April/June 1978 Volume 7. No. 2 CIR's NEW DETEGATES · April/June 1978 Volume 7. No. 2 MARTTAND HOUSESTAFF WANTS CIR The College of Medicine and Den-tistry of New Jersey (CMDNJ) employs

Apri l /June 1978 Volume 7. No. 2

MARTTAND HOUSESTAFFWANTS CIR

The Col lege of Medicine and Den-t istry of New Jersey (CMDNJ) employsmore than 700 housestaf f at af f i l iatedhospi ta ls, which include: Mart land,Newark Beth lsrael , Newark Eye andEar, St . Michael 's Medical Center,Uni ted Hospi ta ls Medical Center-Chi ldren's Hospi ta l of Newark, Uni tedHospi ta ls Medical Center - NewarkEye and Ear Inf i rmary, Uni ted Hospi-ta ls Medical Center-Presbyter ian,Uni ted Hospi ta ls Orthopedic Center-Hospi ta l for Cr ippled Chi ldren andAdults, Rutgers Psychiatr ic lnst i tuteand the East Orange VA.

The housestaf f associat ion is cert i -f ied by the New Jersey PERC (pubt icEmployees Relat ions Commission).and has recent ly re-negot iated a two-year contract ending June 30, 1979.Nonetheless, the housestaf f see aneed for an organizat ion l ike ClR,which suppl ies administrat ive staf f ,negot iat ing ski l ls , and other ongoingservices and coordinat ion. BecauseCMDNJ housestaf f are spread over anumber of inst i tut ions, they have foundi t d i f f icul t to maintain their gains.

As a resul t , CMDNJ housestaf fformal ly approached ClR, and theHouse of Delegates is now in theprocess of vot ing them into the organi-zat ion. On their part , CMDNJ house-staf f is working for a rat i f icat ion f romtheir membership.

Larry Boxt, M.D. president of ClR,welcomed "fel low housestaf f f romacross the r iver. CMDNJ wi l l be io in inoEnglewood Hospi ta l and Jersey City

"as the th i rd hospi ta l complex in NewJersey to be represented bV ourorganizat ion. "

Susan Grossman, M.D., CMDNJHousestaf f Associat ion president saidthat " the leadership of our organiza-t ion have considered jo in ing CIR forsome t ime. We bel ieve i t wi l l bebenef ic ia l to us to take advantaqe ofCIR's 22 years of exper ience. ' '

CIR stafter Carol Davis answersquestions at Bronx Municipal /AECOM Elections

GEORGE JHAGROORCBERTO INGLES

GARY MYERSONB.J. PATIL

CHARLES SULLIVAN (A)IFTIKHAR IV]ALIK (A)

YORAI\1 BTER (A)LAZLO HITTS (A)

Brooklyn Jewish I Greenpoint

Coney IslandRICHARD ASH SUSAN FUCHS (A)

BrookdaleSTEVT SII \4ONS RENA ROBBINS (A)CHARLES CRANE TONI FIELD (A)

Catholic Medical CenterWARREN KOUTNIK MIR IQBAL (A)ANTHONY SCARAFILE BRI] SHARI\,]A (A)

Contract Administrator David Sto-Iow monitoring elections at KingsCounty.

CIR's NEW DETEGATESCIR's new 1978-79 House of

Delegates has been elected, and thewinners are l is ted below. The resul tspr inted here indicate the ta l ly ingwhich was complete by Bul tet inpress-t ime. The symbol (A) indicatesal ternate delegate.

Arthur C. LoganMUHAMIVIAD TAYYAB JULIAN S. ELIAZ (A)

Bellevue I NYUCAROL EPSTEIN NANCY SOKOLDENA HARR ISI\1ICI{AEL SEGARRA MORTON RUBENSTIIN (A)

Bronx MunicipallAECOMLEWIS OPLER JAIIIIE RIVERAELIZABEIH LEGATT DIAN BLASS (A)SHELLY KOLTON MAURICE LIEBMAN (A)

Bronx LebanonDAVID CARIVlICHAEL fulARTIN HOFFIIIAN (A)ROBERI IVIORELLO ARCOT BHASKAR (A)

Brooklyn-Cumberland

ElmhurstALAN ANTONELLIDOUGLAS PRISCO

AVI BARBASH (A)VINCENT MARONE (A)

EnglewoodSIVA KUIV]AR ALEX PALACIOS (A)

HarlemCALVIN fulATTHEWS ARIFYE IV]ANU (A)SHARON NORRIS JOANNE HUNT(A)

Jersey City Medical CenterDAVID BROWN RICHARD HAYS (A)

KingsbrookTARIQ MAHMOOD BABU JASTY (A)

Kings CountyROBERT KRIGTL STTWART LEWIS (A)CONCHA I\4ENDOZA AISIK NEWI\4AN (A)i \ l ICHATL CUTAIA

LincolnEDWARD FORD ]OHN BAUER (A)VICTOR ALONSO ALDY CASTOR (A)

