- Interview by
- Sara Wexler
Last week, more than 150 resident physicians at Elmhurst Hospital Center in Queens, New York, staged a three-day walkout. The doctors, who are part of the residency program run by Mount Sinai Health System and are represented by the Committee of Interns and Residents–Service Employees International Union (CIR-SEIU), ended the strike on Wednesday, May 24, after securing a tentative agreement.
The strike was the first by hospital doctors in New York City in over three decades. Elmhurst residents say they went on strike to force Mount Sinai back to the bargaining table for new contract negotiations after management had refused to budge on demands including salary increases and hazard pay provisions for situations like the COVID-19 pandemic. Jacobin’s Sara Wexler sat down with Joya Dupre, a second-year resident at Elmhurst and a CIR delegate, to discuss the union’s demands and the strike.
This was the first hospital doctors’ strike in more than thirty years in New York City. What sparked the decision to go on strike?
We are unionized; we have been for fourteen years. Our contract expired in June of last year, so since July 2022, we’ve been in negotiations. We presented our proposals — a lot of time and effort went into this — and we had an initial bargaining session in July. We heard nothing through the rest of the year.
We were quite disappointed. We ended up filing an unfair labor practice suit at the end of 2022 because Mount Sinai had still not come back to the bargaining table. Our big fear was about our residents and fellows who were going to be moving on at the end of our year, which is June. We wanted to make sure that this contract was solidified with a fair deal and fair proposals before they left.
We went back to the bargaining table at the beginning of this year: many, many sessions with, for a long time, very minimal movement in what we wanted. We needed a salary that was going to sustain us. The salary that we had before was not sufficient to pay rent, not sufficient to just do day-to-day things. People really had to struggle. We also were interested in having a transportation solution for the times when we’re leaving a shift late at night and it may be unsafe, or after leaving a very long shift and people might be tired.
We had been trying to get to a point where we felt happy with a contract and Mount Sinai could offer us something, at least in the middle. We had not gotten to that point, and the end of the year was coming. We ended up voting among the union members to see who was willing or not willing to strike.
Prior to this, we had rallies, we did informational picketing, we did other gestures to try to influence Mount Sinai’s decisions. When they came to the table and that didn’t work, we authorized the strike. There was overwhelming support for this strike, and a lot of people came out to vote — 178 members, I believe, at Elmhurst authorized the strike.
We submitted the ten-day notice. We thought that that was going to move the bargaining. It moved it slightly, but ultimately we were bargaining over the weekend, leading up to May 22. I was so hopeful that by May 21, at the very latest, we would come to a decision.
We had a rally on May 21. The Queens borough president came, other city council members came. We had more sessions, and we still could not come to a consensus on a contract. So that’s what led to Monday.
We were picketing Monday, picketing Tuesday and late Tuesday night. We were at the bargaining table, or the virtual bargaining table on Zoom, for many, many hours Tuesday night into Wednesday morning. It was late in the morning on Wednesday that we came to the tentative agreement, and we returned to work Thursday.
How did you all go about organizing to strike? I imagine it’s difficult when you are resident physicians and everyone has crazy schedules.
That was a big hurdle. We usually have many sessions through Zoom, and we have a chat that we all communicate in, and we also communicate via email. There was a lot of that going on in the weeks leading up to voting. We did some informal polls through virtual means first, and then we had an in-person vote that lasted over several days. Then we also had a virtual vote for those people on vacation.
The idea of a strike popped up a long time ago. The first thing that happened was the huge delay in Sinai coming back to the bargaining table. On a very regular basis, people were like, “Joya, what is going on? When is the next bargaining session?” We had been reaching out to them; they kept saying that they didn’t have a date right then and that they were going to get back to us. We always followed up. They never got back to us with any date, and every time we’d get the same excuse.
We tried writing to the doctor who runs our residency program; we wrote and hand-delivered letters to him, demanding him to help us get the bargaining team back together. We did very respectful things in the beginning; every day we were in action or coming up with a new idea for an action.
Then it got to the point of having a rally in front of Elmhurst Hospital. We got some media coverage for that. That was a bit scary for us, because you’re showing your face; your name may come up. When we were getting to that point, I wanted to do what we had to do to make the movement happen.
But then we realized that these things weren’t even working. I was like, “At the rally, they’re going to see us. They’ll see our faces; they’ll see that we mean business.” Nothing happened that night. We went to the bargaining table — there was no change.
