Good afternoon Chair Narcisse, and thank you for holding this valuable hearing today. I am submitting this testimony because the issues of interconnected labor rights, hospitals, and patient outcomes are of high importance to me as Brooklyn Borough President, as they are for millions of people in New York City.
As noted in the Comprehensive Plan for Brooklyn put forth by my office, none of the 15 hospitals located in the Borough have a patient satisfaction rate above the New York state average, and four hospitals were significantly below the average statewide satisfaction rate. This speaks to overarching issues within the hospital system, including problems with the treatment of foundational staff members. Resident physicians work, on average, between 60 and 80 hours per week and are often the first medical professionals patients interact with. Considering their extended workload, improving compensation for this group could address workforce shortages, improve morale, and improve patient satisfaction rates.
The well-being of medical residents is correlated with the well-being of patients. Approximately 50% of resident physicians develop burnout during their training. Physicians experiencing burnout may lead to impaired attention, memory problems, and issues with executive function. This can translate to poorer quality care for patients. Burnout is associated with medical errors and a drop in high-quality patient care.
Inadequate pay and a stressful work environment are two common contributors to burnout. Despite the rising cost of living in New York City, residents at H+H have not received a pay raise since March 2020. The lack of action on this front represents a failure to recognize how medical residents in H+H facilities serve some of our most economically and socially vulnerable neighbors. As a result of this inaction, residents at H+H facilities will be the lowest paid of all residents in New York City’s public and private safety net hospitals by 2025.
Burnout is also associated with numerous poor health outcomes. 1 in 4 resident physicians will develop clinical depression during their training, which is one of the most acute and impactful signs that burnout is occurring. It is unacceptable that suicide is the leading cause of death for male residents and the second leading cause of death for female residents. This is indicative of an issue of systemic devaluation of resident physicians and the critical, multifaceted roles they play in our healthcare system.
This is a dangerous disinvestment that disincentivizes future medical residents, particularly those who want to serve the under-resourced communities from which they come and makes current physicians look to other, often private hospitals that serve a wealthier and whiter client base, employment options at non-H+H hospitals in New York to have their financial needs met.
The lack of pay raise for H+H resident physicians ignores the immense debt the average medical student takes on — $215,000. Black and Brown medical students shoulder a disproportionately high amount of debt from school in comparison to their white peers, which may dissuade physicians from underrepresented backgrounds from joining H+H due to concerns about how they would be able to pay off their student loans. A diverse healthcare workforce is critical for caring for patients. Not only is the quality of care often improved by having a diverse team of medical professionals, but it can also aid in combatting unconscious bias, which can have deadly consequences. Doctors from historically marginalized backgrounds may also bring firsthand knowledge of how our healthcare system often ignores or undermines the experiences of patients.
That H+H hospitals do not compensate physician residents fairly may dissuade medical professionals from starting and maintaining their careers at these valuable institutions. Not only does the average resident physician with both student debt with a demanding weekly schedule, but they also have to consider costs associated with rent and other expenses. To care for New Yorkers, resident physicians must also be cared for.
We must build healthier, more sustainable environments for both physicians and patients. A fair contract is necessary for improved labor rights, patient outcomes, and to create a more equitable future for physician residents at H+H facilities.
Thank you again to Chair Narcisse for holding this oversight hearing and for calling attention to this important issue. We look forward to continuing to work with this Council to improve H+H hospitals in New York.