MaimonidesI\4ALVIN KTLLER JAKOW SHANI {A)PTTTR PRAEGTR ASHOK GIDWANI (A)

- Continued page g

Page 2

l1- PRESIDENT'S MESSAGE CIR AND

ACCREDITATIONThe Joint Commission on the

Accredi tat ion of Hospi ta ls (JCAH)is surveying the fol lowing hospi ta lsdur ing Apr i l , May and June of th isyear: Coney ls land, Cumberland,Jewish Hospi ta l and Medical Center,New Rochel le Hospi ta l Medical Center 'Bel levue, Bronx MuniciPal , MountSinai , NYU and Miser icordia. Theprocess is already under way at L in-coln and Bird S. Coler.

CIR has a history of making Pres-entat ions to the JCAH accredi t ingbody at i ts publ ic interviews. Becauseof CIR's act iv i t ies in the past, hospi-tals have been gjven one-year pro=-vis ional accredi tat ion and have beenforced to improve pat ient care ser-v ices. This year, CIR has taken aninformal posture o{ working closelywith the hospi ta ls to insure fu l laccredi tat ion of a l l inst i tut ions v iacorrect ion of a l l def ic iencies ident i f iedby housestaf f pr ior to JCAH surveys.

Housestaf f and CIR staf fers Gluck-mann, Wol lk, Stolow and Davis canbe found working around hospi ta lswith their counterparts at the Cor-porat ion, accompanying Corporat ionoff ic ia ls going through the hospi ta lsand working to correct : work sched-ules, out-of- t i t le work, broken equlp-ment, inadequate Paging systems,suppl ies and technic ian and nurslngstaffing shortages.

Housestaff at hosPitals to besurveyed who are interested in par-

-.t ic ipai ing in th is process should cal lCarol Davis at the CIR of f ice, (212)725-5500.

Below is a summarY of the Pat ientcare items negotiated between theCorporat ion and CIR Pr ior to JCAHsurveys at Bird S. Coler and LincolnHosoi ta ls.

Lincoln: Review of diagnosticequipment and machines used bYhousestaf f physic ians in Medicine andOB-GYN; re-evaluation of testingprocedures-to expedite testing andto prevent dupl icat ion; re-emphasison the pr inciple that pat ients in c i tyhospitals should be afforded the bestpossible treatment regardless ofabi l i ty to pay; examinat ion of sched-ules to insure the resident 's abi l i ty towork at maximum effectiveness'

Bird S. Coler: lmProved mecha-nisms to work wi th administrat ion;improved night coverage of pat ients;controls over human resource ex-penses; better l iaison with P.A.s andother staff.

F

For the f i rst t ime in a long t ime,CIR suffered no maior t rauma thisyear. In fact , we survived and thr ived.We added 600-plus housestaf f s inceJanuary 1977, when our rol ls were atan al l t ime low of 2,675 PaYing mem-bers. We're now over 3,200; and sincethe last House of Delegates acceptedthe Col lege of Medicine and Dent istryof New Jersey House Staf f Associa-t ion into ClR, our rol ls wi l l soon bepushing 4,000. The signi f icance ofnumbers of housestaf f under CIR con-tract is two-fold: First of a l l , i t showsthat housestaf f . g iven a choice or theeducat ion to understand the necessi tyJor a contract , wi l l lo in ClR. House-staf f have a way of knowing when

CIR has succeSsfullf- Concludedwage re-openers wi th Brooklyn Cum-ber land, Bronx Lebanon, BrooklYnJewish, Montef iore, Maimonides'Kingsbrook, WYckoff , Staten ls landand Englewood. CIR is also br ingingto conclusion the f i rst round of nego-t iat ions wi th WCMC and JCMC.

At Bronx Lebanon, Staten ls land'Englewood and Brooklyn Jewish, addi-tional benefits for housestaff - andconsequent ly for Pat ients - weregained by s igni f icant improvements inworking condi t ions.

At Arthur C. Logan, wage re-openersled to part ia l resolut ion of an imme-diate cr is is regarding malpract icecoverage. Due to the recent lY dis-covered massive mismanagementscandal at Logan, (See storY under"Grievance Update," page 6), house-

A Litt le End of the Yeor RoP

by LAWRENCE BOXT, M.D.

they're being horsed around. Secondly 'the enlargement in the number ofCIR-aff i l iated housestaf f g ives theorganizat ion a sounder f inancial baseon which to operate. CiR is a serviceorganizat ion. l f we're not able toorovide those services and administerthose contracts that housestaf f nego-t iates, housestaf f won' t jo in CIR inthe f i rst p lace.

