“Physicians serving the city’s most vulnerable populations are not seeking extravagant salaries. Instead, we advocate for fair compensation to address the worsening shortages, ensuring the full staffing levels necessary to deliver the quality care that all New Yorkers deserve.”

Imagine waking up in New York City feeling sick. Where do you turn? For countless New Yorkers, they turn to the doctors of New York City Health and Hospitals (H+H). H+H is more than just a healthcare system; it’s a lifeline, particularly for those who depend on it as their primary source of care. For individuals without insurance, H+H is often the go-to hospital when they need medical care.

Health and Hospitals is the largest municipal public healthcare system in the United States, dedicated to promoting and protecting the health, welfare, and safety of all New Yorkers. Currently, we, the physicians represented by Doctors Council SEIU—a union with about 2,800 members—are in the process of negotiating with H+H management.

We manage patient care across 11 acute care and safety net hospitals in all five boroughs. Additionally, our members work in 30 outpatient clinic centers throughout Gotham Health and in various mayoral agencies such as the FDNY-EMS, Department of Health and Mental Hygiene’s sexual health and TB clinics, and the Office of the Chief Medical Examiner.

During the COVID-19 pandemic, when our hospitals were overwhelmed and resources were scarce, physicians worked tirelessly to ensure optimal care, often logging up to 120 hours a week. Now, post-pandemic, we face a staffing crisis. Over the past decade, salaries and benefits—far below market rate—have stagnated. The combination of pandemic-induced burnout and non-competitive salaries has left many positions vacant and entire medical services empty, impacting the quality of care we provide. Without a strong physician workforce, the stability of New York City’s healthcare system is gravely at risk.

Vacancies in every department have led to longer patient wait times, reduced services, and increased healthcare worker burnout. Physicians committed to their mission are carrying an even larger and unsustainable workload. At Jacobi Hospital, departments like rheumatology have closed, forcing patients to travel to other clinics that are now under strain. At Woodhull Hospital in Brooklyn, the ear, nose and throat (ENT) and ophthalmology clinics cannot schedule patients promptly due to staffing shortages.

Essential services like orthopedic surgeries and gastrointestinal procedures have been postponed because of a lack of available anesthesiologists. The average wait time for a medicine clinic appointment is over three months, and a routine screening colonoscopy can take up to a year at some locations. The ER department has lost five doctors due to staffing issues and related job stress, significantly impacting patient care. Both hospitals predominantly serve Black, brown, immigrant, and low-income patients, making these issues even more critical.

As doctors driven by service and mission, we are committed to serving those in desperate need regardless of their ability to pay. Last year alone, we provided care to over 1.2 million unique individuals, including New Yorkers requiring immediate attention in emergency rooms across the city. However, these staffing shortages pose a significant threat to patient care and safety, potentially exacerbating the racial and health inequities already prevalent in our city.

Physicians serving the city’s most vulnerable populations are not seeking extravagant salaries. Instead, we advocate for fair compensation to address the worsening shortages, ensuring the full staffing levels necessary to deliver the quality care that all New Yorkers deserve. Without a resolution, staff shortages and physician burnout will persist, causing New York’s public healthcare system to deteriorate and leaving it unprepared for the next crisis.

Why should this concern New Yorkers? Because New York City’s healthcare system plays a crucial role in providing the best possible care for its residents. The importance of H+H in achieving this goal cannot be overstated. A strong and equitable contract not only improves working conditions but also guarantees access to quality care for all New Yorkers. It ensures a future where our healthcare system is fortified and fully supported, ready to respond effectively to any future disasters.

For too long, the concerns of thousands of healthcare workers at H+H have been dismissed by executives. As we advocate alongside our nursing colleagues for fair compensation, adequate staffing and support from Mayor Eric Adams and elected officials, we are not just championing the cause of healthcare workers; we are also fighting for the well-being of our city.

We can ensure that New York City’s healthcare system remains a beacon of hope and healing for all—but only if H+H and our leaders prioritize our communities by collaborating with the physicians, who serve our patients daily, rather than working against them.

Dr. Bronson Joseph Raja, MD, FACP, is an assistant professor and academic hospitalist at NYC Health + Hospitals. Joanne M. Fernández-Booker, MD, MPH, FAAP, is a field physician at the NYC Department of Health and Mental Hygiene.