As New Mexico Faces a Doctor Shortage “Perfect Storm,” UNM Pays Resident Physicians on Par with the Hourly Rate of McDonald’s Crew Members.

This is the first of several stories dealing with the collective failure of UNMH, the UNM Medical School, the Governor and State Legislature to address an increasing crisis of shortages of health care professionals. Today’s lead story focuses on the plight of resident physicians at the University of New Mexico Hospital – and the indifference of UNM Leaders.

“We are tired of feeling undervalued and belittled at the bargaining table.”

“Becker and the others want to say this is just about money, but I think one of the biggest effects of the pandemic was to expose a gap in values between the people who care for patients at UNM and the ones who run it.”

– Statements from frustrated Resident Physicians at UNM Hospital.

Above: The new Dean of University of New Mexico’s School of Medicine, Dr. Patricia Finn, on a tour of New Mexico with her husband, David Perkins, MD, PhD., who was also hired when UNM appointed Dr. Finn as Dean.

“I really want to be a voice for every voice that I heard.”

So stated Dr. Patricia Finn in a UNM School of Medicine press release about the people she met on a tour of the state of New Mexico in August.

Dr. Finn and her husband started that tour a day or two after she met with physician residents of the UNM Hospital who are trying to get a fair raise and better working conditions at the state’s flagship hospital.

The School of Medicine is closely aligned to UNM Hospital.

The Candle asked UNM’s communication department if we could interview Dr. Finn about her tour and her earlier meeting with the physician residents.

Dean Finn was copied on the email requesting the interview.

She apparently declined, as the request was unanswered (although The Candle did get some emailed information about the expenses she billed UNM for her tour – which will be reported on in an upcoming story).

From conversations The Candle has had with resident physicians, Dr. Finn is not lending her voice to address the concerns and frustration she heard from them.

She and UNM Hospital CEO Kate Becker, along with other UNM leaders, appear to have no desire to seriously address the disastrous health care workforce shortage facing the state of New Mexico.

That indifference is demonstrated by the attitude and actions of the upper echelons of the UNM Health Sciences community towards the hospital’s current health care workforce – including resident physicians.

“While our salary falls further behind, exorbitant raises are awarded to the very people who gaslight and stonewall us,” – Dr. Alisha Berry, a member of the union Committee of Interns and Residents SEIU.

“They refuse to partner with us on improving patient access to care, instead working to keep our salaries low, showing deeply misaligned priorities at stark odds with the supposed mission of the institution,” continued Dr. Berry.

For two years, resident physicians asked to partner with UNM Hospital and the UNM Health Sciences Center seeking to get additional funding from the state to address compensation shortfalls and better conditions for patients and employees.

According to the doctors, when it came time to coordinate messaging to the legislature and executive branches of state government, the UNM HSC leadership essentially abandoned ship.

During the past four years, and into the next fiscal year cycle, the state government will have had about $10.5 Billion in additional revenue for important state initiatives – and that does NOT include the billions of dollars received by the state and UNMH from the federal government for COVID relief and infrastructure development.

In an upcoming installment to this series, The Candle will report further on the lack of a serious legislative effort by UNM HSC to seek access to those revenues for health care workforce development.

Health care workforce shortages are real and about to get worse.

As reported in the introduction to this series, in less than seven years New Mexico will have the third highest percentage of residents over the age of 66.

That’s a lot of old people needing the care of doctors.

The state also has one of the highest average age of practicing doctors – 53.

New Mexico is desperate for new doctors.

But the doctors working as residents at the state’s “flagship” hospital, along with other hospital employees, get a sense the leaders of University of New Mexico Hospital and School of Medicine are out of touch with the financial and workplace realities employees face.

Resident physicians have been in negotiations with UNM Hospital and the School of Medicine for fair compensation for more than eight months.

The existing contract expired at the end of August.