Then we moved into informational picketing. That took a long time to convince people to do. We did our first informational picketing at the beginning of April. We had a bargaining session soon after that. No significant change.
Now, it was the middle of April, and we’re like, we have two months to fix this before the fellows are going to lose anything that they could have gotten, the chief residents are going to lose anything that they could have gotten. The preliminary residents who are going on into their specialty after completing one year with us — they’re not ever going to get the benefits that they deserve for this contract. And the contract had been expired since last year.
So, we were like, OK, it it’s now or never. The process even to have a strike is so long. Voting took a week, because like you said, it’s difficult to get residents who work a lot to take a vote. That took a long time.
You have to then decide, when are we going to do this? When is it going to work theoretically? Then you have to give a ten-day notice, and you have to wait that ten days and hope that we don’t get scared and run with our tails between our legs. We didn’t — I was quite proud of that.
We only have six weeks of our year left, but I’m hoping that things will be resolved. The back pay will happen for us. The ratification bonus will happen. All these things will happen before people’s direct deposits expire, and they can have that money in their pockets that we’ve fought so hard for and that I’m sure they need.
Could you describe physicians’ complaints about working conditions and other issues at Elmhurst? What did you all find unacceptable?
I wouldn’t say that this particular fight was for working conditions. We talked about salary; transportation was one of the issues we were talking about. Hazard pay was another big one for us, because we were ground zero for the COVID-19 pandemic. We did not have hazard pay language in our contract, anything like that — it wasn’t addressed. We wanted a hazard pay clause in our contract in the event that something like this were to happen again; we did come to a tentative agreement on that.
Also, residents in their third and fourth years can be chief residents, [which involves] additional duties. Typically, those folks are paid for that, because you have to do your clinical duties, or you’re maybe staying an extra year to do chief duties like making schedules, organizing lectures, and educational things for the residents, answering questions. Also, some chief residents have to work as attending physicians in certain scenarios. They deserve a difference in their salary; we did achieve that. It was a struggle to get that.
I read that there was a pay disparity between the Mount Sinai doctors at Elmhurst Hospital and Mount Sinai doctors in Manhattan, and that this was a big complaint.
The last time we got a raise was in March of 2021. At the time, COVID was still a huge thing. The cost of living wasn’t quite as high, but things since then have changed drastically. The economy is much better; people are back in the city in all the boroughs. Rent is skyrocketing again; the cost of groceries is skyrocketing.
Mount Sinai’s main campus has the same contract as Queens Hospital, where it also runs their residency program. They had a similar salary until recently. Mount Sinai gave their residents at the main campus and at Queens Hospital over by us the raises that they deserved.
So a first-year resident or intern at Elmhurst Hospital would make $68,000, and a Sinai resident or intern at the main campus or Queens Hospital would make $75,000. That disparity would have increased this coming July 1: an intern at Sinai main campus is going to start out making $79,000, and if we were still negotiating this contract, our interns would be making $68,000, a nearly $11,000 difference.
For what reason? We don’t know. Our theory was union busting — they want to prevent the main Mount Sinai campus from unionizing, was the theory. We have no idea if that’s the truth.
Could it have anything to do with the demographics of the patients you’re serving?
I would seriously hope not, but that’s a huge thing. That’s just the elephant in the room. The area in Queens where Elmhurst is probably one of the most diverse places in the world. It’s a largely immigrant population, largely a population that does not speak English, a population of people who may not have ever had health care before, have little access to health care, and face a number of challenges that somebody else in a different neighborhood, in a different borough may not experience, which is why Elmhurst is so special.
You would think that it would behoove management to think about this and that our residents suffer some unique challenges as well. Many of our residents are immigrants; some are on visas. We want to be respected and treated fairly.
How many of you were on strike and out on the picket line? What did the strike feel like?
On the first day, over a hundred people had signed in, and the majority of us had voted in support of the strike. It was a beautiful thing to see so many of us there. Not everybody is physically here because of different rotations. People may be on vacation. I know a few people were also sick.
The night before, I did not sleep. I really didn’t think, even as a delegate, even as somebody who’s had a vital role in this whole bargaining process and getting to this point — I guess I was in denial that we’d have to go on strike. I thought Sinai was going to do the right thing and give us something fair that we could be happy about.
So I was quite stressed the night before, but then I got there, and it was a beautiful thing. It turned out that it was a nice thing to be out there showing our courage, showing our strength, showing that we are a resilient community and that we want to support that.
What did you win in the tentative agreement?
