Resident physicians at California-based Kaiser Permanente have recently negotiated a new agreement that includes compensation increases and expanded mental health and wellness employee benefits.
The agreement came after months of negotiations and included salary increases over the next three years, along with more paid time off and enhanced financial support for resident physicians. It also included roughly $40,000 to fuel an annual patient-project fund.
The deal brings much needed support to providers and patients alike, according to Dr. Brandon Anderson, internal medicine resident physician at Kaiser Permanente’s San Francisco Medical Center.
“To tie this with what residents, fellows and resident physicians in palliative care and hospice experience, that training is incredibly difficult,” Anderson told Palliative Care News. “What gets lost in the legitimate struggles of medical training is that you’re worried about paying bills and for things like child care, feeding your family and taking care of your mental health. That can unfortunately get in the way of learning to provide the best care to patients. The biggest benefit of this deal is recognizing that without advocating for providers and ensuring they’re protected, we’re harming our patients.”
Recruitment, retention impacts
Approximately 460 resident physicians at Kaiser Foundation Hospitals across northern California were represented in the negotiations by the Committee of Interns and Residents (CIR), a local of the Service Employees International Union (SEIU).
Under the new agreement, resident physicians could receive up to four weeks of vacation per year and increased sick leave. With clinical rotations lasting six days each week, the expanded paid time off to recharge is deeply appreciated by resident physicians as an incredibly important part of their overall career longevity, Anderson stated.
Higher salary rates in coming years could have meaningful impacts among the workforce in terms of the ability to sustain and remain focused on their careers, he added.
The new agreement’s widened mental health support could have significant effects on future hospice and palliative care clinicians in particular, according to Anderson.
“For some of our residents and fellows this was hugely life-changing,” he said. “We’re really excited to start to tackle all these kinds of systematic forces that make this training difficult. What we hear a lot of in the palliative and hospice care workforce is that you’re working with patients in a vulnerable, critical time. This helps to set the tone early on in their education, and that’s why we’re taking this business scope here.”
Having stronger support for resident physicians could come with recruitment benefits as well, according to Anderson. The agreement included the establishment of a new committee that will address ongoing concerns and continuous improvement opportunities. One aim is to attract a deeper pool of quality clinical candidates, including palliative and hospice physicians, among other health care providers.
The CIR/SEIU union members at Kaiser Permanente will vote to approve their contract in the coming weeks.
The agreement represents an opportunity to strengthen the retention outlook of its physician workforce, according to Caroline Lucas, executive director of the Coalition of Kaiser Permanente Unions.
“Resident physicians are a vital part of the patient care team, and we are thrilled that their voices have been heard,” Lucas said in a press release shared with Palliative Care News. “This agreement ensures that doctors can focus on what they do best — saving lives and providing exceptional care — without worrying about how to pay their bills or whether they’ll have the time to rest and recover.”
Care continuity effects
The new agreement tentatively established an annual $40,000 budget to fund new patient projects. While the structure has not yet been formalized, the project could allow for greater education opportunities among clinicians, Anderson indicated.
Among the initiatives under discussion is to allow for more formal education on death, dying and serious illness, he stated. The project could help fund palliative and hospice training efforts and give future clinicians greater exposure to these types of care, according to Anderson.
Generally, clinical residents often have limited training in the full scope of interdisciplinary palliative care, and having this education could help strengthen goal concordant care delivery across the continuum, he stated. Having resident physicians understand the importance of advance care planning integration could go a long way toward supporting their own mental health and providing quality emotional support to patients and families, Anderson stated.
“One of the most striking findings is that a lot of times residents need help from our palliative and hospice care providers to have those difficult goals-of-care conversations,” he told Palliative Care News. “The reason is because they are often too emotionally burdened or stretched so thin in their primary rotations. Instead of senior residents filling that void who aren’t as close to the patient, this new union contract systematically supports them to help manage that stress and have deeper, meaningful interactions with patients.”