From the beginning, UNM Hospital CEO Kate Becker and the other three UNM medical/health leadership officials have dug in their heels and provided excuses instead of reasonable solutions.

“CIR residents and fellows have faced appalling disrespect and outright dismissal at the bargaining table, where our essential contributions to patient care are consistently undervalued,” according to Dr. Berry.

UNM Hospital has about 714 doctors that are in various residency programs.

Most of these doctors, having completed a minimum of four years of undergraduate school and another four years of medical school, are carrying six-figure debt – averaging about $250,000.

They represent much of the “boots on the ground” physician force at UNM Hospital.

They work exceedingly long shifts – most clocking 80 hours a week.

They are not paid overtime.

As another resident physician stated, “It’s predatory. There’s no way around that.” 

He suggested that UNMH has “this overwhelming desire to just milk residents for everything and pay them pennies on the dollar for the work that they do…”

UNM Hospital Pays Resident Physicians an Hourly Rate on Par with the Hourly Rate of McDonald’s Crew Members.

So when you look at the annual “stipend-type” salary they receive – ranging between $59,456/year for a first year resident, to $74,287/year for a seventh year resident – it is important to understand their compensation is the equivalent of working two full-time jobs as a highly trained medical caregiver at a rate of, on the low end – $14.86/hour; and on the high end – $18.57/hour.

That is the rate of pay for many of the doctors you are likely to be treated by when visiting the emergency department at UNMH, or any of the various clinics throughout the University Hospital system.

It is on par with what McDonald’s pays crew members in Hobbs, New Mexico.

The latest offer from UNM is for a 2% raise for the resident physicians.

Becker claims that she and other highly paid officials have taken a temporary cut in pay of about 5 percent.

Despite the 5% temporary pay cut, Becker is still hauling in $662,916/year.

And three other UNM hospital officials claiming the HSC Health System can’t afford a fair raise for the front line folks, are also sitting pretty comfortable: UNM School of Medicine Dean Patricia Finn, M.D., CEO of UNM Health System Douglas Ziedonis, M.D., M.P.H., and Sr. Associate Dean for GME, Joanna Fair, M.D., Ph.D., make between $214/hour and $342/hour (see annualized salaries below).

Left to Right, UNMH CEO Kate Becker, J.D., M.P.H.; Patricia Finn, M.D. Dean UNM Medical School; Joanna Fair, M.D., Ph.D., Sr. Associate Dean for GME; and Douglas Ziedonis, M.D., M.P.H., CEO UNM Health System.

While Telling Employees at Hospital Things are Tight, UNMH Quietly Gives Management Negotiator $23,316-a-Year Pay Increase – Calls it a Promotion.

Although the CEO’s claim that “chiefs, associate chiefs and executive directors” were taking a temporary 5% cut in pay was reported last June in the Becker’s Hospital Review , The Candle found at least one of UNM Hospital’s lead negotiators was given a significant pay increase in September.

Ryan Randall has worked for UNM Hospital since about 2007. He has sat across the bargaining table from the unions representing hospital workers for many of those years. He usually rolls out the “the hospital is facing financial strain” routine when workers seek a raise.

In 2019, after telling hospital workers during negotiations that the hospital couldn’t afford a long overdue 7% increase, he offered 2% then finally settled with the unions for a tiered 3.5% to 5% increase.

About two months after the contract was signed in 2019, UNM Hospital gave Randall a 15% increase, raising his pay by $21,569.

History seems to be repeating itself.

While the resident physicians sought a 12% increase from UNM Hospital, Randall and his management bargaining colleagues continue to stick with a 2% offer for doctors already being paid at fast food service rates.

The union last countered with 11%.

UNM Hospital has insisted on 2% and appears to be pushing for arbitration.

Randall Calls Resident Physicians “Wacky.”

Resident physicians feel insulted and discouraged.

“As New Mexico faces a critical and growing physician shortage, we are simply asking UNM for fair wages that will help keep resident physicians in this state after training.” Dr. Rupali Gautam told The Candle.

