<p>Sakky, I don’t think this is getting us anywhere. I have no doubt that we each fully understand and appreciate the other’s points on the cable issue, but we’re arguing from very different end points - where I don’t believe there is any middle ground. I keep saying that we aren’t in a position to question the decisions they’ve made and you are saying they need to make better decisions. I don’t see where this can go any farther.</p>
<p>As for the negotiation of cell phones (and please remember that I don’t know of any hospitals that have actually done this, only heard rumors)…here’s my take - certainly attending physicians, nurses, staff, etc that are employed by or have privileges with the hospital have the leverage to make such negotiations. And I fully agree that it’s only fair in such a situation for the hospital to make some sort of subsidizing payments.</p>
<p>In the case of residents though, all the leverage rests with the residency program. As much as the hospital needs the cheap labor provided by residents, completing a residency successfully is much more important for the resident than labor issues are for the hospital. While residency is a job, it’s also an educational component, one that if not completed leaves one’s career hopes sharply diminished. Because of the match and the timing of it, there’s almost zero freedom for residents to move once they’ve committed to a program. I believe (don’t quote me on this) that submittal of a rank-order list confirms understanding that the resident is in agreement to work where they are matched and only in extreme circumstances can changes be made. Because of this set up, residents are lacking one key component that the people you made reference to have - the ability to walk. Regular employees (of any business) don’t have to worry about the detriment to their future careers that leaving a residency program might have on a young physician’s. All the power in such a situation lies with the residency program. What options does a resident have?
[ul]
[li]They can stick it out and refuse to get a phone, only increasing the ire of all those they work with, yet some how manage to avoid getting fired.</p>[/li]
<p>[li]They can cave and get a phone and survive with little to no repurcussions</p>[/li]
<p>[li]They can stick it out, refuse to get a phone and get fired, thus leaving them mid July/early August with no where to go, and a dismissal on their hands that they have to explain when they go through match for the following year. (And Residency Directors most definitely talk to each other).</p>[/li]
<p>[li]They can quit on principle, still have no place to go, have no job, massive debt and have to go through the match again. </p>[/li]
<p>[/ul]</p>
<p>Now if you’re in a city like Chicago, and a common specialty like Peds, there are probably some other options, and you can explore what nearby programs have open spots…but it’s not like there’s a whole lot of hope. </p>
<p>But if you’re an Ortho resident in Denver at the University of Colorado…at the only Ortho residency in the state, you have zero other immediate options nearby, and since ortho is so competitive, it’s not like there are open spots just laying vacant all over the country. </p>
<p>Of course all this assumes that you’re some sort of weirdo anyways who has managed to live through 2007 without a cell phone (I know of one person under the age of 40 who doesn’t have a cell phone - hell, my grandmother has had three phones this decade). So who knows what sort of crazy decision such a person might make.</p>
<p>But the point is, yes, there is a chance at negotiation, and yes, the fair thing would be for the hospital to subsidize, but those things aside, the situation is more complicated than that.</p>