There are real housestaf f leadersin the hosPitals now. Furthermore,there are"staf f avai lable to provideservices to these housestaf f leaders 'Most important lY, housestaf f havebeen doing things themselves. Thisyear, seven wage re-openers and four

Continued on Page 3

Negotiote We Musl

by EDWARD T. GLUCKMANNstaff there weren't covered by mal-pract ice insurance. Pat ients, workersand housestaf f were al l PaYing theor ice for administrat ive corrupt ion'Leading the f ight to keep the hospi ta lopen and defending the hosPitalemployees was Distr ict 1199. CIRworked closely wi th the heal th careemployees union throughout the cr is is,and sends i ts plaudi ts to 1199 for i tshard work throughout Logan's t imeof t r ia l .

At Westchester CountY MedicalCol lege and Jersey City Medical Col-lege, contracts are close, but not yetf inal ized. At JCMC, the issues arepar i ty wi th housestaf f f rom Mart landiwho rotate through the hospi ta l ) andresolut ion of the cr i t ical need forparking improvements for housestaf f ,whose-cars are f requent ly towed whi lethey're working.

SI

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t\/lct - DIRECTOR'S REPORT

Page 3

HR 2222i sunnARy oF HousE EDtJcATtoN AND r.ABoR IIMMITTEE REpoRrIn March, the House Commit tee on

Educat ion and Labor recommendedpassage ot HR 2222, the amendmentto the Nat ional Labor Relat ions Actwhich specl f ical ly declares thatmedical housestaff are to be con-sidered professional employees ofnon-prof i t heal th inst i tut ions, coveredby the Act 's col lect ive bargainingprovis ions. Interns and residents havebeen excluded from coverage bYthe Act s ince the so-cal led Cedars-Sinal decis ion of 1976, in which theNLRB ruled housestaf f to be "pr imari lystudents" and not emPloYees.

In a report submit ted to the tu l lHouse of Representatives, the maiorityo{ the Commit tee suPPorted house-staf f 's c la im to be considered em-ployees with the fo l lowing arguments:

The PROS1) that every labor relat ions board

decis ion before and af ter Cedars-Sinai has held that publ ic hospi ta lhousestaf f are employees, and thatNLRA coverage of housestaff was theor ig inal intent ion of the Congresswhen the 1974 amendments expandedNLRA inclusion to personnel em-ployed in non-prof i t heal th inst i tut ions;

2) that every component of atypical employment relat ionship existsbetween housestaff and hospital ; thathousestaf f are fu l ly cert i f ied andl icensed medical personnel del iver ingservices for which hospi ta ls aremonetar i ly compensated;

3) that the educat ional componentof housestaf f 's work exper ience isaddi t ional to, but does not al ter , theiressent ia l ly economic relat ion wi ththe hospi ta l -employer,

4) that the IRS has ruled thathousestaff earnings are to be taxedas salar ies and not tax-exempt "schol-arships"; that in terms of vot ing r ights,workers ' compensat ion and veterans'reemployment r ights, housestaf f arenot c lassi f ied as students;

5) that there is no inherent in-

compat ib i l i ty between the r ight tocol lect ive bargaining and the conductof educat ional t ra in ing-that thescope of the NLRA aPPl ies to suchissues as wages, hours and othercondi t ions of employment which areeasi ly dist inguished from educat ionalmatters.

The CONSA minor i ty of d issenters on the

Commit tee presented the fol lowingarguments against passage ofHR 2222:

1) that the relat ionshiP betweenhousestaf f and hospi ta ls is educat ionaland not economic; that the r ight tocol lect ive bargaining would interferewith the " inherent ly inegal i tar ian"relat ionship between the teachinginst i tut ion and i ts interns andresidents;

2) that the amendment is disrupt iveof graduate medical educat ion bYmaking the NLRB lhe arbi ter of thecontent of teachingf and training;

3) that Interns and residents arenot "hired," but rather, selected andassigned to housestaf f posi t ions; thatthey do not undertake their housestaf fappointments " to earn a l iv ing" butto learn, and that their economicstatus thus resembles that of studentsnot that of employees;

4) that the pay of housestaff isregarded as scholarship or st ipend,not as quid-pro-quo remunerat ion forlabor oerformed:

5) that legis lat ion is not an appro-pr iate way to address the unpopulardecis ion of the NLRB in Cedars-Sinai ;that the Cedars-Sinai decis ion doesnot forever and universal ly precludehousestaf f f rom being held as em-ployees in part icular cases; that HR2222 thus undermines the author i tyof the NLRB;

6) that s ince many states requirea year of internship before l icensureis granted, f i rst-year housestaf f cannotbe considered ful ly qual i f ied medicalpersonnel ; and that s ince speclal ists

must complete advanced trainingbefore being board-cert i f ied, residentsin special ty t ra in ing are l ikewise inthe process of being educated asspecial ists and are not fu l ly- f ledgedspecial ty labor.

