A group of hospital doctors at Providence St. Vincent Medical Center in Portland has taken the unusual step of unionizing in order to have more say over working conditions.
The doctors voted 54 to 8 on Monday in favor of forming a union under the Pacific Northwest Hospital Medicine Association, according to a National Labor Relations Board filing online. The vote follows a wave of efforts by the Oregon Nurses Association, the state’s largest nurses union, to organize health care workers who’ve become increasingly scarce following the pandemic.
Doctors, who often command the highest salaries and prestige in medical settings, are less likely to be represented by a union. But Dr. Shirley Fox, an obstetrician at Providence St. Vincent, told The Lund Report that’s starting to change. She said she and other physicians unionized to have more say over workloads and resources that have remained strained even after the pandemic subsided.
“I think we’re in the beginning of a very bad crisis in medicine. It’s already unfolding, but patients aren’t really aware of how hard it is to be in medicine.”
“I think we’re in the beginning of a very bad crisis in medicine,” she said. “It’s already unfolding, but patients aren’t really aware of how hard it is to be in medicine.”
While post-pandemic shortages of other health care workers, particularly nurses, have drawn the attention of the press and policymakers, Fox cited figures from the American Medical Association pointing to the dwindling number of medical doctors. She also said that during the pandemic doctors faced “unsustainable” workloads and are now caring for sicker, more complicated patients with inadequate staff and resources.
Fox said that she empathizes with hospital administrators who have to make do with limited resources. “That’s why I think we want to be a part of that decision-making of how to best allocate resources,” she said.
Those reasons follow those of the nurses union, which is allied with the union representing the doctors and has sought to organize health care workers to advocate for pay, staffing and patient care as hospital executives focus on revenue.
The Pacific Northwest Hospital Medicine Association is under the umbrella of AFT Nurses and Health Professionals, a national labor group affiliated with the American Federation of Teachers that represents more than 70,000 members in 100 locals in 18 states and territories. The Oregon Nurses Association provides staffing for the Pacific Northwest Hospital Medicine Association.
Providence Health & Services, a Renton, Washington-based chain of nonprofit hospitals, is currently locked in bitter negotiations with three bargaining units represented by the nurses union, which led a historic five-day strike in June.
A Providence spokesperson issued a short statement in response to the union vote expressing respect for the doctors’ decision.
“We have a long history of working collaboratively with unions that caregivers have chosen to represent them, and we’re committed to negotiating in good faith over the terms of a first contract,” reads the statement.
Fox said she anticipates that other doctors and health care workers will also seek to unionize.
There were just under 68,000 physicians represented by unions in the U.S., about 7% of all doctors, according to an issue brief by the American Medical Association. The brief identified burnout as a central reason driving an increase in unionization among doctors of more than a quarter since 2014, though their representation lags behind that of nurses. About 17% of nurses in the U.S. are represented by a union, according to unionstats.com.
The Oregon Association of Nurses helped organize the Pacific Northwest Hospital Medicine Association, the first union for hospital doctors in the country, nurses union spokesperson Kevin Mealy told The Lund Report in an email.
There aren’t exact figures for how many doctors are represented by a union in Oregon. However, Mealy said there are more than 1,000 unionized doctors in the state, with the largest group at Oregon Health & Science University, where residents, interns, residents and fellows voted for union representation in 2021.
The hospital doctors union began in 2015 at PeaceHealth Sacred Heart in the Eugene area. Doctors began organizing in response to hospital administrators’ plans to increase efficiency that cut into how long physicians could spend with patients.
Fox said that now the doctors at Providence St. Vincent have voted to unionize, they’ll vote to elect its leaders and settle on priorities for negotiating a contract with Providence. In addition to staffing and work conditions, Fox said one issue that could come up is compensation for doctors who stay longer than a 12-hour shift to care for patients.
She said the unionization is part of making “a meaningful change” to health care.
“I think it’s going to be all in little baby steps,” she said. “I don’t think we could make dramatic changes. But we’re all patient. We all work hard. We’re all very unified and making our goal happen.”