Our demands included an increase in salary over the three-year duration of the contract. We won a 7 percent increase for this year. That’s retroactive to November of last year. And then the second year of the contract, we’ll get a 6 percent increase, and there’s a 5 percent increase in the third year of the contract.
We have hazard pay — they finally agreed that we should have hazard pay in the event of a health care emergency like the pandemic that we just went through. We have a yearly meal allowance. We’ll get a $2,000 ratification bonus.
A transportation committee will be created. We didn’t come to a full agreement on how they were going to help us with transportation in extreme circumstances, which happen more frequently in certain departments. So we’re forming a committee to sort that out.
Some shifts end at an hour when it’s a little dangerous getting home. The transportation is supposed to be for that, in the event that you’re leaving quite late, or especially if you’re leaving late and you’re tired, because some of us do twenty-something-hour shifts at times. If it ends at 10 at night or into the late hours for whatever reason, you want to know, do I have to pay for a $40 Uber, or am I going to have the program cover it for me?
There was an instance where one of the pediatric residents was leaving late. He was tired from a long shift, he wasn’t comfortable taking the subway, and he took another mode of transportation, I believe a bike or a moped. And he was in a horrific accident. He was in the hospital; he had to have major back surgery. He was out from residency for some time. We don’t want something like that to happen to someone if we can prevent it.
Then we have an educational fund. A lot of us want to go on to do fellowships. So a lot of us will go to conferences to present research. These things are expensive: the airfare, the hotel, the cost of making a poster for your research. We used to have separate funds, one fund with CIR, another fund with Mount Sinai. That fund will be combined now, and they gave us a little bit of extra money. We also got the differential in salary for chief residents’ extra duties.
How did the organizing and the strike affect workplace relationships between resident physicians?
I think it strengthened those relationships. [During the strike,] we would see somebody come out of the hospital who was clearly working, and they’d have “Doctor” on their badge. And then someone would say, “This is somebody from psychiatry’s leadership.” And they were so supportive.
There are many medicine departments and specialties, and the whole hospital basically was supporting us throughout the day. We would see nurses that we work with, nurse practitioners that we work with, other ancillary staff, our transporters, our chemistry lab technicians — basically everyone was quite supportive. And we were welcomed back yesterday with open arms.
The nurses’ union came out — they were there from the start. They came on Sunday for our rally, and they were there every day picketing with us. As the movement continues, you’ll see [us supporting] the nurses’ union and other health care workers’ unions as well.
In terms of other programs, unionizing in the area of New York and even beyond that, we’re all interconnected. We had residents from Bellevue, King’s County, Mount Sinai Morningside, and Mount Sinai West, who’ve authorized a strike. They’re in a very similar position to us, and they share our employer, Mount Sinai.
One of their residents, a CIR delegate, spoke at our press conference. I felt like that was a huge thing. He lit a fire and said, “Hey, we’re authorizing a strike today.” So we have a lot of residency and interunion support for sure. We even had someone who is a Starbucks employee who recently unionized at his store who came out.
Do you have any thoughts on why all this labor activity has been happening among doctors lately?
COVID for sure. And I think in general, residents are realizing that they can have a voice through CIR. Little by little, CIR has done so much great work, and they’re getting that exposure that they need. We have a big CIR presence in New York, and now nationwide CIR is getting a lot of attention. A lot of programs are unionizing, and people are seeing it.
I think social media has helped that tremendously. If we didn’t have social media, we probably wouldn’t know a lot about this, because it’s not major news, even though it should be. Social media is helping things travel. Everybody loves to be in organizations with other like-minded people, so many of us are on doctors’ forums or resident forums. You’re finding out about these things through those avenues.
The pandemic [is definitely a reason], because while your program may be solid and while your program might have protected you at one point, the pandemic was an unprecedented time. We just ran out of stuff: we fully ran out of help, out of PPE [personal protective equipment]. If it wasn’t for the union, we would’ve been stuck. Our program leadership was trying to keep the hospital afloat, trying to keep people alive, and unfortunately it came at the expense of what the residents might need. So our union came in to help us, because that’s exactly what a union is for.
What did you learn from your experience going on strike?
I learned that whenever you stick together, you have a stronger voice. It’s important to realize that even residents can do this. I think, largely, if you ask doctors in training or even doctors who’ve completed their training if they felt like they had a voice, the answer would be no. This whole process proves that; I think the answer is a resounding no. But if you have a voice, you can move mountains.