The Setting

"North Entrance". 8/10/12 via wikimedia. Attribution Share Alike 3.0 Unported.

To further understand the story,  it is important to understand setting and where the controversy is located.

The story takes place in the beautiful and busy city of Seattle, Washington, where the sound of rain is like constant background music, the night chill a sort of calming lullaby. Specifically, we are looking at the hospitals affiliated with the University of Washington Medical School. This medical school is rated one of the top medical schools in the country and has received significant recognition thanks to it's passionate students and dedicated staff. Walking into a hospital is typically like walking into an extremely controlled tornado, in a way. There are numerous procedures and tests being run, sneakers squeaking everywhere, small gusts of wind as scrub-wearing faculty walk by. But everything is organized and people are communicating. Residents are of utmost importance to keeping the whole show running. They complete procedures, scrub into surgery, monitor overnight care, complete paperwork, and numerous other activities depending on their residency and/or specialty. There is not a single resident there who has free time during a shift, everyone is hustling. Every resident is difference and comes from a diverse background, but one issue they all have in common is the pile of debt they are buried under due to medical school am living expenses. This financial burden is usually still not addressed during residency due to resident pay rates. Although the rates are relatively even across the country, living in the expensive city of Seattle is not helping. Young residents continue to work long shifts, power through being on call, continue learning new procedures, and maintain somewhat of a social life. Stories have been shared of residents such as Katie, who was 36 weeks pregnant before being forced to take a small leave from her residency due to complications. Or Andrew Korson, who claims he barely makes enough money afford his rent. These stories are fairly common among residents, which is why the issue has been brought up by a organizations such as UWHA and are supported by Seattle City Council. With these stories in mind, it is easy to see why living in a beautiful city, working a wonderful job, can still cause stress for medical residents.

 What do you think the importance of the location is?

Stakeholder #2

Over time, the debate over resident pay rates at the University of Washington has reached people outside of the medical community.

Another group that has an interest in this issue is Seattle City Council.

"Seattle City Hall" 5/31/08 via wikipedia. Attribution ShareAlike 3.0 Unported.

Imagine, you have worked your way up in the government system and are currently serving in the Seattle City Council. A normal day in the office is constructed of piles of paperwork, smooth desk tops, the sounds of heels and quiet chatter, and then like always, you become aware of an issue in the city. Members of the city council offer a relatively unbiased view of the controversy because they are not working in the medical field. Their job is to consider the facts and think of ways to solve an issue. Five members released an official letter to the University of Washington president, asking her to consider compromising and meeting the requests of the UWHA. To the public, city council takes the role of a counselor, who considers issues and tries to facilitate agreements that will benefit the whole community, while minimizing repercussions or weaknesses in the agreements. City council members are elected by the community for four-year terms, so they represent the needs and priorities of Seattle. They are relatively easy to contact since they provide information on their website and hold community meetings and hearing.

Specific Claims

• Excerpt from letter: “We write to express our support for the University of Washington Housestaff Association (UWHA) and to urge you to meet the UWHA’s reasonable demands in contract negotiations”

• Except from letter: " These physicians provide an invaluable service to our community and deserve to be compensated fairly. Shockingly, however, many of these physicians early less than our city's hourly minimum wage"

• From article: "Councilmembers Mike O’Brien, Kshama Sawant, Lorena González, Nick Licata and Jean Godden sent a letter to UW President Ana Mari Cauce this month urging her to meet demands of the association that represents about 1,500 doctors who are UW residents and fellows"

Validity of Claims

• Primary source, the city council is supporting the UWHA's efforts and uses keywords such as "urge" and "reasonable" for appeal

• More use of key words such as "invaluable" and "fairly", this is where the main argument is presented that physicians should be paid more, appeal to logos because they cite the fact that physicians make less than minimum wage in some cases

• The author of the article is addressing the size of the community involved to appeal to the audience, because the more people involved, the more credible the issue

Similarities and Differences from other Stakeholders

• Very similar to the claims made by UWHA
• Physicians need to be paid more
• There must be an effort made to negotiate

• Slightly different from UW administration
• The city council wants to administration to cooperate and meet the requests of the UWHA
• The administration has stated some of the requests are not reasonable, like parking passes and fees

What role do you think credibility plays in claims?

 

Stakeholder #1

A stakeholder is someone who is personally involved in an issue and has something to potentially lose or gain. To further understand the sides of the controversy, it is important to analyze the big stakeholders.

My first stakeholder is the University of Washington Housestaff Association (UWHA).

"City Skyline". 9/26/06 via pixabay. CC0 Public Domain.

