3 Predictions for the Future of Hospital-Union Relationships

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Labor unions will continue to play a major role in hospital-employee relations in states where unions have traditionally had a presence — and that presence is likely to increase in other states, according to James M. Dawson, JD, of law firm Felhaber Larson in Minneapolis.

Mr. Dawson discussed union activities and trends in healthcare during the Healthcare Workforce Summit 2nd annual conference Nov. 7 in Grapevine, Texas. "Unions are finding success in organizing healthcare workers," he said, which is contrary to trends in other industries.

The following are three trends and predictions Mr. Dawson shared during his presentation.

Unionized physicians. One healthcare worker base Mr. Dawson suggested will be the next to unionize is physicians. "[Physicians are] potentially the next area where organizing will occur," he said. As more physicians become employees of hospitals, health systems and other provider organizations, they are more likely to seek representation. Mr. Dawson noted that the Service Employees International Union already has 40,000 physician members, and that number is likely to grow.

Future strikes. As unions gain ground in the healthcare industry, the likelihood of strikes grows. Mr. Dawson has seen "significant upticks" in strike activity in healthcare in recent years. Unlike in years past, unions have adopted striking for limited periods of time, which makes it more difficult for hospitals to staff during the strike. Additionally, as unions become more sophisticated, Mr. Dawson said he sees unions in different states attempting to coordinate strikes to fall on the same day, which would "make it almost impossible to staff" for, he said.

Mandatory ratios. Pushing for mandatory nurse-patient ratios is "in vogue" for unions, according to Mr. Dawson. Currently, California is the only state that has mandatory ratios for nurses in hospitals, but other states are on their way there. Seven states have nurse staffing plan laws, where hospitals must develop nurse staffing plans with input from staff nurses. "It's not hard ratios, [but it's the] first step in that direction," Mr. Dawson said. Additionally, six other states have mandatory disclosure of nurse staffing levels.

There is also a bill that has been introduced for many years that would establish mandatory ratios through federal regulations. "Nurses have been very effective in lobbying these issues," he said. "It's something to be aware of."

Overall, Mr. Dawson warned that, especially in states where unions did not have much presence in healthcare, more union involvement is on its way in the industry. "I think you'll be challenged like never before," he said to healthcare employers.

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