complained, I was fired. I decided to sue the hospital for wrongful termination, and shockingly, I won. It was a small monetary victory, but a great victory for other residents and interns suffering the same abuses. The program eventually closed. The experience allowed me to realize how little knowledge I had of the legal system. When I decided to sue, I was not quite sure even how to go about submitting a complaint. Fortunately, several excellent attorneys helped me through the process. I learned that there are very few laws protecting medical residents, all of which fall into a gray area that does not allow residents the usual rights of any typical American worker, even a worker in Foxconn’s Chinese factories.
Healthcare is a highly regulated industry, and currently undergoing tremendous change due to the Affordable Care Act and other efforts to reign in the worst abuses of the insurance system. I want to be at the forefront of this change and improve labor laws with regard to medical training. The best way for me to do this is to become more knowledgeable about healthcare law and to help reform laws relating to medical residency training.
In the future, I envision myself practicing as a physician while consulting medical residents on the side. By educating myself on healthcare law, I can prevent future residents from enduring what I experienced in medical training. Where there are no laws in place, I would like to help develop those laws. Additionally, I want to be able to provide medical-legal counsel to residents who are in similar circumstances as I was, protect them from experiencing what I endured, and if necessary provide them with a means to get justice. Medical residents deserve to have rights and labor protections, just as Chinese factory workers deserve to have rights and protection of those rights. Just as our healthcare system is being overhauled, so should medical training and labor laws protecting healthcare providers. As someone who has gone through this process of medical training, I can see clearly how these laws need to be written to prevent the abuses I suffered. Having knowledge of the law will enable me to play a leading role in shaping the future of labor protections for medical residents and interns.
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