The University of Washington Housestaff Association  is a non-profit group that advocates for the University of Washington residents. They want to help make the voices of staff heard. The members of the organization are willing to go the extra mile to help the residents at affiliated hospitals. Members are residents and fellows who volunteer their time. They are in the middle of a complicated and tiring experience as medical doctors. They work strange hours, often heading into the hospital when the night falls or when the sun is barely starting to shine. They spend around 80 hours a week running around hospitals, becoming accustomed to the smell of disinfectant and sound of medical supplies. The organization is peaceful, yet firm. It appears as to others as a branch of residents who are seeking change in the system not only for themselves, but for others. As a group, the organization appears like the kid on the playground who you know is just trying to make recess more enjoyable and relaxing for others. Individually, members are scrub-wearing heroes who save lives regularly.


Specific Claims

• Mission statement excerpt: "Fair compensation for physicians in training, recognizing their collective and extensive education, their debt, their cost of living in a large metropolitan city, their level of responsibility, and hours of providing care to their patients"

• Another excerpt: "Knowledge, skills and information that may be useful to our members either now as physicians in training or later as attendings, especially regarding debt management, retirement planning, or any other personal or professional issues viewed as helpful to our member physicians" 

• Except from article published from UWHA President, Jacob Sunshine: "Residents are doing this not because they are dissatisfied with their training. Indeed, we are not asking to work one moment less than our roughly 60 to 100 hours per week (not more than 80 averaged over a month), nor trying to usurp control over how our teachers want to train us"

 Validity of Claims

• Addresses the financial and education aspects of issue, no facts involved, but directly claims what they wish to get out of an agreement, credible because this is a primary source

• Addresses the time frame of the changes they want to see, presents as credible because coming from direct source, broad focus 

• Addresses that residents are reasonable, they do not want to work less, just work under conditions they believer are fairer, this establishes them as logical and credible

Similarities and Differences from other Stakeholders

• Both the UWHA and the medical residents at affiliated hospitals (stakeholder #2) want to work towards better and safer environments for patients 

• The UWHA is making demands that the UW administration does not seem entirely possible, such as the parking fees

• The UWHA and UW administration both want to come to an agreement to end dispute

What else should I research about this stakeholder?

The Big Event

Every good story has a clear beginning. In order to present the issue in my project, I have to decide was aspects of the beginning I should share.

Altmann, Gerd. "Road Start". 1/17/06 via pixabay. CC0 Public Domain.

During a chilly March night in 1984, patient Libby Zion arrived at the emergency room of a hospital in New York. Residents at the hospital rushed to her aide, probing around to figure out what was wrong with her. They were puzzled, but after some thought and discussion, they produced a treatment plan and prescribed medication. As the temperature outside decreased, Libby's fever increased. It was only a mater of time before she passed away from cardiac arrest in that hospital, surrounded by the sound of rushing physicians and the smell of disinfectant. The cause of death was uncertain, but the exhaustion of the residents could be felt, and the question whether Libby's death occurred due to malpractice from sleep deprivation.

By 1989, the state of New York put into place a law that limited residents' work hours to 80 a week. The hope was to end the sleepless lights and quiet the hum of exhaustion the residents too often felt while working. Unfortunately, the law, like any person, has an Achilles heel. Residents still find themselves working over 80 hours because they are on call or have paperwork and notes to review. In 2012, a resident at Harborview Medical Center named Katie Benziger was forced to leave her job temporarily because she had developed complications in her pregnancy due to the stress of her job. And even before Katie's story was shared, other residents at the University of Washington have been unionizing to ask for better pay and benefits. The University of Washington Houstaff Association (UWHA) has picked up momentum in mid-2015, and continue to strive for change in 2016, with the support of city council members and various other residents.


Do you think this is an effective summary of the big event leading up to my controversy?

My Sources

Now that I know what I am doing, it is time to climb the steps of research.

I've got to search for sources far and wide, nothing will escape me.

Kennedy Chuck. "President Barack Obama Uses Binoculars". 3/25/12 via wikimedia. Public Domain.

Okay, I am going to analyze 10 different sources, and the information is going to be slightly overwhelming, so I am going to add pictures of cute puppies because those pictures make me happy (and they provide a nice break from reading).

Source 1

• Where Found
• UW Housestaff Association website (UWHA)
• run by organization, credible
• Who
• No specific author mentioned
• "About us" page reveals website run by organization, but no individual member posts anything individually.
• This does affect credibility due to the potential bias, since members are volunteer residents and posts are relatively anonymous.
• When
• January 6, 2016
• This is the time when the UWHA and ACGME are still trying to come to an agreement, but issue has been going on for a while.
• What
• Provides fantastic overview of what the issue is, who is advocating for it, why it happened, and what can be done to improve the issue.
• Stakeholders: Medical residents, UWHA, ACGME
• Important because it is coming from the point of view of the organization and summarizes their claims.

