Unions are not without critics or potential disadvantages. Physicians considering joining a union should be sure that the union’s positions or mission align with their own. Unions that include physicians from multiple specialties may have a range of goals that are not always aligned.

Members of a union may be called on to strike, which may be a moral concern for physicians, and is something to consider. However, striking within health care follows specific rules as stipulated by the acute care update to NLRA, which states that health care units must provide 10 days’ notice in writing to an employer of the intent to strike.¹⁷ There is also fear, founded or not, that membership in a union, or leading an effort to form a union, could influence career prospects.

“This will likely be a career-ender for me,” Dr. Codier said. “This was my last effort to improve our practice and out of that, my determination was to make sure that anybody who needs help unionizing gets that help.”

Ms. Lawrence is a freelance health writer and editor based in Delaware.

References

1. Hendrix JM, Burgart AM, Baker EB, et al. Physician Unionization: Opportunities and Challenges for Anesthesiologists in the United States. Anesth Analg. 2023;139(2):432–438.
2. Salem Physicians Union. Mission. https://salemphysiciansunion.org/mission. Accessed March 24, 2025.
3. Rooke-Ley H, Richman B, Bowling DS, et al. Unionization Efforts by Physicians Between 2000 and 2024. JAMA. 2025;333(4):347-348.
4. Terrel E. Founding of the National Labor Union and the 1st National Call for a 8-Hour Work Day. Business Librarian, Science & Business Reading Room. https://guides.loc.gov/this-month-in-business-history/august/national-labor-union-8-hour-work-day. Accessed March 24, 2025.
5. Gallup. Labor Unions. https://news.gallup.com/poll/12751/labor-unions.aspx. Accessed March 24, 2025.
6. National Labor Relations Board. National Labor Relations Act. https://www.nlrb.gov/guidance/key-reference-materials/national-labor-relations-act. March 25, 2025.
7. ACEP. Unionization. An Information Paper. https://www.acep.org/siteassets/new-pdfs/information-and-resource-papers/unionization.pdf. Accessed March 25, 2025.
8. Kane CK. Recent Changes in Physician Practice Arrangements: Private Practice Dropped to Less Than 50 Percent of Physicians in 2020. AMA Economic and Health Policy Research. May 2021. https://www.ama-assn.org/system/files/2021-05/2020-prp-physician-practice-arrangements.pdf. Accessed March 25, 2025.
9. Quarles. DOL Publishes New Rule for Determining Whether Individuals are Independent Contractors under the Fair Labor Standard Act. https://www.quarles.com/newsroom/publications/dol-publishes-new-rule-for-determining-whether-individuals-are-independent-contractors-under-the-fair-labor-standard-act. Published on January 17, 2024. Accessed March 26, 2025.
10. U.S. Department of Labor. Wage and Hour Division. Frequently Asked Questions – Final Rule: Employee or Independent Contractor Classification Under the FLSA. Accessed March 25, 2025.
11. American Medical Association. Advocacy Resource Center. ARC Issue brief: Collective bargaining for physicians and physicians-in-training. https://www.ama-assn.org/system/files/advocacy-issue-brief-physician-unions.pdf. Accessed March 26, 2025.
12. Ahmed AM, Kadakia K, Ahmed A, et al. Trends in Labor Unionization Among US Health Care Workers, 2009-2021. JAMA. 2022;328(24):2404-2411.
13. Del Savio A. Doctors at Providence Medford ratify first contract. https://nwlaborpress.org/2025/02/doctors-at-providence-medford-ratify-first-contract/. Published February 19, 2025. Accessed March 25, 2025.
14. Beresford L. The ER Docs Strike Back. ACEP Now. https://www.acepnow.com/article/the-er-docs-strike-back/. Published August 28, 2024. Accessed March 26, 2025.
15. Wells K. Detroit ER docs must re-apply for their own jobs after controversial staffing company fired. Michigan Public. https://www.michiganpublic.org/health/2024-06-19/detroit-er-docs-must-re-apply-for-their-own-jobs-after-controversial-staffing-company-fired. Published June 19, 2024. Accessed March 26, 2025.
16. Edelman H. Physicians file to unionize to address understaffing, corporatization at ChristianaCare. Delaware News Journal. https://www.delawareonline.com/story/news/health/2024/05/20/christianacare-physicians-first-in-state-to-file-to-form-union/73719214007/. Published May 20, 2024. Accessed March 26, 2025.
17. National Labor Relations Board. The Right to Strike. https://www.nlrb.gov/strikes. Accessed March 27, 2025.