However, unionization increasingly is being suggested as a solution to some of the challenges currently facing the industry, including lack of resources, ever-dwindling reimbursement, boarding issues, understaffing, and loss of physician autonomy.

“Everyone expects that people unionize over pay issues,” Dr. Codier said. “Being a lead organizer in our effort, I was surprised to see that after having 150 to 250 conversations, I still had yet to run across a single person that brought up pay as the first issue.”

Instead, 100 percent of the time, the concerns people had were related to the changing care environments and the patient care itself, he said.

Although uncommon, the history of physician unions in the U.S. dates back several decades. In 1959, a small group of doctors employed by the City of New York began efforts to organize to negotiate for a pay increase, workers’ compensation, sick leave, and other benefits. Known now as the Doctors Council, affiliated with SEIU, it represents doctors from New York, Illinois, Delaware, Minnesota, and Wisconsin.¹¹

There are many other large unions within the U.S. Dr. Codier and colleagues at Salem Hospital chose to organize with one of the largest public services employees’ union, the American Federation of State, County, and Municipal Employees (AFSCME). Other large unions include the Laborers’ International Union of North America, which represents health care workers among others; Communications Workers of America (CWA), which represents various private sector employees including health care; and more. Other large U.S. unions are more specific to certain industries such as the American Postal Workers Union or the National Education Association.

Outside of attending physicians, physicians in training have been organizing for years. SEIU is also affiliated with the Committee of Interns and Residents (CIR), which has a membership of more than 30,000 residents and fellows across specialties. A simple Google search for “residents on strike” or “resident unionization” will result in news stories detailing unionization efforts, resident strikes, or strikes called off from a variety of institutions including the University of Minnesota, University of Buffalo, Western Michigan University, Brown University’s Warren Alpert School of Medicine, the University of Colorado, George Washington University Hospital (www.acepnow.com/article/health-care-worker-unionization-uncommon-but-sometimes-necessary/), and more.

“In my experience, the doctors most interested in change are the younger to middle-aged doctors,” August said. “Older doctors seem to be supportive of efforts because they are worried about burnout and that doctors are leaving the profession.”