The disrespect is not new – it has been felt for several years – especially during the COVID pandemic.

Dr. William Wylie related the following to The Candle,

“In 2021, resident physicians bargained our full contract. It was the height of the pandemic and after fighting the virus without vaccines or proven treatments, grieving as our patients died and worrying that we would be next, I thought that admins would be eager to help out.

“Instead, their lead negotiator Ryan Randall called us ‘wacky’ and fought against proposals that would have protected residents’ families.

They talk a lot about prioritizing resident well-being, but it feels like their actions send a consistent message that we aren’t respected and aren’t valued.

Adding to the insult – this year, as Randall and his bargaining team colleagues were telling the residents and other hospital employees that the hospital had little money for them, Randall was quietly treated to, ironically, a 12% increase in pay – initially described as a promotion by UNM.

“Recently, UNM Hospital had an open position of “Executive Director of HR Labor Relations” for which we conducted a competitive hiring process,” the UNM Communications Department wrote to The Candle.

“Mr. Randall applied and interviewed for the position.  The hiring committee found Mr. Randall most qualified, he was offered the new role, and he accepted.  This was a promotion from his previous role.  We are always pleased when employees find UNM Hospital offers careers with upward mobility.”

But when pressed by The Candle, the hospital admitted it was a new job, writing in an email:

“It was a new position, so it did not have a prior incumbent. We had 21 applications (not all who apply qualify), we interviewed 3 individuals.

And to The Candle’s question as to who else applied for the job?

UNM responded: “We do not disclose candidates’ names because of confidentiality.”

According to records The Candle received, Randall was given a $23,316/year boost in pay – raising his salary from $194,230/year to $217,547/year (see chart of Randall increases in pay since 2019 below).

But according to UNM, it wasn’t, at least technically, a pay raise.

NamePositionHourly RateAnnual AmountDateDollar Increase% Increase
Ryan RandallDir Employee Labor Relations$69.07$143,665June 201900%
Ryan RandallDir Employee Labor Relations$79.44$165,235Nov 2019$21,56915%
Ryan RandallDir Employee Labor Relations$93.38$194,230July 2022$28,99518%
Ryan RandallDir Employee Labor Relations$93.38$194,230June 202300%
Ryan RandallExec Dir HR Labor Relations$104.59$217,547Nov 2023$23,31612%

Dr. Gautam’s response to UNM’s increase of pay for Randall is reflective of the feelings of the resident physicians and other hospital workers:

“…We are offered crumbs for 80-hour work weeks, while the person across from us at the bargaining table gets a massive raise.

“Our cost of living has risen, inflation has impacted everyone, student loan repayments have picked back up, and we are struggling to pay rent and afford food for our families.

Dr. Gautam’s comments are representative of most resident physicians, “We are tired of feeling undervalued and belittled at the bargaining table. UNM needs to remember that resident wellness equals patient wellness.”

And the frustration is not limited to the resident physicians.

The Candle has spoken to employees represented by District 1199NM, which represents thousands of UNM Hospital nurses, technicians, and support staff.

Dr. Wylie offered his observations of how much employees outside of his bargaining unit are demoralized and angry – to the point of leaving the hospital.

“I’m pretty sure this goes beyond resident physicians, because over the last five years a lot of the front-line people I admired and enjoyed working with have left UNM.

“Becker and the others want to say this is just about money, but I think one of the biggest effects of the pandemic was to expose a gap in values between the people who care for patients at UNM and the ones who run it.”

In the next few days, The Candle will be reporting on the other UNM Hospital employee groups that are also being denied fair compensation and a safer workplace.

There will be more reporting on the failures of leaders of UNM Hospital, the School of Medicine, and related health systems of UNM HSC, as well as the failure of state policy makers to get a grip on the importance of maintaining a nurturing environment for its health care workforce.