The conventional wisdom was physicians don’t need to unionize. We are highly paid professionals. We have power and autonomy. While we remain highly paid, our power and autonomy has rapidly evaporated over the last several years. We have lost our ability to effectively advocate for our patients within the massive corporate bureaucracy of for-profit and “non-profit” health systems. The power structure in medicine is now, without a doubt, Health Insurance Company > Health System > Physician/Care Team > Patient. The exact inverse of what it should be.
Primary care physicians in particular are treated like expendable cogs in a machine — do what you are told or leave. All of this and more, exacerbated by the pandemic, has led to unprecedented levels of burnout and shortages amongst physicians.
The recent survey from the AMA, Mayo Clinic and Stanford Medicine in December showed an alarming 62.8% of physicians experienced symptoms of burnout in 2021, up from 38% the previous year. This follows similarly concerning studies that indicated one in every five physicians—planned to leave practice within two years, while one in three doctors anticipated cutting back their hours.
I am a primary care physician and I have lost multiple excellent partners at my clinic to burnout and moral injury over the last 2 years. Many physicians have no good options. Keep doing what you are told and sustain the moral injury of knowing it is wrong, or leave your practice, or leave medicine altogether. The effect on patients is devastating. Imagine if we lose 20 percent of our physicians over the next few years. The health care system in our country, already crumbling, will collapse.
What is the solution? What can put some power back in the hands of the people actually practicing medicine, the ones that swore an oath to do right by their patients? Maybe this (from the National Labor Relations Board):
Tally Issued Date:10/13/2023
No. of Eligible Voters:589
Total Ballots Counted:525
Votes for Labor Union:325
Ballot Type:Single Labor Organization
Labor Union:Doctors Council SEIU Local 10MD
Union to Certify:Doctors Council SEIU Local 10MD
That’s right, the vote was counted today and it was 325 for unionizing and 200 against. This is huge. Getting a huge margin of victory while organizing hundreds of physicians scattered across over 60 clinics around Minnesota. This will be the largest private sector physician union in the country. I heard the results through the grapevine today and now NLRB just posted the results. I expect it will be headline local news, and likely national news, over the weekend.
Several months prior, a smaller group of hospital based physicians at Allina’s Unity and Mercy hospitals in suburban Minneapolis voted 67 to 38 in favor of unionizing. It wasn’t even close, all that is required to win is a simple majority. Allina’s response — refuse to recognize the union and challenge the results and spend lots of money meant for patient care to bring in “the nation’s premiere union busting law firm.”
I have plenty of experience with Allina. There are countless amazing physicians and nurses and others that do compassionate life-saving work there every day. Good people trapped in a terrible corporate bureaucracy. Some recent highlights:
Front page New York Times story:
This Nonprofit Health System Cuts Off Patients With Medical Debt
Doctors at the Allina Health System, a wealthy nonprofit in the Midwest, aren’t allowed to see poor patients or children with too many unpaid medical bills.
From Truthout story on a recent report by Senator Bernie Sanders:
Sanders Report: Major Nonprofit Hospitals Fail Poor Patients, Exploit Tax Breaks
Rather than providing affordable medical care for low-income patients, some are instead enriching executives. Nonprofit U.S. hospitals are legally required to provide affordable medical care for low-income patients, but many are failing to do so, while taking advantage of major tax benefits and enriching executives, according to a report released Tuesday by Sen. Bernie Sanders.
Allina 2021 revenue: $4.85 billion. Percent of revenue spent on charity care: 0.346% (the lowest percentage of all the nonprofit health systems reviewed in the report). CEO annual compensation: $3.53 million.
So bravo to the SEIU Doctors Council and to these brave physicians and other healthcare providers at Unity and Mercy Hospitals and at the Allina Clinics. They have forced their way back to the decision making table and their patients will benefit greatly. The profession of medicine and our healthcare system will benefit greatly if this is the beginning of a movement. I am hopeful physician unionization will spread to the system I work for (there are already discussions) and beyond.