Hospital hemorrhaging

City could slash residents' salaries at S.F. General by 15 percent, and that's just the beginning of the budget pain

By Rachel Brahinsky

The scene on the grassy strip in front of the San Francisco General Hospital's main entrance April 17 was chaos. About 65 hospital residents (essentially, doctors in training who provide frontline care) gathered to draw attention to their battle with the city over proposed wage cuts.

While one spoke through a bullhorn about long hours and low pay, beepers went off wildly among the crowd. One man held up an X-ray film toward the sun to examine its image. Others wolfed down union-bought pizza before heading back in to complete their shifts, which they say often keep them on the job for 80 to 120 hours each week.

There's no question these people work hard.

Some 200 of them face a wage cut of up to 15 percent this year as the city struggles to balance its books on a $347 million deficit. "We want to learn," by working as residents here, family practice resident Christine Dehlendorf told us. "But we have to live at the same time. Residents around the country are underpaid, but this is disproportionate."

The situation is complicated by the fact that, as a matter of course, residents periodically rotate in and out of S.F. General, UCSF, and the San Francisco V.A. Medical Center. While working at UCSF, first-year residents earn $1,800 less than they do over at General. By their third year, residents earn $6,169 less. (S.F. General residents receive raises each year – they earn up to $55,454 in their sixth year. But most only spend three years in the program.)

The Service Employees International Union local 1957, which represents the residents, reports that while S.F. General residents make $38,800 in their first year, equivalent positions at the Santa Clara Valley Medical Center are paid $40,397. In New York City, SEIU says, first-year residents in public hospitals typically pull in $46,296.

In the larger scheme of city budget slashing, the plight of S.F. General's residents is a little worse than some. They are temporary employees with limited benefits and already low pay. But theirs is only a small part of the story of program and salary cuts hitting the Department of Public Health. So far DPH plans to dramatically scale back hours at community health centers and eliminate mental-health treatment beds, and is requesting salary givebacks from all employees.

"We're asking everybody to do the same," DPH director Dr. Mitchell Katz told us. Essentially, he said, in a bad year, there's not much he can do to stop the bleeding. And this is a really bad year. "It's all about whether we're going to cut services or whether people will take less salary. I don't want to see these programs cut."

But critics argue that Katz has options. SEIU is pushing to keep salaries static and urging the department not to cut programs. "We think health care should be a city priority," union rep Joshua Rutkoff said. Rutkoff said the union hopes to reach a settlement before May 1. SEIU is also pushing the city to consider tax increases to boost the General Fund in the future, although any tax hike requires voter approval. (Last fall's Proposition L, promoted by SEIU, would have raised the real estate transfer tax, but it was defeated at the polls.)

The outlook for the residents, as with the rest of the health department, is fairly grim. Last year Sup. Chris Daly called for carte blanche protection for health programs. But this year, as the San Francisco Board of Supervisors Budget Committee chair, he says cuts are unavoidable. "I signed a pledge ... to find $40 million in savings in the public safety departments [including fire, police, and sheriff]. In the past I have prioritized health services. But I can't pledge to stop these cuts this year."

The Budget Committee is holding a hearing on the DPH budget Thurs/24 at the Joseph Lee Recreational Center, 1395 Mendell Street. More meetings in each supervisoral district will be held on select topics. Contact the Budget Committee at (415) 554-7723 for the schedule.

E-mail Rachel Brahinsky