Thursday, January 20, 2011

Mayo Foundation for Medical Education and Research v. United States

Congratulations to the Supreme Court for making a decision that is probably firmly based in legal precident yet completely fails to take into account reality.

Look here for the full text: http://www.scotusblog.com/case-files/cases/mayo-foundation-for-medical-education-and-research-v-united-states/

 Resident physicians have a dual role that is mostly work but also contains an extensive educational component, especially during the first year. They are no longer doctors in training, but rather doctors who are pursuing board certification. They are licensed physicians that work on average 80-100 hours a week, attend scheduled educational sessions (usually daily over the noon hour), and occasionally provide indepedant care at facilities other than their primary employment (moonlighting).  Formerly classified as not quite student and not quite employee, this vagueness meant that institutions and residents did not have pay into the social security system prior to 2005.  This is similar to postdoctoral research fellows.  Like residents instead of pay they receive "stipends" that FICA is not withheld from.

Now that residents are "employees", do they have employee rights, the same as other employees in America? The National Labor Relations Board already ruled almost a decade ago that residents could unionize, but so far this phenomena has been limited to a few locations.  As employees, will residents have the right to collectively bargain? Will they be able to renegotiate the pathetic "salaries" that haven't changed in two decades? What about work strikes or slowdowns? What about continuing to work (so that patient care is not affected) but refusing to bill for their work until demands are met? Heck, what about overtime pay?

Perhaps this decision will be the beginning of a change the in power balance between institutions and residents. While certainly not their intention, the Supreme Court might have changed the cheap labor racket that hospitals have been taking advantage of for decades.    

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