More than 160 resident physicians at Elmhurst Hospital, one of the city’s largest public hospitals and ground zero of New York’s COVID pandemic response, voted to authorize a strike if they do not reach a deal on raises and hazard pay, their union announced on Wednesday.

Though public-sector workers in New York are prohibited by state law from striking, the doctors claim they can go on strike because their residency program is operated by Mount Sinai’s Icahn School of Medicine, meaning they are not employed by the city’s Health + Hospitals Corporation.

Talks between the doctors’ union, the Committee of Interns and Residents-SEIU, and Mount Sinai are ongoing. Key to the union’s proposal is demanding pay parity with Mount Sinai’s main, non-union campus on the Upper East Side. 

Elmhurst residents currently earn $7,000 annually less than their non-union peers on average, a disparity that is expected to widen to $11,000 this summer when Mount Sinai’s planned 6% increase for its East Side doctors goes into effect in July, according to the union.

“We see a huge discrepancy of how Mount Sinai treats their main campus residents versus the Elmhurst campus residents,” said Dr. Tanathun Kajornsakchai, a union delegate and fourth-year psychiatry resident at Elmhurst. “And it’s staggering and it is heartbreaking.”

The doctors, who are medical trainees who staff nearly every department at the hospital, voted to authorize a strike, with 92% in favor and 8% against, with 91% of eligible union members voting. No date for the work stoppage has been set.

A spokesperson for Mount Sinai Hospital did not respond to a request for comment.

In a statement, Health + Hospitals spokesperson Stephanie Buhle said the agency hopes Mount Sinai and the union can reach a deal without a work stoppage.

“Residents at NYC Health + Hospitals/Elmhurst play an essential role in serving our patients,” Buhle said in a statement to THE CITY on Wednesday. “We hope they are able to come to a satisfactory agreement with Mount Sinai, and we are confident that patient services will not be affected.” 

The union’s vote comes a week after doctors at Jamaica and Flushing hospitals authorized a three-day strike if they do not resolve their own collective bargaining agreement before May 15. If resident physicians at all three hospitals move to strike it could bring the number of doctors to walk off the job in Queens to almost 500, according to the union.

If doctors at any of the three hospitals walk out on the job, it would be the first strike by doctors in a New York City hospital since a nine-day strike at the hospital then known as Bronx-Lebanon Hospital Center in 1990.

Doctors held a strike at Bronx-Lebanon hospital in 1990. Credit: Courtesy of CIR-SEIU

The potential labor stoppage could be the second workplace disruption in the city’s health care system this year after 7,000 nurses at two major city hospitals struck for three days in January.

A Larger Awakening?

Elmhurst doctors received their last raise in 2021 and have been negotiating their contract ever since it expired 10 months ago.

The negotiations between the union and Mount Sinai have been tense: the union filed two unfair labor practice charges with the federal National Labor Relations Board in December 2022 and again in February alleging that Mount Sinai “refused to bargain in good faith with the union.” Both unfair labor practice charges are still under investigation by the board. Mount Sinai did not respond to THE CITY’s requests for comment on the charges.

Elmhurst Hospital residents rally next to a giant inflatable rat for better pay and benefits. Credit: Claudia Irizarry Aponte/THE CITY

In the early phase of the pandemic, Elmhurst doctors successfully petitioned for $300 weekly hazard pay. Now they claim that Mount Sinai has declined the union’s proposals for contractual hazard pay in the event of a future public health emergency.

Their demands are similar to those raised by doctors at Mount Sinai’s campuses in Harlem and the Upper West Side who, in the midst of their own collective bargaining negotiations, gathered in protest last week charging that Mount Sinai is shortchanging its unionized doctors by thousands of dollars a year. Those doctors have not yet voted to authorize a strike or to announce their intent to do so.

Doctors say the labor strife at Elmhurst, Flushing and Jamaica hospitals is representative of a larger awakening for doctors and health care workers not just in New York but nationwide

In January, nurses at Mount Sinai’s main campus and at Montefiore Medical Center walked out on the job after contract negotiations fell apart, returning to work three days later after securing 19% raises and a highly sought-after improvement in staffing ratios. In November, more than 1,000 residents at Montefiore Medical Center unionized with CIR-SEIU.

Residents who spoke with THE CITY said the pandemic was a radicalizing factor for young doctors, and nowhere was that more apparent than for those who cut their teeth at Elmhurst Hospital, which for a period in 2020 was the global center of the pandemic.

“When COVID started, it shifted the whole health care system of how things are running with uncharted territory – and unfortunately, Elmhurst Hospital was the epicenter for the world at one point,” said Dr. Kajornsakchai, 27. “There were dead bodies everywhere with nowhere to go. We were there the whole time. And the fact that we were not compensated or at least acknowledged for that is disappointing.”

People enter Elmhurst Hospital in Queens in September 2021. Credit: Ben Fractenberg/THE CITY

Doctors at Jamaica and Flushing hospitals, which are operated by MediSys Health Network, are bargaining for higher wages and improved patient loads. Doctors at the hospitals care for up to 40 patients at a time, the Daily News reported, and told THE CITY they often work 80-hour weeks with $15- to $17-per-hour pay. 

“Out of title” work like blood draws and patient transportation are also common practices in Flushing Hospital that have both distracted residents from bedside care and left them strapped for time, said Dr. Neha Ravi, 29, who has rotated in Flushing Hospital in the past and is now a first-year family medicine resident in Jamaica Hospital, where she said the patient load has been overwhelming.

Contract negotiations began in November last year but have “hit a dead end at every turn,” Ravi said, with negotiation sessions sometimes canceled without notice. The union has also filed several unfair labor practices against MediSys, including for allegedly blocking employees from posting union literature.

Xavia Malcolm, a spokesperson for MediSys, said “negotiations are ongoing” but did not respond to THE CITY’s inquiries about the residents’ specific concerns.

“Sessions are currently taking place and we are hopeful a resolution is reached,” Malcolm said.

Residents at Jamaica and Flushing hospitals have created a volunteer patient safety task force to handle emergencies in the event of a three-day strike later this month, Ravi said, and have given the hospitals “plenty of time” to staff its facilities adequately before then.

“The things we’re arguing for, they’re about patient care ultimately. So we want to all be on the same side,” Ravi told THE CITY.

It is up to doctors to be patient advocates, she added, noting that Jamaica Hospital serves a “primarily Black and Brown and immigrant” patient base.

“We just want what’s fair — we want what’s fair for us, and what’s fair for our patients,” Ravi said. “We’re not going to let our patients be put on the backburner and treated second class compared to other concerns that hospitals may have.”

Work stoppages by doctors in New York, and the rest of the country, are rare. For several decades until 1999, the NLRB considered resident physicians students, not employees, and therefore excluded from federal labor law protections, though doctors at several hospitals including Elmhurst won union recognition in that time. 

Elmhurst doctors last walked out of the job in 1979, when they joined nine other Health and Hospitals Corporation facilities in a 25-hour walkout to protest planned hospital closures and cutbacks.

This article has been updated to include input from the Health + Hospitals Corporation.