Medical Establishment Hopes to Thwart Residents’ Lawsuit
The nation’s medical establishment has grown increasingly anxious about an antitrust suit contending that residents are forced to participate in a system that ensures they work long hours and receive low pay.
Medical schools and teaching hospitals, the principal defendants, are so worried that in recent weeks they have asked their allies in the Senate to enact legislation that would derail the suit, inoculating them from damages that might otherwise run into the hundreds of millions of dollars.
The defendants maintain that the suit, filed by several young doctors, has no merit, and express confidence that they would prevail in court. But they are clearly troubled by the possibility the suit could upend the decades-old system of medical residents’ selection and deployment around the country.
The defendants have also hired lobbyists with previous connections to two senators who have been most directly involved in the effort to introduce such legislation: Hillary Rodham Clinton of New York and Edward M. Kennedy of Massachusetts, both Democrats.
At issue is the National Resident Matching Program, known in medical circles as the Match. Every March, a computer determines where new graduates of medical schools will spend the next several years as residents, gaining experience and honing their skills.
More than 80 percent of first-year residency positions are offered exclusively through the program, which is based on rankings submitted both by hospitals, which list the graduates they want, and the 15,000 or so graduates, who list the hospitals they prefer. Both sides agree in advance to accept the pairing.
The suit contends that the Match keeps salaries artificially low ? the annual pay for residents is about $40,000 and varies only marginally regardless of region or speciality ? and crushes any competition that might force teaching hospitals to offer better conditions like shorter working hours. The industry’s defense of that system has long been that a residency is not a job per se but instead a continuation of medical education in which the resident ought to be entirely immersed.
And residency is training. This suit really does not make sense. Without residency training, one cannot practice. One can restate residency as post-graduate training. The residency system prepares physicians for their future practice. While some programs might pay more for residents, I doubt that salaries would change dramatically.
Sherman Marek, a Chicago lawyer representing the plaintiffs, said he conceived of the suit when he was representing some young doctors in an unrelated matter and learned of their long hours and low pay.
“It’s no secret to residents that they were being mistreated,” Mr. Marek said. “Sometimes it takes a lawyer to educate people about a legal right.”
Surprise, surprise, this challenge springs from a lawyer. He uses interesting language about educating people about a legal right. What he really wants to do is receive a large judgement (and the fees associated with that judgement).
The match does work. Because of the match, we (the programs) get those students who want to train at our programs. Without the match, we would return to hard sells, arm twisting, and deceit. We would have to make deals to get students; they would have to decide on their residency slot prior to visiting a wide variety of programs.
This suit would hurt future students more than programs. I doubt that it would change work hours or pay at good programs. But it would disminish the process of finding the best residency.
