What the U.S. health system owes its lowest-earning workers


The notion of paying any health worker merely the federal minimum wage is objectionable to many, and also can be ethically fraught. In many areas of the U.S., the cost of living is at least twice that amount. As a result, besides facing constant risk of injury and illness, health aides, environmental services workers, nursing and medical assistants, paramedics and other health workers—as well as their families—may face chronic financial instability and lack of health insurance coverage.

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The AMA helps physicians build a better future for medicine, advocating in the courts and on the Hill to remove obstacles to patient care and confront today’s greatest health crises.

The September issue of AMA Journal of Ethics® (@JournalofEthics) investigates what physicians and health care organizations owe these essential, but often undervalued and underpaid health workers.

The issue includes the following articles.

  1. What Do We Owe Health Workers Earning Low Wages Who Are at Risk of Harm?

    1. Psychiatric aides and technicians are part of direct-care workforces in inpatient units who are subject to high rates of violence but earn far less than higher-status clinicians.
  2. How Should Health Care Organizations Protect Personnel in Environmental Services and Related Fields?

    1. The National Domestic Workers Alliance continues to organize around adequate labor protections for members, including care workers.

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  3. AMA Code of Medical Ethics’ Opinions Related to What We Owe Health Care Workers Earning Low Wages

    1. This article applies opinions to organizational obligations and interprofessional collaboration in health care.
  4. How to Better Value EMS Clinicians as Key Care Team Members.”

    1. Interdisciplinary care requires mutual understanding, trust and respect.

The journal’s September “Ethics Talk” podcast features a discussion with Noelle Driver, MD, an anesthesiology resident at the Mayo Clinic in Rochester, Minnesota, about the status of low-wage health workers.

The September issue also features seven author-interview podcasts. Listen to previous episodes of the “Ethics Talk” podcast or subscribe in Apple Podcasts or other services.

Also, CME modules drawn from this month’s issue are collected at the AMA Ed Hub™ AMA Journal of Ethics webpage.

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Upcoming issues of the journal will focus on health care waste, and price transparency and economic decision-making in health care. Sign up to receive email alerts when new issues are published.

Table of Contents

  1. Listen and learn
  2. A look ahead