Union contagion has become a familiar refrain in many industries. When the coffeehouse down the road organizes, this activity can cause a chain reaction that spreads to nearby retail and food service establishments. We’ve noticed similar effects for white-collar workers, and increasingly, physicians are becoming union targets. Of course, the healthcare industry has long been plagued by unions going after nurses, but physician organizing is accelerating in a way that employers can’t afford to ignore.
Mind you, none of this happened overnight. The opening of the floodgates for resident organizing began after a pivotal 2022 NLRB ruling. Fast forward to now, and the Committee of Interns and Residents (CIR-SEIU) claims to represent 40,000 resident physicians and fellows, up from a reported 17,000 members a few years ago. The recruitment of attending physicians was logically bound to be next for SEIU, and it’s happening.
The chain reaction in motion
Unionization of attending physicians is still relatively rare. As of the most recent National Institutes of Health (NIH) data, cited in the Healthcare Financial Management Association’s (HFMA) reporting, only about 8% of attending physicians nationally were unionized in 2024. That’s part of what makes a 10,000-physician organizing push landing in the same summer a warning signal that can’t be ignored.
Case in point: in mid-July, news broke on a tentative deal for 6,400 University of California residents and fellows represented by CIR-SEIU. Reportedly, the deal included an 18% wage boost, increased benefits, and assurances regarding ER overflow. That deal capped a year of negotiations, but what came next is of even more interest for employers.
Eight days later, SEIU announced a new affiliate, which plans to mass-organize physicians at the University of California’s medical centers. In effect, this was the launch of UC Doctors United as a Doctors Council-SEIU offshoot with the mission of unionizing 10,000 UC physicians.
This also isn’t the only attending-physician development this year. In June, Doctors Council-SEIU ratified a first contract for 500 attending physicians at ChristianaCare in Delaware.
Unions are climbing the physician career ladder
Most industry watchers know that residents and fellows’ workplace concerns revolve around their relatively low pay and grueling schedules, as is customary for doctors-in-training. These fledgling doctors frequently lock into multi-year agreements with a specific institution, which they depend on for licensure. In contrast, attending physicians have cleared the licensing hurdle and theoretically have more freedom for jumping to a different healthcare system if they’re not happy with their current employer.
Yet the attending physicians who are organizing have not chosen to go elsewhere. Instead, they’re turning to unions, which will attempt to brute-force contract demands, regardless of whether the resulting agreements are financially sustainable. Any employer in healthcare knows that hospitals aren’t sitting on an endless pile of money, no matter what tall tales a union rep will tell during an organizing drive.
Now is the time to be proactive
Attending physicians aren’t organizing purely over pay, mobility, or other concerns that are typical of residents and fellows. We flagged this last year with Doctors Council-SEIU’s targeting of primary care physicians because doctors have valid concerns about heavy caseloads and burnout. And whether a physician is in-training or licensed, they’re now an organizing target, because unions want the dues from this profession’s high salaries.
As it turns out, doctors are as susceptible to union contagion as the retail workers watching that coffeehouse down the road. Hospital systems tracking resident and fellow organizing should assume their attending physicians are watching right along with them. A resident’s tentative deal, ratified or not, can become the template for the next round of negotiations, or the reason SEIU announces its next 10,000-doctor campaign.
FAQs
What’s the difference between a resident physician and an attending physician?
Residents are physicians-in-training, and they’re typically working under supervision for several years after medical school while completing their specialty education. Attending physicians have cleared that licensing hurdle and, in theory, they have the ability to switch workplaces if they’re unhappy with their current employer, although apparently, some attending physicians are choosing to organize instead of leave.
Why are attending physicians unionizing now?
The trend began after a 2022 NLRB ruling that opened the door to resident organizing, which has since grown from a reported 17,000 CIR-SEIU members to a claimed 40,000. With that hurdle cleared, attending-physician organizing was a logical next step for SEIU. Attending physicians who are organizing point toward heavy caseloads and burnout, complaints that were visible with Doctors Council-SEIU’s targeting of primary care physicians last year.
What is UC Doctors United?
UC Doctors United is a Doctors Council-SEIU offshoot launched with the mission of unionizing 10,000 attending physicians across the University of California’s medical centers. This new affiliate was announced mere days after CIR-SEIU reached a tentative deal covering 6,400 UC resident physicians and fellows, and the timing is significant (the resident deal closed out a year of negotiations, and the attending-physician push followed almost immediately afterward).
