Physicians, particularly those in the field of structured medicine, understand the importance of strength in numbers. This was demonstrated in a number of arenas, including union membership.
As more and more physicians engaged in employment arrangements, membership in physician unions grew. Recent webinar, co-hosted AMA . Medical Students Department And the Department of Academic Physicians AMAI looked at the basics of physicians’ unions and how they serve their membership. For medical students who may choose to work at an institution with a union, here’s a look at some of the questions covered in the webinar.
Unions serve three primary functions: collective bargaining, political advocacy, and mutual assistance (health insurance and membership pensions). For clinicians, the right to collective bargaining — loosely defined as the act of negotiating contract terms with an employer on behalf of its employees — tends to be the driver of union membership.
Diomedes Tsituras is Executive Director of the American Association of Professors – Biomedicine and Health Sciences of New Jersey, a nonprofit organization representing 1,400 faculty members at Rutgers/Rowan Universities.
“The idea with collective bargaining is that, unlike individual bargaining, employees in the workplace can come together to unite their strength,” Tsitoras said. “By combining their strengths, they can achieve equality with an employer who typically has more economic power, and then provide better working conditions for everyone.”
Tsitoras said the importance of collective bargaining has grown as many markets have developed in which hospitals have market power and doctors have few alternatives to hospital staffing and are often overwhelmed.
Relatively few doctors are members of the union, but the demand is growing. As of 2019, there were about 68,000 doctors in unions. The number represents about 7% of the nationwide physician population, but it has also grown by 25% over the previous five years.
Some examples of large unions representing physicians include:
- Service Personnel International Federation – Physicians Council, Interns and Residents Committee.
- American Federation of State, County, and Municipal Employees – Federation of American Physicians and Dentists.
- American Federation of Teachers.
- American Association of University Professors.
Referring to the major changes brought about by his union, Tsitoras said the group has improved minimum wage standards based on the standards of the Association of American Medical Colleges, created mechanisms to reduce gender-based and arbitrary wage inequality, enhance access to child care, parental leave and Other policies support a better work-life balance.
“Sometimes the people at the top don’t always realize what’s going on at ground level, and we can kind of bridge that gap and point out problems and be a voice for problem-solving in hopes of solving them,” Tsitoras said. In recent years, the need for union intervention in healthcare has been evident. One case occurred in a group of union residents in Stanford, where resident physicians did not have access to COVID-19 vaccines before non-essential hospital staff. Last May, Stanford residents voted overwhelmingly to join unions.
“Interestingly, you know – what might be seen as kind of a good resource, probably better wages than a lot of places, and it’s kind of nice work – in some ways these workers were still really motivated to organize to get improvements, said Rebecca Jevan, PhD, associate director of the Rutgers Center for Work and Health. “Realizing that this was the only way to get a voice in the job they really needed.”
You know why More residents are looking to the union.
Strikes are uncommon among all unions, particularly medical unions.
“In general, there are a lot of ways to gain strength, and the strike is just one of those ways,” Jeevan said. “There are a lot of other approaches, things like button campaigns, social media campaigns…
To show the collective unity and urgency of a particular demand of interest. “Medical strikes are illegal in some states and even in those states that do not prohibit strikes, the union would need to vote by an overwhelming majority—likely more than 90% of union members who vote in favour—to enter into a strike.