Union activity among physicians has skyrocketed in the last two years, according to a recent JAMA study.
While fewer than 10% of physicians in the U.S. are unionized, the number of official union drives among private sector physicians each year went from between zero and six between 2000 and 2022 to 21 drives in 2023 and 12 in the first five months of 2024, according to the study.
The union drives from 2023 and 2024 alone will represent 3,523 new physicians, almost the same number represented by unions over the previous 22 years.
Approximately 8% of all physicians in the U.S. are represented by unions, including some in the public sector. According to the National Labor Relations Board, there were 33 physician union petitions filed from 2023-2024, compared with 44 between 2000-2022.
These efforts have paralleled trends of increased physician-employment consolidation and declining physician autonomy and independence. Hayden Rook-Ley of the Center for Advancing Health Policy Through Research, told Medscape in a Dec. 19 report that increasing dissatisfaction in employed settings could be driving unionization.
"We suspected that declining morale and increased corporate employment for physicians were leading them to consider unionization," he told Medscape.
Consulting firm Bain & Co. recently released its "Frontline of Health Survey" in an October blog post, which highlighted that nearly 25% of physicians in health system-led organizations are debating a change in employers, compared to 14% in physician-led practices.
According a September report by the Physicians Foundation, employed physicians also reported more "inappropriate feelings of anger, fearfulness or anxiety," compared to independent physicians. Employed physicians also reported higher rates of burnout — 62% — compared to 53% of independent physicians.
"I hear from physicians all the time about how they no longer have … any input in their patients' care," Harry Severance, MD, an adjunct assistant professor at Durham, N.C.-based Duke University School of Medicine, told Becker's. "Instead, a business manager comes in and tells them, we need to increase profits, so you need to see more patients per hour, increase your billings, make more in-house referrals, keep your patient satisfaction scores up, don't report violent patients, etc."
Of the 66 unionization efforts from 2000 to 2024, 62% were certified, according to the JAMA study. The researchers only analyzed private-sector unionization and did not include physicians who are unionized at public institutions.
While some remain doubtful that physician unionization will effectively remedy the ongoing issues related to satisfaction, autonomy and compensation in healthcare, others see these efforts as a key step in combatting these issues — particularly when it comes to decreasing physician reimbursement rates from both private and public payers.
"I think the only solution is to allow physicians to unionize. I feel that would allow for a more reasonable discussion with payors," Ravi Krishnan, MD, an ophthalmologist at the Eye Institute of Corpus Christi (Texas) told Becker's. "Frankly, I do not understand why we are not allowed to unionize, especially in this current day and age, when over 70% of doctors have now become employees. One of the arguments against a physician union is that ours is an 'essential service,' but so is nursing and so is air traffic control for that matter, and both of those professions have unions."