In November 2023, all 27 resident doctors who work at West Suburban Medical Center, located on the border of the Austin neighborhood on the West Side of Chicago and the suburb of Oak Park, signed union authorization cards, held a union election and won with a unanimous victory. Joining the House Staff Association, which has been fighting for the wellbeing of patients and residents since 1974.
Since unionizing in November, ongoing contract negotiations between the resident union and hospital CEO Manoj Prasad have stalled. Prasad continues to refuse to provide a budget for the residency program, or allocate graduate medical education (GME) funds to curriculum advancement. Over the last several contract bargaining sessions, Prasad and his legal team have stonewalled the residents and struck down all proposals to improve the residents’ working conditions, including providing safe drinking water and working telephones.
The Family Medicine Residency at West Suburban was once regarded as a top program with a long history of providing robust, full-spectrum family medicine training. In the past, residents learned directly from doctors of family medicine, cardiology (including cardiac surgeons), intensive care, and other specialists. In the last few years, however, resident education has seen a steep decline due to multiple changes in hospital ownership. The hospital receives hundreds of thousands of federal dollars every year to support the residency program, however that money is not allocated to resident raises, resident training, or reasonable compensation for teaching faculty.
West Suburban Leadership have strategically destroyed the structure of the residency program. Working conditions under Prasad and Fitzpatrick have been so volatile over the last several months that multiple faculty have resigned, leaving the program currently with only three core faculty, when at least eight are required to sustain a functioning program, per ACGME - the national residency accrediting body. Necessary requirements to graduate from a family medicine residency program- such as resident-led research projects, weekly protected instructional time, and faculty mentorship all which are set by the ACGME- have not and will not be completed with all but three faculty members left to lead these roles.
Residents have to seek out external learning opportunities to fulfill both required and desired learning that residents (as well as faculty) deem necessary for their career goals. Residents must also fund their external learning opportunities, including malpractice if said opportunity is out-of-state, as current CME (Continuing Medical Education- funds provided to doctors by their employer to remain up-to-date on the most current medical information) is woefully insufficient. Some residents have even expressed a desire to seek open spots in other programs in pursuit of a better education.
The hospital also suffers from dire patient safety issues. Many residents, nurses, attendings and other personnel can attest to multiple incidences where a specialist could not be reached or equipment malfunctioned (or simply was not available) in a life-or-death situation. There are patients who decompensate because they have not been seen by a doctor in 24 hours. There are cardiac arrest events without a working defibrillator. All of these traumatic patient experiences fall on the residents, who are required to assume responsibility of care in these situations, regardless of who the patient’s primary provider is.
Residents have served as primary advocates for these patients, fighting daily to address and improve these conditions via the hospital’s patient safety event reporting system, but to no avail. Despite residents speaking about these concerns over and over, Prasad and Fitzpatrick claim there are no patient safety issues at West Suburban Medical Center. As residents continue to escalate these concerns - concerns that are shared by all hospital staff - to hospital leadership, Prasad has retaliated by barring residents and faculty from patient safety meetings, claiming he is working with a small group to address these issues instead.
The residents of West Suburban Medical Center strive to provide excellent patient care in the face of disinvestment in the surrounding community, however there is only so much we can do with a system so broken. The goals of a for-profit healthcare system at West Suburban are in opposition to its needs as a safety-net hospital. Moreover, West Suburban’s descent into poor patient care and safety, as well as lack of adequate medical personnel reflects a disinvestment in the Black and Brown communities it serves.
