A Seat at the Table: Physicians Have Been Unionizing in Droves

A flurry of recent unionization efforts have included those by seasoned physicians, as well as those who are early in their career. In this story, we recap some significant organizing strides from this past year, and the factors that have been contributing to these efforts.

Physicians have increasingly demonstrated that they want a seat at the table. This sentiment coincides with the changing landscape of practice, with more physicians now being employed rather than heading their own practice. Union organization efforts at many different institutions have kicked off a chain of similar events across the country, with groups both large and small.

Indeed, many physicians involved in recent unionization efforts have told MedPage Today that they have been motivated and encouraged by watching each other.

Late last year, researchers reported in JAMA that unionization among healthcare workers had remained low in recent years, even though union membership or coverage has been tied to higher weekly earnings and better non-cash benefits. Lately, however, there has been a resurgence in such efforts.

“For healthcare workers, the toll of the COVID-19 pandemic — including struggles obtaining personal protective equipment, inconsistent testing and notification of COVID-19-positive exposures, and inadequate pay with increased work hours — against the backdrop of increasing burnout prior to the pandemic, has amplified calls for labor unionization to improve working conditions in the U.S. healthcare system,” wrote Xiaojuan Li, PhD, of Harvard Medical School and Harvard Pilgrim Health Care Institute in Boston, and colleagues.

In July, physicians and other emergency department workers who were contracted through private equity-backed staffing firm TeamHealth to work at Ascension St. John Hospital in Detroit voted to unionize. There were 43 eligible voters, and 31 ballots counted — all in favor of unionization, according to the National Labor Relations Board (NLRB).

Then in August, more than 550 physicians and other healthcare providers working for Minneapolis-based Allina Health filed to unionize. More than 300 providers voted in favor of the union, and the results were certified by the NLRB at the end of October.

Of note, there has been a particular increase in unionization efforts among early-career physicians, or residents and fellows, across the country.

Most recently, in early December, house staff at Northwestern Medicine in Chicago became the latest group of young physicians seeking to unionize. The group is comprised of nearly 1,300 physicians employed by McGaw Medical Center.

Mugdha Mokashi, MD, a second-year ob/gyn resident, emphasized that residents and fellows often take care of patients with the greatest needs and the fewest resources.

“This is about having a seat at the table” to help make decisions that affect working conditions for residents and fellows, as well as others, including nurses and midwives, Mokashi told MedPage Today, adding that the people “directly responsible for making patient care better” should hold power within an institution.

Other unionization efforts by residents and fellows this year have included those at Mass General Brigham in Boston — despite house staff receiving a significant salary increase — the University of Pennsylvania, Montefiore Medical Center in the Bronx in New York City, Stanford Health Care in California, and the University of Southern California’s Keck School of Medicine in Los Angeles, among others.

With these new arrangements come new questions. Only time will tell whether the increased pace of physician unionization efforts will continue, and the extent to which collective bargaining efforts will benefit physicians. MedPage Today will be watching closely.

Jennifer Henderson joined MedPage Today as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.

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