And in New York. . .Whi le the Educat ion and Labor

Commit tee of the House of RePre-sentat ives recommended the passageof HR 2222, the conf l ic t over housestaf fstatus went on in New York Ci tY'

Dr. Mart in Cherkasky, President ofMontef iore Hospi ta l in the Bronx,recognizes the Commit tee of lnternsand Residents as the col lect ivebargaining agent for housestaf f .Cherkasky was quoted bY the NewYork f imes as saying that " the house-staf f ought to have a forum, eventhough i t may be a l i t t le uncomfortablefor management." On the issue ofwhether interns and residents arestudents- in- t ra in ing or qual i f ied physi-c ians, Cherkasky remarked, "Whenit sui ts the housestaf f physic ians,they're workers . . . but the only wayto learn to be a doctor is to bea doctor."

Dr. lvan L. Bennett , Jr . , provost ofNYU Medical Center, which does notrecognize ClR, was reported bY thef imes to say that interns were"pr imari ly students" and that theirdemands are best met on "acol legial basis."

Congress, or District CourtAl l that fo l lows the Supreme Court

decis ion not to hear CIR's case againstthe NLRB over the r ights of statesto (re)exercise jur isdict ion overhousestaf f in the pr ivate sector. Thatdecis ion now leaves resolut ion of theproblem to: a) a PNHA/ClR courtcase now pending in WashingtonFederal Distr ict Court over the legal i tyof the Cedars-Sinai ru l ing; b) thepassage oI HR2222 (S1884) by Cong-ress and c) direct act ion by housestaf ffor recogni t ion.

Presidenf's MessogeContinued from page 2contracts were negotiated fromscratch. Housestaf f , who used to pro-vide only input into these funct ionF,did the vast major i ty of the work, and- in some cases - a l l of i t . House-statf at these hospitals and staff whoaided the housestaf f should be con-gratulated on a job wel l done.

This spr ing is the t ime housestaf f

must form demands for the upcomingsummer and fal l contract negot iat ions.As of th is moment, we're st i l l notunder Nat ional Labor Law. l f the de-mands CIR makes to hospi ta ls do notreoresent the wishes of the member-ship, i t would be fool ish to exPecthousestaf f to take necessary pol i t icalact ion to win these demands. TheCIR Demands Commitee cannot beexoected to read the minds of mem-bership. They must receive data f rom

al l members of the organizat ion sothey can formulate al l demands bYthis summer and present them to thevoluntar ies and the City.

On a personal note, I would l ike tosay that when I started my term aspresident of ClR, I contemplated thepossible ser ies of events that couldadversely af fect housestaf f . Now, ayear later, I am proud of what I 'm apart of and look forward to the comingvear wi th conf idence.

Mr. Fred Gluckmncomittee for Intelns & Residents

386 Palk Avenue south Room 1502

New York, N. Y. 10016

Dear M!. GluckMn:

Thank you for the part you ptayed in keeping

Arthur c. Logan Hospital OPen.

_w? are conf ialent that with the sveeprng

chanqe in the Hospital staff we can Iook fosal ' l

to the proper funct ioning of the Eospital ' I t is

also oui bel ief that Logan stands a good chance

of surviving beyond the 60 day Period' vhich the

judge granteal for the purpose of coming forth

ei th a plan to cont inue the Hospital '

Howeve!, ue have lots more to do in ou!

effot ts to turn this HosPital around and aeay from

its unfortunate last. we thelefore look fosard to

your continueal suplDrt and comitment in helPing to

ieep the Arthur C. Logan Hospital open so- that i t

can continue to Provide the comunity with the

necessary treal t l t care.

we expect to cal l on you for EuPlrcrt in those

aleas ue bel ieve vi tal to the t i fe of this Hospital

and in which your contr ibut ion in part icular ' is

necessarY.

sincfrelY,

J"Q,;\tiltlcdu;t-iu-r-/

Doris Turne!

Execut ive vice President

. REGTSTERED NURSES GUTLD

. LICENSED PRACTICAL NURSES GUTLD

. CIVIL SERVICE GUTLD

. TECHNICAL GUILD

. CLEBICAL & NON'PBOFeSStONAL EMPLOYEES

. PUBLICsERVICE EMPLOYEES Dlvts lON 1N

HOTEL, Ht]SPITAL, NURSING H()ME & AL

233 WEST 4Sth STREET. NEW YORK, NEW

Page 4

WE GETAND

EVEN AOR

DAILY OCCURREII'CES

Dear Sir :

Below is a col lect ion ol thoughts I

formulated recently after another of

what seem by now endless dialr, ibes

that I have been involved in over

lunch at the hosPital I am a Medical

lntern at. I make no claim whatsoever

at any poet ic ski l ls . This is str ict ly

ad l ib. In v iew of the in i t iat ion of a

let ters to the Edi tor column I thought

such might be aPProPriate.