Source 2

• Where Found
• The Daily, student-run news website for the University of Washington
• relatively credible
• Who
• Author: Susana Machado
• provides Twitter page, not a professional reporter 
• The author does not have ideal credibility established, but the website has some credibility.
• When
• January 14, 2016
• This was published during a time when the UWHA and ACGME are trying to negotiate.
• What 
• Provides information on stance of administration and students, while focusing on the salary aspect of the issue.
• Stakeholders: administration and union members
• Important because written from perspective of someone who has no personal stake in the issue.

Jiratarawat, Teerasuwat. "Chihuahua". 1/29/15 via pixabay. CC0 Public Domain.

Source 3

• Where Found
• Slate Magazine website
• Focus on science, politics, technology, mostly credible
• Who
• Author: Jacob Sunshine
• President of UW Housestaff Association and second year resident studying anesthesiology 
• Twitter page provided
• Due to credentials, he is credible, but possibly biased
• When
• May 20, 2014
• This is very early in the timeline, before the majority of the interaction between UWHA and administration. 
• What 
• Provides explanation of how residencies and match days work and emphasises the need for change.
• Stakeholders: Jacob Sunshine, UW Residents, UW Administraton
• Important because he is a second year resident and president of UWHA, which provides a unique account of the issue.

Source 4

• Where Found
• UWHA website
• Credible for the most part
• Who
• Unspecified author
• Website run by organization as a whole
• When
• October 29, 2015
• This was published earlier in the dispute period, but still during a time when students were hearing about the issue.
• What 
• Provides answers to frequently asked questions by incoming or potential UW residents.
• Stakeholders: Incoming resident aka medical school graduates, UW administration, UWHA
• Important because it focuses on a different group involved in the issue! It will be interesting to analyze how UWHA handles the issue with the incoming classes.

Wiedmeier, Lisa. "Puppy". 11/3/12 via Flickr. Attribution ShareAlike 2.0 Generic.

Source 5

• Where Found
• The Seattle Times online news site
• Credible
• Who
• Author: Daniel Beekman
• Seattle Times staff who likes to report of politics and government
• This is good news because he has no stake in the issue, so unbiased
• When
• December 27, 2015
• This was after the initial attempts by the unions to find common ground with the UW administration. The issues were not fixed, so more attention was drawn and more people were getting involved at this time.
• What 
• Provides a quick re-cap of the events between the UWHA and UW administration, and lists the city council members who are supporting the union of residents. 
• Stakeholders: council members, UWHA, UW administration
• Important because the article identifies new stakeholders who have joined the issue.

Source 6

• Where Found
• Puget Sound Business Journal under "Health Care" section
• Owned by American City Business Journals, which expands across the U.S. and publishes frequently
• Who
• Author: Valerie Bauman
• Journal staff member who likes covering business news concerning health care.
• When
• June 9, 2014
• This was published early in the issue timeline, around the time Jacob Sunshine, president of UWHA, published his own article on the issue for Slate Magazine. The issue is building momentum during this time, so the content discussed is fairly business like and reflects the ideas that allowed for the progression of interaction between UWHA and the UW administration.
• What 
• She actually mentions Sunshine's article and comments that he does not address specific numbers nor does he take certain economic issues into consideration.
• Stakeholders: Health care industry, UW
• This article shines light on some issues Sunshine may not have touched in his article. It offers a more economic view on the issue, which helps eliminate bias.

Benenovitch. "87 Day Bambi". 6/23/11 via Flickr. Attribuion NonCommercial 2.0 Generic.

Source 7

• Where Found
• "State of Reform" Website
• Focus on "Bridging the gap between health care and health policy"
• Lead by DJ Wilson and other contributors who meet up at annual conferences to discuss issues.  
• Currently looking to hire more reporters and analysts, still growing., affects credibility.
• Who
• Author: Stephanie Wick
•  Not much information provided, besides that she has been working there for about a year.
• When
•  January 14, 2016
• More recent time when more people have become involved in the issue and stakeholders are trying to find a common ground.
• What 
• Presents issue as an argument and provides links to demands from UWHA and responses from Byron Joyner, who is vice president of ACGME. 
• Stakeholders: UW administration, UWHA
• Important because provides information on direct responses among stakeholders.

Source 8

• Where Found
• UWHA website
• Who
• Author not specified, but website is somewhat credible
• When
• October 20, 2015
•  This time period was after the issue was first being talked about, but before it gained more attention. This is during the time when requests were being made.
• What 
• Details the burden of having to pay for parking, which was one of the issues brought up with administration. 
• Stakeholders: UWHA, UW residents, UW administration 
• Important because it addresses one of the demands the UWHA is making, but that seems to not emphasize so much at later times.

 

Federspiel, Manuela. "Chihuahua". 10/25/15 via pixabay. CC0 Public Domain.

