Why more physicians are unionizing

While labor actions during the pandemic have more often involved nurses and other healthcare professionals, physicians are increasingly involved in union activities, including votes to unionize.

There are various factors underlying the trend. Physicians are seeking greater investments by hospitals in working conditions, staffing and other resources needed to provide patient care. Hospitals, meanwhile, have emphasized their commitment to quality care and these professionals during a challenging time in healthcare.

According to the American Medical Association, there were 67,673 physician union members in 2019. That represents 7.2 percent of physicians actively practicing nationwide — and that 2019 total is up about 26 percent from 2014.

Two attorneys and a physician argued in a viewpoint article published July 28 in the JAMA Network online that the pursuit of physician unions is likely to continue amid the consolidation of health systems and medical practices. Data from Avalere in a study sponsored by the Physicians Advocacy Institute shows the percentage of U.S. physicians employed by hospitals, health systems or corporate entities grew from 62.2 percent in January 2019 to 73.9 percent as of January 2022.

Residents and fellows at the University of Southern California's Keck School of Medicine in Los Angeles are among those who have recently chosen union representation. They voted in the spring to unionize with the Committee of Interns and Residents. And St. Charles Medical Group physicians, nurse practitioners, physician assistants and other healthcare workers refiled their petition in August with the National Labor Relations Board, seeking to hold an election to decide whether to join the American Federation of Teachers. St. Charles Medical Group is the employed provider arm of Bend, Ore.-based St. Charles Health System.

And the Valley Physicians Group, which represents Santa Clara (Calif.) County's employed physicians, podiatrists and dentists, reached a tentative agreement with the county in October to avert a four-day strike. Members of the Committee of Interns and Residents also reached a tentative agreement with UCSF Benioff Children's Hospital Oakland (Calif.) in October, averting a looming strike. This agreement addressed pay and cost of living issues through measures such as a housing stipend increase starting with $11,000 in the first year of the contract.

In instances where a strike is on the table, hospitals have expressed their goal to avert such situations while remaining fiscally responsible in negotiations.

Most recently, resident physicians and fellows at Montefiore Medical Center in New York City requested voluntary recognition of their union, according to a news release from the Committee of Interns and Residents.

"So many of us chose to do our residency here because we want to work in the Bronx and with the diverse and historically underserved community that lives here — and we know we can do more. Our hope is that through our union, we can advocate for the resources we need to help improve healthcare access in the Bronx," Rex Tai, MD, a second-year internal medicine resident at Montefiore Medical Center, said in the release, which was shared with Becker's on Nov. 1. "An investment in full staffing, sustainable working conditions and quality training is an investment in patient care."

The physicians are not officially unionized. If Montefiore does not voluntarily recognize the union, physicians would move toward official unionization and likely hold an official vote, a union spokesperson told Becker's.

Montefiore provided the following statement to Becker's: "Montefiore Einstein is nationally recognized for clinical excellence, and for delivering patient-centered care to the most diverse urban areas in the country where the population is global, the disease burden is high and the need for quality care is great. Our residents come here, armed with a passion to address those challenges and a commitment to carry those experiences into the demanding roles they are likely to step into. Our success and our reputation are grounded in the world-class training we provide and the compassionate care we extend not just to our patients, but to our residents and all who make the selfless commitment to provide care here."

Montefiore Health System, which includes Montefiore Medical Center, is the university hospital for Albert Einstein College of Medicine.

The Committee of Interns and Residents is a local affiliate of the Service Employees International Union. In the most recent wave of house staff unionization, more than 2,000 residents chose to join the union in the last six months.

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