We All Have Horror Stories

It was toughFortunately, l 'm now, generally, more comfortable

Hours long, sti l lResponsibil i ty, maYbe greater

Less bloodCity hospital bloodWake up American medicineNow that you know about medicine-and pol i i ics

0nly you know what is truly behind that off-quoted"relatively small percentage of disadvantaged"

lmagine yourself as one of those horror stories

City hospital bloodTake yourself awayAway from the worries of a busy practice

The frustrations of realizing the public no longethas faith

The rising costs of your children's educationThe competit ive concern you have developed ou

of excellence and fearWake up to the presence of horror stories-l

dai ly occurrenceYou, collapsing downtownYou, on a stretcher, in an emergency room

y-**s

F"F,$"wffi

Apit l 11, 1978

f , " . . r r t - r ,lllf t AL144l : - " -

' !

LIEO HEALTH SERVICES UNI(]NYORK 10019 (212)265-2366-7-8-9@

t1/'il .1ft//"y

fu/," .ll"t7o"cEx!.d v. vice Pd

Dt. Iffence Eoxt

.'nirl"kr' aa/*li' preslatentC@lttee of Intems ed Resldetrces

.thr/i, '(ihn. 386 Park Avetrue So.

Ro@ 1502

, i low/, / t l " , , " t Ner York ' N.Y. 10016

.haal ' .* te1

ha,l . tlirftnn?Y sa: &' hxti

- , "

I Chsk vou f or vour te legre of suPport ' Your cdt tee

' ' tonk uatv of l ' terns aad Reel iences aie to be congraturated ln the @ner ln

. ," ' . - ' - ; """ . ' whtch vou handled the ehergeacy' No one 1lkes to wi tness oldtlttu.nt il

1tt""v o"oo1"- "tf

rer md r knd 1t nst have been a tfa.rutic exPelience

ior th@ to be noved fron their varlous nulslng hones to a new

eovlronment. H@ever, now that lhe strlke ls over' lt 1a our

slnc€re hoPe that thlngs w111 retum to nomal as qulckly as

Posslble.

h behel f of the of f lcels atrd neBberEhtp of Local I44

I wet to thank you Eost s lncerely for your suPPott and I request

you to convey th;6e sentlnents to your coonlttee of Intelns atrd

Resldences.

i 'Togethe! we a6Plre ' togetheE we achieverr '

PO: ytop€tu 153

AFFILIATED WITH SERVICE EMPLOYEES INTERNATIONAL UNION' AFL-CIO

Page 5

IETfERSSOMETIMESPOEMTWO

Bleeding, with nothing typed and crossedAn intern looking for a bott le of normal sal ine

and tape, yet to be foundA resident, evalLiat ing the EKG, diagnostic of acute

Ml, two rooms doWnOther help off duty, change of shif t , lunch-what's

the dif ference i t 's nothing new-except to youYou're sweating, y0u see the blood return now

and the normal sal ine infusingInternal bleeding-type and cross pending-1.V.

inf i l t rated-no other good veinsStat page unanswered-You have f ive minutesYou never make i tHorror storiesA backdrop to the guise of the best medical care

in the world

Horror stories-a dai ly occurrenceFound, as only you truly know, behind that oft

qu0ted "relat ively small percentage ol disad-vantaged"

Wake up American medicineNow that you know about medicine-and pol i t ics

W.M.S., lntern

The CIR welcomes contributingarticles from members, and thanksthose who write to us.

DEPARTMENT OF HEALTH, EOUCATION AND WELFARE

hrch 16, 1978

Lauence Boxt, M.D.President

Comlt tee of Intems and Resldenlsof New York Ci ty

386 Paik Avenue SouthNew York, New York 10016

Dear Larry:

I e ffiltlng to thank you for playlng host !o rhe PM/NHSC

recruitnent cosference ln New York. I felt the conference

was a success both 1n nmbers of people participatltrg and

apparent 1eve1s of intelest . Do 1et us know i f you have

other ideas for says in whlch we catr develop both recruitEent

and plac@ent strategles for your Eenbels in and around the

Ci ly of New York.

Speaklng for the alumni, keep up rhe good work.

NEW YORK UNIVERSITYEel levue Hospi ta l CenterNtw YoR(, N.Y. r0016ARr^?r267e- 3200 Ext. 3991

Intermediate Care Unit

MEDICAL CENTER

Apxt l 17,1978

Mr. Edward T. cluckmn

Comit tee lntems & Residents

386 Park Avenue South Ih 1502Neu York, N. Y. 10016

Dear Mr, Glucknan:

I personally want to thank you atrd your Comittee in asslsting us inobtaining (2) Physlc ians for our Unir .

We st i l ] have need foi at least (3) addl t ional physic ians to startas of July 1, 1978.