Source 9

• Where Found
• University of Washington website, under "labor relations"
• Credible source, since it is coming right from the UW webpage
• Who
• Published by UW Labor Relations as a group, unspecified authors
• Somewhat affects credibility
• When
• Dates of posts are not provided
• However, each post title includes the date of an update 
• The earlier post dates back to January 26, 2015
• The most recent post is from January 25, 2016
• What 
• Publish updates on demands and negotiations between UWHA and UW administration. Provides details and summaries.
• Stakeholders: UW students, UW administration, UWHA
• Important because this page provides the most information throughout the longest time period of all the sources I have found. It is also the most direct and unbiased.

Source 10

• Where Found
• KPLU 88.5 Radio Station 
• Provide news for Seattle
• Who
• Author: Ashely Gross
• Business and Labor reporter working in the field for over five years, works for three different news organizations
• Credible source, Twitter page provided
• When
•  January 11, 2016
• At this point, many people are aware of this issue since it has gained momentum and the stakeholders have been trying to come to an agreement for months. The issue and arguments are well developed.
• What 
• Provide a summary of what started the issue and who is trying to find a solution. 
• Stakeholders: UW administration, UW residents, labor unions
• Important because it will reach a broader audience of people, so the issue will continue to expand.

Do you think I will need to find more sources? Maybe different types of sources?

Analysis of my Rhetorical Situation

So, I have chosen a story that interests me. But now, what am I going to do with it? How am I going to approach the project? Wait, what exactly am I doing again?

To continue with the project, I have to consider the writing situation I am in by conducting a rhetorical analysis. If I think of my project as a puzzle, bu completing this analysis, I will have completed the frame of the puzzle.

Braxmeier, Hans. "Pieces of the Puzzle". 7/8/14 via pixabay. CC0 Public Domain.

Audience 

• Pre-Medicine Undergraduate students, Medical Students, Current Medical Residents, Attending Physicians or other health care professionals

• Consume other media such as: social media (Twitter, Facebook), Medical journals or blogs

• Demographic factors: mode age range is 18-28, in debt due to medical school costs, difficult to narrow down further due to diversity of students

• What is important to them
• Learning about the medical field
• Gathering information that will aid in career decisions

• What they value
• First account stories from primary sources
• Unbiased analysis of field

Purpose

• The purpose of this project is to give the audience an account of how professionals in the medical field turn to writing to argue or advocate for causes. 

• I want to make the intent, strengths, weaknesses, and biases of the articles and different stakeholders clearer.  

• It is important for the audience to know the following about the stakeholders
• all related to the medical field in some way
• all have a different perspective based on where they are in their career
• in order to understand their stances, must analyze the situation as a whole
• setting: hospitals, medical schools
• time period: recent times, 2000-present

•  I am slightly worried the audience will not understand some details of the story because they might not be familiar with the regulations at Harborview Medical Center, so I will need to make those details clear.

Author

•  I bring a unique spin to this rhetorical analysis because:
• I care about this issue
• I am critical of accounts, so I always question credibility and the types of appeals people are using

•  This topic interests me because I am interested in applying to medical school, so the information presented in the story and the analysis of the writing occurring in the field will be beneficial to know.

• I would say this story is a perfect fit for me because I care about the entire story. I want to learn more about medical resident regulations, maternity leave regulations, how regulations differ with hospitals, and analyze every angle of it. 

What do you think is the most important aspect to keep in mind?

Considering Genre

Woo! I have reached the end of Pre-Production week! #survivor

Chen, Duncan. "Rocky Balboa". 2/12/06 via Flickr. Attribution Non-Commercial ShareAlike 2.0 Generic.

Now that a good bulk of the research is over, it is time to pick a genre for Project 1.

(Queue the mental drumroll please)

1. I have chosen the Quick Reference Guide! Honestly, At this point I do not think I am prepared to complete anything else but the QRG. And none of the other genres seem appropriate for my topic at the moment. The QRG will allow me to:

• summarize the main arguments
• make lists and add links
• organize information into subsections

I believe all of that will definitely help me express what I have learned.


2. Before I begin production, I will have to:

• view the example QRG's on D2L
• read some one my peer's "Investigating Genres" blog posts
• figure out a way to minimize word count while maximizing efficiency (interestingly, I don't talk a lot, but I do write a lot)

I need to master the art of subsections, word condensation, and organization in order to present my research in a successful way.



3. How am I feeling going into Project 1? Um, I think I have lost the ability to feel. I am so stressed, I cannot even feel the stress. The stress has become a quiet hum along my entire body and mind.

"Learning" 7/12/12 via Flickr. Attribution ShareAlike 2.0 Generic.

I'm kidding, of course. I feel weirdly excited! I will be writing about the lives of medical residents. I hope to be a medical resident someday, so I am looking forward to continuing to research a topic that truly interests me and that will teach me something that will last way past this semester.

Brown, Gerard. "Excited Dog". via Getty Images.

I can't wait to share the information I have found! And I've never written a QRG before, so this is overall a new experience.

What are you most excited for?