What medical students need to know about unions

Physicians, especially those working in organizational medicine, understand the importance of the power of numbers. This is demonstrated in many areas, including union membership.

Membership in physicians’ unions is growing as more doctors work for employment.A recent webinar co-hosted by AMA Medical Student Division When AMA Academic Physician Section, examined the basics of physicians’ unions and how they contribute to membership. For medical students who may choose to work for an institution with a union, let’s take a look at some of the questions that were addressed in the webinar.

Unions perform three basic functions: collective bargaining, political advocacy and mutual aid (health insurance and pensions for their members). For physicians, collective bargaining rights (loosely defined as the act of negotiating contract terms with employers on behalf of employees) tend to drive union membership.

Diomedes Tsitouras is Executive Director of the American Association of University Professors of New Jersey Biomedical and Health Sciences, a non-profit organization representing the 1,400 faculty members of Rutgers/Rowan University.

“The idea of ​​collective bargaining is that employees in the workplace can come together and join forces, unlike individual bargaining,” Tsitouras said. “By combining their strengths, they are typically able to level the playing field with more economically powerful employers, thereby creating a better working environment for all. .”

Collective bargaining is becoming more important as more markets develop where hospitals have market power, doctors have few options for hospital employment and often suffer burnout, Tsitouras said.

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The union has relatively few physicians, but the demand is growing. As of 2019, approximately 68,000 doctors are members of the union. That number represents about 7% of the nation’s physician population, up 25% from five years ago.

Examples of large unions representing doctors include:

• Service Employees International Union—Doctors Council, Interns and Residents Committee.
• American Federation of State, County, and Local Employees — American Physicians and Dentists Association.
• American Teachers Federation.
• American Association of University Professors.

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Citing the important changes his union has made, Mr Tsitouras said the group would improve minimum wage standards based on those of the National Association of Medical Colleges and develop mechanisms to reduce arbitrary wage inequalities based on gender. It said it has strengthened access to childcare, parental leave and leave. Other policies that support better work-life balance.

“People at the top don’t always know what’s going on on the ground. can be,” says Tsitouras. In recent years, the need for union intervention in health care has been evident. One of the cases in which a group of residents formed a union occurred at Stanford. There, the resident doctor did not have access to her COVID-19 vaccine before non-essential hospital employees. In his May of this year, Stamford residents overwhelmingly voted in favor of forming a union.

“Interestingly, well resourced and probably better paid than many places, they may be viewed as something of a sweet gig, but in some respects these workers are in a position to improve. Still really motivated to get organized, said Dr. Rebecca Givan, co-director of the Rutgers Center for Work and Health. “I realized that was the only way to get the voice of the work they really needed.”

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Strikes are very rare among all unions, especially doctors’ unions.

“In general, there are many ways to gain power, and hitting is just one of them,” says Givan. “There are many other methods, such as button campaigns and social media campaigns.

Physician strikes are illegal in some states, and even in states that don’t ban strikes, unions would have to get a supermajority vote. Favor — to strike.

of The AMA has trade unions must comply with AMA Medical Ethics Principlesdo not engage in “strikes by withholding essential medical services from patients”.