This is, as you know, a salar led posir ion 1n an Internedlare Medici t reUtrlt wlthln the Departnent of Medicine of a prestigious Universiry-Aff l l iated Ner York Ci ty Hospi ta l . I r is a ronderful opportunl ty forphyslc ians who have conpleled at leas! lwo years of r ra i t r ing in Eedl-

L97A

Mr. Edward T. c luckmanExecut ive DirectorComittee of Interns I Resialent.s666 Third AvenueNew York, N.Y. 10017

Dear Mr. c luckman:

Your act ive part ic ipat ion alur ing our recentJCAH/Health Dept. Survey was appreciateal.I t was rewardjng Lo hear the f indings ofthe survey at the sumation conference.

Thank you for support ing the Lincoln MedicalCenter with your presence.

for their FLEX and/or Anerlcanan act ive teaching hospiral ,d"Universi ty enployee,

S incerely,

-1,11"t1a llazz,Norma Noriega / / ' -Act ing Execut i te Direc

NN/nt

Sitrcerelv.

a'NFttzhugt\ {u l lan, M.D.Director \Nat lonal Heal th Servlce

,hz<)

,/ {-tu ),' ,.H. lesl ie, M.D.,F.A.C.P

late Acute Medlcal Uni t

Page 6

KCH Surgery Schedules Re-written

A gr ievance sett lement putt ing al ljunior surgery residents and interns atKings County on every th i rd night orless has been reached between CIRand the hospi ta l . At the arbi t rat ionhear ing, the hospi ta l conceded thatthe contract was being violated andasked for a week in which to post newschedules acceptable to ClR.

CIR contract Administrator DavidStolow and counsel Arnold Pedowitzmet wi th the surgery program directorand Kings County 's Labor Relat ionsManager to work out these schedules.As a resul t , a l l junior residents havebden on every th i rd night or betters ince ear ly March. The one servicewhere problems st i l l exist is t rauma.The f i rst revised schedule provedineffect ive, but was quickly modif ied,and by mid-Apr i l th ings seemed tobe working out. However, as the"one night in three" standard is beingmet only because the second cal l isbeing sent home, the service couldeasi ly s l ip back into an every-other-night rout ine.

As part of the gr ievance sett lement,the hospi ta l and the HHC have agreedin wr i t ing to an enforcement mech-anism far more streamlined than theusual procedure. Should any surgeryresrdent be assigned duty more thanone night in three, the hospi ta l -upon hot ice f rom CIR- must correctthe s i tuat ion wi th in f ive days. l f thereis no correct ion, CIR wi l l have ther ight to immediately f i le a demandfor an expedi ted arbi t rat ion.

Logan Buys Malpractice

Logan Hospi ta l 's new administra-t ion, appointed to at tempt to avoidbankruptcy, has responded to house-staf f and purchased malpract iceinsurance coverage for housestaf fof f icers. The hospi ta l , which has beenin Chapter Xl bankruptcy proceed-

ings s ince October, 1976, had al lowedits malpract ice to lapse withoutadvis ing physic ians employed at thehospi ta l . This informat ion only recent lycame to l ight as one of the revela-t ions of mismanagement reported tothe bankruptcy court .

Fol towing a l imi ted job act ion bythe housestaf f , in which they refusedto expose themselves to the r isks ofmalpract ice, the new administrat ionagreed to purchase a pol icy. Thoughthe coverage is l imi ted, i t doesprovide protect ion, and i ts very exist-ence shows a new att i tude on thepart of the hospi ta l . ln addi t ion tocoverage, Logan has pledged to returnto housestaf f by June 4th, the oneweek's salary which the hospi ta l hadwithheld f rom al l employees. CIRwi l l next in i t iate negot iat ions for anindemnif icat ion agreement to cover thehousestaf f dur ing the per iod whenno malpract ice coverage was in force.

Malpractice Survey

Al l CIR contracts orovide for mal-pract ice coverage. As the cost ofinsurance has r isen, some hospi ta lshave dropped insurance pol ic ies andsel f - insure or indemnify their house-staf fs. CIR's contracts contain strongprovis ions to enforce such indeminf i -cat ion. Under our var ious agreements,CIR has undertaken a survey of a l lhospi ta ls carry ing insurance to deter-mine the extent of coverage andwhether pol ic ies are actual ly in force.

Kingsbrook Arbitration

Last year, when housestaf f movedup to PGY level on July 1st , Kings-brook, Montef iore and Bronx Lebanonceased paying lhe 31/zok salaryincrement due to incumbents as ofApr i l 1, 1977. The two lat ter hospi ta lsagreed to resume paying the incre-ment based upon their CIR contracts,but Kingsbrook steadfast ly refused.

GRIEVANCES UPDATE

by DAVID STOLOW, CAROL DAV|S, and

crR-crTYCONTRACT CIOSER. . .

