Josephine Valenzuela, MD
Emergency Medicine, San Francisco General Hospital

I love CIR. I love the premise of it: that a group of people who are otherwise fairly vulnerable (the house staff) can band together to have a voice on things that really matter to us: our working conditions, our patient care, and our communities. We work for powerful, well-funded institutions, but we are the people on the front lines of health care. We have a responsibility to advocate for ourselves and our patients, and CIR is one way we can do that effectively.

CIR does a tremendous amount at my home institution. Here are some issues we have tackled: pay parity between different hospitals (we work at many different institutions in my program, and we used to get paid different amounts at different times for each one), cafeteria hours and selection, bicycle parking, enforcing reimbursement for educational expenses, addressing safe staffing and stocking of our clinical areas, decreasing out of title work, and lobbying around gun safety legislation and patient safety. Through our patient care fund, we have provided ultrasound machines for multiple departments, books in many languages for our pediatric patients, a piano for our psychiatric patients to play, picture frames to display our young patient’s art work, home blood pressure cuffs for patients with hypertension, balloon pressure monitoring equipment for intubated patients, padded mattress pads for our high risk pregnant patients, among many, many other things.

Looking forward, we have many challenges to tackle in the coming year.

• The most pressing issue for our patients in my opinion is police and gun violence and the role of race in these issues. These are a public health issue, and physicians in training are on the front lines of caring for these patients. We are motivated and ready to advocate for our patients on these issues. We need to find tangible, effective ways for residents to get involved and make changes in their institutions.
• The ACGME will announce a new policy for work hours in the fall; we need to make sure that the resident voice is heard on this.
• Many of our hospitals will be negotiating new contracts, and our priority as always is to make sure these contracts emphasize good patient care, safe working conditions, and resident well-being.
• As it stands, many residents have no official representation in their contract negotiations. CIR needs to expand to cover more hospitals and more residents.
• Depending on the results of the election, the health care environment in this country may change dramatically, and our residents and fellows need to be ready to respond quickly to these changes to protect and advocate for our patients.

Thank you for giving me the opportunity to represent you. It is a pleasure and an honor.