Spike in Physician Unionization Another Sign That Healthcare Needs Change

The murder of a health insurance executive last month on the streets of New York and the lack of public empathy for the victim are just the most visible signs that people are fed up with the current healthcare system in the U.S. If you look around, there are plenty of other signs albeit less headline-grabbing.

I found one last month in a short research letter in the Journal of the American Medical Association. Five researchers with Brown, George Washington and Stanford universities and Georgia State College wanted to know if more doctors were joining unions as a result of more of them intentionally or unintentionally becoming employees of large medical practices, hospitals, health systems, health insurance companies, private equity firms or other types of corporate entities.

Some 49.7% of physicians were employees in 2022, according to the latest available data from the AMA. That’s up from 41.8% in 2012 but down slightly from 50.2% in 2020. I speculated on why that trend may be flatlining in a blog post last year, “As Physician Ownership Goes, So Goes the Healthcare Industry.”

Anyway, the answer to the researchers’ investigation was a resounding yes. Far more employed physicians want to join unions today.

Here are the details. The researchers identified 77 union petitions filed with the National Labor Relations Board from 2000 through May 2024 with physicians as part of the proposed collective bargaining unit. Of the 77 petitions, 44 were filed from 2000 through 2022, or about two per year. The balance — 33 union petitions — were filed in the last 17 months of the study period, about two per month.

The average size of proposed collective bargaining units for the entire 25-year study period was 93 with physicians only making up 34% of the units, physicians and advanced practice providers (APPs) making up 40% of the units and physicians, APPs, nurses and administrative staff making up 26% of the units.

The researchers did further research into 26 union campaigns from 2023 through May 24. They found that the leading reasons physicians wanted to unionize were, in ranked order:

• Working conditions (85%)
• Lack of voice in management (81%)
• Patient care concerns (54%)
• Financial compensation (4%)

In other words, money wasn’t the issue. Work environment was. Or, more specifically, lack of control over their work environment.

“Organizing efforts were motivated by concerns about working conditions, physicians’ autonomy, and voice in management, and the quality of patient care,” the researchers said.

The study results support another study I wrote about earlier last month in this blog post, “Physicians Freaking Out Over Control.” The other study found that more than four in 10 doctors said they don’t have sufficient authority or autonomy over the work for which they’re responsible.

As consumers, we may not feel sorry for physicians because we think they’re part of the problem. But it turns out they’re feeling the same way that we feel. We both feel that we’ve lost control over our health and our respective healthcare journeys to faceless corporations that dictate every aspect of how medical care is delivered and paid for in this country.

It’s time to take back that control. It’s time for a customer revolution in healthcare. Let’s make it happen in 2025.

Thanks for reading.