The CIR-HHC contract cover ingnearly 2000 city-paid housestaff hasbeen condi t ional ly approved by theEmergency Financial Control Board.CIR and the ci ty must concludediscussions to sat isfy the EFCB thatal l necessary condi t ions establ ishedby that body have been met. Thecondi t ional approval now opens theway for retroact ive cost-of- l iv ingadjustments to be paid and for the fu l limplementat ion of revamped andimproved gr ievance and discipl inaryprocedures.

Payments due under the contractfor the per iod of Oct. 1, 1976 to Sept.30, 1978 include:. cont inuai ion of cost-of- l iv ing pay-

ments of $336 retroact ive to Oct. 1,1 976.

r four product iv i ty payments of varyingamounts that total approximately$871.50. Of th is $199.50 has beenpaid to al l other HHC employees,and the remainder is pendingapproval of product iv i ty plans sub-mit ted by the City-wide LaborManagement Commit tee to theEFCB'

. . o

WOULD YOU LIKEA COPY OF

YOUR CONTRACT?lf you'd l ike to know precisely what

your r ights are, you can wri te for acopy of the CIR-hospi ta l contractwhich appl ies to you. Send requeststo ClR, 386 Park Avenue South, Room1502, New York, New York 10016. Besure to ment ion the name of thehospi ta l which pays you and clear lyindicate your mai l ing address.

Now an arbi t rator has ruled againstClR, holding that the hospi ta l couldcease paying the increment on thegrounds that the contract and bar-gaining history were vague, and thatCIR didn' t meet i ts burden of proof.As a resul t , the Kingsbrook housestaf fhave been denied three months of apay increment paid to housestaf f atother inst i tut ions under substant ia l lvident ical agreements.

ROBERT WOLLK

Page 7

Finqnciql StotementNotice' In accordance with New York State laws regulat ing Iabor unlons,CIR's f inancial statement for 1977. A copy of the fu i l audi ted f inancialmembers upon wri t ten requesi or at the CIR of f ice,386 park Ave. So..9 a.m. to 5 p.m., Monday through Fr iday.

we reproduce herewithreport is avai lable to

New York 10016. f rom

Committee of Interns & ResidentsStatement of Al l Receipts & DisbursementsFor Fiscal Year Ending December 31, 1977

Cash Balance-January l , 1977

Cash ReceiptsDu es

. Interest'Div idends

$ 41287

$3076341207300

1051 8611922501627349t82510

House Staff Benefi ts P/anPNHA Expense ReimbursementsCo ntr i butl o nsPostage & Mai l ingSubscr ipt ions To Bul let inStr ike Fund ExchanseHospi ta l izat ion Reimbursement

Ambulonce: City Poys -Cqbr in i WontsTo Drive

Charges that c i ty hospi ta ls "snatch"pat ients f rom the voluntar ies con-t inued recent ly, as Cabr in i Heal thCare Center (a voluntary) accused theHealth and Hospi ta ls Corporat ion ofshutt ing down Cabrini 's ambulanceservice. Distr ict Counci l 37, repre-sent ing the c i ty 's emergency medicaland hospi ta l employees, accusedCabrini of not d iscussing the ci ty 'sambulance controversy responsibly.

The ci ty, says D.C. 37, cannot af fordto subsidize the pr ivate ambulanceservices any longer, and has discon-t inued the subsidies i t has t radi t ional lyadvanced to Cabr in i . "Cabr in i is st i l labsolutely f ree to cont inue i ts ambu-Iance service" to the c i ty say thehospi ta l and ambulance workers, butwi thout being underwri t ten by publ icmoney. '

The ci ty has channeled more than$170 mi l l ion year ly into the voluntaryhospi ta ls, and D.C. 37 accuses thepr ivate, non-prof i t hospi ta ls of fa i l ingto account for their use of the money,as wel l as of shirk ing their respon's i -b i l i t ies to the medical ly indigent.Saying that the ambulance controversyhas become "gr ist for media sensa-t ional ism," the union urged al lconcerned part ies to let EMS developi ts potent ia l under the new HHCleadership.

CIR has long stood for a strongcity hospital system to care for thosein need. "Body snatching" by thevoluntar ies cannot be al lowed tocont inue," stated Dr. Larry Boxt, CIRPresident. "ClR supports a c i ty ambu-lance service under HHC control . ' ,

saranes I0 staf i members (gross amount $106993less deduct ions of 29289) - net

Witholding taxes paidPayrol l tax expense[mployee benefi tsLegal fees & expensesAccounting feesOff ice & administrat ive expensePubl icat ions. publ ic i ty and educat ional expensesu0 nIr | 0ut t0n sPurchase of f ixed assetsConvenlions, meetings & delegates expensesSIrrke tun0 txchanseRent SecurityMiscel laneous

