Labor Unions Are Growing: Should Doctors Join?

What are labor unions? As a definition, a labor union is an organization that is created by a company’s group of workers for the purpose of protecting their rights to fair wages, work hours, and working conditions. In the United States, labor unions first began to grow in response to the industrial revolution. Nowadays, this pattern is repeating itself as physician unions continue to exist and an increasing number of physicians are expected to join to return to physician-driven patient care. So what are the pros and cons of labor unions?

Pros

• Protection of employees’ interests – The main objective of labor unions is to ensure that workers receive fair compensation for their hard work. Members of a labor union are given a voice to express their demands for a safe working environment, higher wages, and overtime pay for additional work hours. Without labor unions, there would be no support system to impose rights and appropriate policies.
• Protection from employee discrimination and inequality – Each labor union has a policy which prohibits discrimination and inequality of members in terms of age, gender, race or religion. Without such organizations to protect the rights of employees, it would be much easier for employers to hire individuals based on preference as opposed to qualification.
• Additional benefits – According to recent surveys, members of a labor union are more likely to enjoy benefits such as insurance coverage, retirement plan, as well as number of paid leaves, as opposed to non-union members.
• Collective power – As the saying goes, there is strength in numbers. Several aspects of labor unions stress the importance of presenting a united front in order to receive benefits such as higher wages and better working conditions. Through collective power, labor union organizations can work both effectively and efficiently.
• More satisfied employees – Employees who are satisfied with their jobs are more likely to remain loyal to their posts. With labor unions to negotiate on employees’ behalf in terms of wages, work hours, and working conditions, resignation rates are lowered and employees remain content. This, in turn, also leads to increased team productivity and sales.

Cons

• Exempted from taxation and antitrust laws – As an organization, a labor union is free from from taxes, which several critics believe should be paid to the government. Moreover, labor unions give employees the right to restrain from work and go on strike, thereby resulting in reduced supply and commerce.
• Reduced numbers of available jobs – According to several opponents, as labor unions demand higher wages, this approach cuts down on the percentage of jobs available. It may be beneficial to those within the labor union; however, for several employers, this means reducing the hiring process for certain occupations.
• High financial costs – Labor unions require membership fees that can be quite costly, especially for employees who have families to care of. While labor unions can bring about several benefits, in the long run, it is the employees and employers that will pay the price for participation.
• Poor employee performance – One of the main disadvantages thought to be seen with labor unions is the ability of such organizations to influence employee behavior and performance. Labor unions can demand that members stop conducting their everyday work tasks, thereby reducing a company’s productivity and sales levels.

Both the pros and cons aspects of labor unions prove relevant points that should be taken into consideration. The most significant thing is for employees to understand the labor union definition and the policies invoked within each labor union before he or she joins one. Flavio Casoy, vice president of the Committee of Interns and Residents (CIR), notes that “all these forces in healthcare make it so the places where patients are going to get care are bigger and bigger institutions. Care is becoming less and less humane, and increasingly less patient centered. I think physicians need to have a voice to ensure [that] good, clinical care is the main objective, rather than the profits of some corporate entity”. Casoy stresses that with a labor union looking out on his behalf, he “can actually do what needs to be done to take care of this person.”

While there are currently a few physicians’ unions, some have gained immense popularity, including the Union of American Physicians and Dentists (UAPD). Founded in 1972 by Sanford A. Marcus, a surgeon in private practice, today the Union of American Physicians and Dentists is the largest union for physicians in the United States. Over the last 40 years, it has grown in representing countless licensed physicians in the United States. UAPD is a successful running labor organization that has been able to strengthen the labor movement and organize resources to support its efforts on the behalf of healthcare professionals. It is fully committed to bringing physicians back in control of their practices and ensuring better healthcare for all. “We don't like to strike. We're always concerned about the effects strikes can have on patients, but striking has to remain an option if no one is listening. You have to do something to get their attention” said Dr Bussey, president of the UAPD union. The primary reason physicians are opposed to strikes is due to the possibility of patients being harmed.

The Union of American Physicians and dentists welcomes all physicians, dentists, and podiatrists. Employed physicians have the right to join the labor union and negotiate over wages, work hours, and working conditions. The benefits seen from the UAPD include the following:

• A collective member-run union;
• Higher wages;
• Shorter work weeks / overtime pay;
• Increased job security;
• Increased control over quality of care;
• Benefit packages (health and dental insurance, retirement plan, malpractice coverage, paid leave, and more.);

Private practice physicians can also join the labor union as individuals; however, they are forbidden by federal law from negotiating over benefits. UAPD supports the participation of private practice physicians so that they can receive numerous benefits, including the following:

• Protection of both physicians’ and patients’ interests;
• Complementary CME (continuing medical education) classes;
• Access to the Independent Physicians Association (UAPD-IPA);
• Access to contract review services;
• Expert advice and referrals for physicians with at-risk licenses;
• Litigation programs that support significant medical causes;

No longer does the term ‘labor union’ refer to or simply bring to mind laborers such as construction workers. “Employed doctors need a union. One doctor speaking up against management is not going to be heard” said Dr. Frank Proscia, president of the Doctors Council, a union with over 4,000 represented physicians and dentists. Unions are seen as useful approaches to empowering physicians concerned about lack of control within their workplace and helping them to present a unified front. To accommodate such members and address their concerns over lack of control, Dr. Proscia notes one example where the Doctors Council union has built a prerequisite for routine meetings between management and physicians into its new contract with NYC Health + Hospitals in New York City. “Everyone is truly involved in the decision-making process” he said.

Today, more and more healthcare professionals are joining labor unions. According to a survey conducted back in January 2017, 60% were in favor of unionization. “I think the time is fast approaching when a combination of trends will drive physicians to organize” said David Leffell, Section Chief of Dermatologic Surgery and Cutaneous Oncology at Yale School of Medicine. Members of labor unions have better health because such organizations ensure that employers are held responsible for safe, working conditions. Furthermore, labor unions strengthen professional and personal lives of physicians by allowing them to receive health insurance, better leave policies, and retirement benefits. As a result, the strength of collective power is seen through better contracts, improvements in the workplace, safer working conditions, as well as increased productivity, job security, and control over quality of patient care.