Resident physicians at the Detroit Medical Center held a spirited protest outside the Children’s Hospital of Michigan last Thursday to demand better wages, working conditions and lower out-of-pocket health care expenses. The medical school graduates, who are training to become independent doctors, said Tenet Healthcare, which acquired DMC in 2013, was refusing to recognize their newly organized union.
In June, the residents voted by 508-8 to join the Alliance of Resident Physicians, which is affiliated with the American Federation of Teachers. This followed last year’s unionization votes by resident physicians at nearby Wayne State University and emergency room doctors, physician assistants and nurse practitioners at Ascension St. John Hospital on the city’s east side.
The disastrous experience of the pandemic has spurred unionization among residents and fellows throughout the country. The average first-year resident at DMC reportedly makes $59,000 a year, but they regularly work 80-hour weeks and are burdened with massive student loan payments from debts accumulated from eight years or more of undergraduate and medical school studies.
Hospital chains have long opposed unionization, claiming that residents are medical students not employees. It was not until 1999 that the National Labor Relations Board ruled that they should be recognized as employees.
Residents at the protest described chronic levels of understaffing, job overloading and burnout. “Six-figure student loan debt is common,” a young resident in the Neurology Department, told the WSWS. “With the long hours it is difficult for residents to manage their life and work while you have this looming debt hanging over you. We feel we’re undervalued and that with all the work we put in, we should be able to get by without the stress of paying our bills. We’ve got stress enough trying to care for our patients.”
She continued: “The Detroit Medical Center is unique. It has to treat anyone regardless of insurance and severity of conditions. We have the most challenging cases, which need more resources, not just medical but housing, social work and insurance needs. But we are severely understaffed in all departments and that puts more pressure on residents to balance all these things that are an extension of care. It is a great challenge to provide the medical care that you want and that patients should get when you literally don’t have the resources.”
The ongoing pandemic, she said, had exacerbated the crisis. “Safety regulations are seemingly non-existent. You can be exposed anywhere in the hospital, especially in the Emergency Department, but you never know. They might take precautions after the fact but you’ve already been exposed to so many infected patients.”
Regarding the incoming Trump administration, she said, “We already face so many challenges, and I only see more barriers, hurdles and obstacles to providing people with their basic needs when Trump comes in, whether its women’s needs or basic health care. People at DMC will suffer the most. It will only add to the stress and the burnout we are already suffering.
“For-profit medicine is hurting everyone. Medications are not covered, there are tests the hospitals never do and delays and that only prolong the medical care we are trying to provide. That prolongs hospital stays, makes patient more prone to getting infections and getting sicker, not better. Health care has to be a human right for everyone.”
Another resident told the WSWS, “At lot of people within the administration do things more for profit, not what is best for the patients. There’s plenty of stories where orders aren’t carried out or nurses aren’t aware of something going on with their patient because they’re too busy taking care of other patients. It’s not due to lack of trying, but the lack of staff. You can only be in one place at one time and when you have 15 patients to take care of on the floor it is impossible to do that.”
In Detroit, 30 percent of the population lives below the official poverty line. Nearly 10 percent are uninsured while more than half of the city’s residents rely on Medicare, Medicaid or the Children’s Health Insurance Program (CHIP) for medical care.
DMC officially became a for-profit health care system in 2010 when it was taken over by Vanguard Health System. In 2013, DMC was acquired for $1.8 billion by Tenet, which claimed it would continue the hospital’s commitment to so-called charity care. Instead, it slashed its spending on indigent patients by 98 percent in the first five years of ownership, according to a 2018 report by the Michigan Nurses Association, with spending falling from $23 million in 2013 to just $470,000 in 2016.
In 2020, Tenet received $850 million in pandemic relief grants from the US Congress. Despite reporting $3.1 billion in profits that year and paying its top executive Ronald Rittenmeyer $16.7 million in total compensation during the first year of the pandemic, Tenet cut spending by $377 million. The savage cost-cutting provoked the longest health care strike in Massachusetts history. The 301-day walkout by hundreds of nurses at St. Vincent Hospital nurses in Worcester was isolated by the Massachusetts Nurses Association and other unions and was defeated.
The struggle by the DMC resident physicians deserves the support of workers throughout the metro Detroit area. But a warning must be made: the American Federation of Teachers bureaucracy has no intention of waging the type of struggle against the health care monopoly that is required to end these oppressive conditions.
At Michigan Medicine in Ann Arbor, officials from the AFT-aligned United Michigan Medicine Allied Professionals (UMMAP) have repeatedly blocked collective action by 4,500 medical technicians who are fighting for their first contract. Last month, UMMAP officials called off a one-day strike, claiming they had reached a “memorandum of understanding” with Michigan Medicine that creates a “framework” for contract negotiations.
Radiological professionals, physical therapists, lab and medical assistants, rehab and social workers and other clinical technicians had voted by 98 percent to authorize the walkout. But UMMAP officials ignored the vote without achieving any of the workers’ demands for improved wages, benefits and working conditions.
Detroit public school educators have also had bitter experiences with the Detroit Federation of Teachers, which has collaborated with the city’s Democratic Party establishment for decades in the shutdown of schools and the carrying out of mass layoffs.
AFT President Randi Weingarten, who pulled in $499,874 in salary and other compensation in 2024 is a staunch defender of the capitalist profit system that stands behind the exploitation of workers in the healthcare industry. She is also a supporter of the wars promoted by the Democratic Party in the Middle East and against Russia.
Rank-and-file resident physicians must take the conduct of the struggle into their own hands through the formation of rank-and-file committees. These committees, controlled by the residents themselves, must unite with health care, auto, education and other workers in Detroit to break the resistance of Tenet Healthcare to their demands.