Resident physicians in Buffalo are taking their case for better pay high up the chain -- above the city's main highway, to be exact.
They've posted two billboards on Route 190. One charges that University at Buffalo (UB) residents are "Overworked. Underpaid. Exploited."
Another says UB residents make below minimum wage, which is "Bad for Patients. Bad for Buffalo."
It's a strategy deployed by residents and fellows in the local chapter of the Union of American Physicians and Dentists (UAPD), which is in its first contract negotiation after forming in the spring of 2023.
They argue that their salaries are the lowest of all residency programs in New York state.
"Our goal is to make the general public aware," Armin Tadayyon, MD, MBA, an anesthesiology resident at UB and union member, told . "The general public thinks doctors are rich, but they have no idea what a resident physician is. We put it out there that residents are making less than minimum wage. It challenges the [image] that the public has."
Tadayyon said residents "aren't making a livable wage in Buffalo, and we are hundreds of thousands of dollars in debt" from student loans.
"They're the lowest residency salaries in New York, around $58,000 or $59,000 per year," Stuart Bussey, MD, JD, president of UAPD, told . "If you divide that by 80 to 100 hours per week, it's below minimum wage."
Tadayyon also noted that residents don't get hazard pay during weather emergencies, which snowy Buffalo is prone to. During states of emergency, "they send staff home who they would have to pay extra. If the CRNA [certified registered nurse anesthetist] were to stay, they would be accumulating overtime. But residents are free labor."
Union members came up with the phrases, then sent them over to the billboard company, which has a graphic design team, to make their vision come to life.
Tadayyon said of the posted to r/Residency on Reddit have garnered thousands of views and hundreds of comments.
Residents and fellows at University at Buffalo , which was finalized in June, and bargaining began in August, Tadayyon said. Negotiations had moved slowly, which helped prompt the billboard campaign, he said.
As healthcare becomes more business-driven, Tadayyon said he expects to see more interest among residents and fellows -- and even among physicians further along in their careers -- in joining unions.
"Physicians are going from being in private practice, either self-employed or partner-employed, to being hospital employees. And they're losing the autonomy that they had -- in their level of care, and the way that they practice medicine," Tadayyon said.
Unionization offers physicians the chance to "have a say in their practice and ... in their work, and how they practice medicine and how they treat patients," he added.
Bussey said UAPD has chapters in "five or six states now. It's popping."
The billboards went up in December, Tadayyon said, and they've led to "small incremental gains, but we are still not where we want to be. There's still a lot of work to be done."
In an emailed statement, the University at Buffalo said that University Medical Resident Services (UMRS) is the residents' official employer "and negotiator of record by the National Labor Relations Board."
"Accordingly, UB and its hospital partners are not parties to the negotiations," the statement continued. "UMRS has retained outside legal counsel to assist in the negotiations. While UB is not party to the negotiations, we have provided input to address concerns raised by the residents. The university remains hopeful that negotiations will continue to progress, and an agreement can soon be reached."