California has long been at the vanguard in addressing society’s most pressing issues. In the 1960’s, growing concern about the health impact of automobile emissions spurred passage of the Clean Air Act, which established national standards barring states from regulating vehicle emissions. But the bill had one notable exemption: California, which had already developed stricter regulations to address air pollution. Now, the Golden State has an opportunity to lead in another arena: Combating the epidemic of burnout in medicine, investing in the public health, and redefining the living wage.
Senate Bill 525 (SB 525), introduced by state senator Maria Elena Durazo (D), would increase the minimum wage for healthcare workers in California to $25 an hour and tie it to inflation (the current state minimum wage is $15.50/hour). This bill couldn’t come at a more propitious time. Half of health workers report symptoms of burnout, including nearly two thirds of physicians. There has been an exodus of healthcare workers from the field, with even more exits predicted in the coming years. It is undeniable that the healthcare system is in crisis and our collective well-being is at stake.
Resident physicians are struggling in particular. As a current resident, this doesn’t surprise me. The average resident in the U.S. earns about $64,000 annually while working 60-80 hours a week, which on an hourly basis comes out to essentially the current minimum wage. We spend most of our waking hours in the hospital and are an indispensable component in the delivery of patient care. Yet many of us are struggling to cover basic living costs, and the stresses of being a physician coupled with economic insecurity takes an incredible toll. Burnout leads to the moral injury of failing to meet our own high standards for patients, which only leads to more burnout.
SB 525 would be a transformational investment in us, the providers who the public depends upon every day. Ensuring that healthcare workers, including residents, are fairly compensated would afford us breathing space to focus on patients, rather than being pushed to our limits or leaving healthcare altogether. It would also be an investment in the next generation of physicians, precisely at a time when we need to strengthen the workforce. More than half of doctors go on to practice medicine in the state where they completed their residency. SB 525 would thus immediately make California a highly desirable place for physicians of all socioeconomic backgrounds to pursue training, knowing they will be supported in this state. We can attract the most talented doctors in the country; doctors who, in their late 20’s and early 30’s, will be caring for Californians into the 2050’s and beyond.
The financial insecurity of residency, combined with an average of $250,000 in student loan debt, means that many of us struggle to establish stability for ourselves and our families. As a result, many residents feel pressured to set aside their aspirations and pursue higher-paying specialties to make up for the years we spend pursuing our education and getting paid below-market wages. The provisions of SB 525 would mean that residents would have more freedom to pursue critically needed positions in primary care or in rural and urban underserved communities; careers that are not well remunerated in our fragmented, capitalist healthcare system.
It’s fair to ask why we should increase resident physicians’ salaries when the skyrocketing cost of living and rising inflation are eating away at everyone’s income. As frontline healthcare providers we are acutely aware of the state’s affordability crisis. We see its devastating effects on our patients when they are unable to pay for life saving medications or are evicted from their homes. The fact is that the current state minimum wage of $15.50 an hour, or $32,240 per year, is inadequate to cover food and shelter, let alone support a family or save for retirement. SB 525 would increase the minimum wage for all healthcare workers — resident physicians, nurses, patient aides, technicians, food service workers, and many others — whose ranks include some of those patients struggling to make ends meet. In our rich and prosperous country, it’s time we demand that healthcare workers are paid a living wage. As doctors, we know this bill is just the beginning, and we stand with those fighting for a future where everyone can earn a wage that affords dignity and respect.
After California set its own emissions regulations, many other states followed suit; with a true living wage, we can once again lead the nation. Amidst a critical physician shortage, with one out of every five doctors saying they intend to leave their practice in the next 2 years, the status quo is simply unsustainable. SB 525 is an investment in the healthcare workforce and the health of all Californians.
Teva Brender, MD, is an internal medicine resident physician at University of California San Francisco Medical Center and a member of the Committee of Interns and Residents/SEIU.
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