Toial Cash Receipts

Total Cash Accountabi l i ty

Cash DisbursementsPNHA duesSalaries to staff members (

Total Cash Disbursements

Cash Balance-December 31, 1977

Cash -

Total Liabi l i t ies

Fund Balance-excess of assets over l iabi l i t ies

37 1983

45418

77704290926386

1 0446654494000

75 1301 7069

3601 5528884205439681423

330696

348935

$ 23048

Manufacturers Hanover Trust Co. - Checking accountHarlem Savings Bank

Iotal CashAccounts Receivable_Securit ies at cost (market value 98325)Furniture & f ixtures (net of 94,770 accumulated depreciat ion)rrepard expensesRent Secuii ty

Total Assets

Accounts PayablePayrol l taxed oavableAccrued expens6s payable

Statement of Assets, L iabi l i ty and Fund Balanceas at December 31, lg77

Ass ets

l iabi l i t ies and Fund Balance

$ 526817780

$ 23048556251101816892

9733967

$1 I 1523

$ 28854311312t4

78342

$ 33181

Total Liabi l i t ies and Fund Balance $111523

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CIR's NEW DELEGATESCont inued from page 1

MartlandJAIV]ES LIGUORI JENNIFER RUDDSUSAN GROSSIV]AN KEN CASEY

MethodistGERALD CALNEN B. SINGH (A)

Metropolitan I F lower F itth I ColerLAWRENCE BOXT LAWRENCE SCHEK (A)

IV]ICHAEL SCHOOLN]AN LEONARD SILBER (A)

CARL LEE ,

MontetioreROBERTA FALKE ELLIOT II IOSHIV]ANDAVID FINLEY BARNEY NEWIV]AN (A)

DONALD SCHOCH ARYEH SHANDER (A)

Nassau CountyROGER COLETTI GENE GIANTLLA (A)

HOWARD HEIIVIOWITZ ANDY I\ ' IYERS (A)

New'RochelleEUCLID DE SOUZA MARINO RUIZ (A)

Staten IslandLORNE SHEREN STEPHTN LOIV]BARDO (A)

SydenharnREYNOLDS ALERTE FRANTZ BERNADINE (A)

TVestchester CountyGARY BIRNBAUIVI IV]ARY WOLFE (A)

Wyckott lleightsMOHAN JACOB JOSEPH VIDAL (A)

Carol Davis again atducting elections.

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PNHA ELECTS NEW LEADERSPNHA held i ts annual conference

May 4-7 in Washington, D.C. CIR sent20 delegates and staf f to the meet ing,and staf fers David Stolow and CarolDavis held workshops in ContractEnforcement and Pat ient Care lssues.

Panels on the subjects of Publ icHospi ta ls and Indigent Pat ients andHospi ta l Cost Containment werefeatured, and on Saturday evening atest imonial d inner was held for thesponsor of HR 2222, New JerseyRepresentat ive Frank Thompson, Jr .

PNHA's new Execut ive Commit teeincludes: President: Jay Dobkin, FirstVice President. ' Ron Blevins, Secre-tary: Bonnie Renf ro, Vice President f orOrganizat ional Af la i rs: Peter Orr is,Vice President for Racial Minorit ies:Claudia Johnson. Vice President torForeion Medical Graduates: ShibbanGanju, Vice President lor W6merrDoris Suciu.

Meanwhi le, PNHA is st i l l act ivelyworking on passage of HR 2222 (seestory, page 3).

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AGENCY SHOP REFUNDln the Oct.-Nov. 1977 CIR Bul let in,

the introduct ion of agency fee at c i tyhospi ta ls was descr ibed. In accord-ance with appl icable law, agency shophousestaf f at c i ty hospi ta ls may askfor a proportional retund of agencyshop fees paid in proport ion to theexoenses of the union that are notdirect ly related to the workings of theunion in behal f of covered employees:That is, expenses for ideological orpol i t ical purposes are computed anddiv ided by total housestaf f payingdues or fees. That amount is thenrefundable i f requested in wr i t ing.Agency shop housestaf f on the c i typayrol l can reQuest their refund of$0.01 by sending a let ter to the Com-mit tee of Internsbnd Residents, 386Park Avenue Soir in, New York, NY10016, Room 1502, Attent ion: RonaldBagner, M.D., Sebretary-Treasureralong with a sel f -addressed, stampedreply envelope. Your refund wi l l besent to you prompt ly. Requests mustbe received by CIR by June 30, 1978for the last quarter ot 1977,

Computat ion of Agency Fee Refund0ctober-December 1977

Non-union ex0enses $10.00 contr tbut ion tothe Texas Farmworkers.

Average number of CIR dues and agency shopfee paying housestaf f ' 3,256

Refund $10.00' . 3,256: $0.003 rounded to$0.01.

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. . .PLEASE.. .In order f0r us t0 keep an accurate, up-to-date membership mai l ing I is t , Y0U MUSTc00perate by te l l ing CIR when you move andgive us the new, complete address.

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