Unionization among physicians has skyrocketed in recent years as consolidation and burnout rise, while physician autonomy and satisfaction diminish.
An April 29 report published by the American College of Physicians in the Annals of Internal Medicine highlighted some of the factors shaping current unionization efforts among physicians.
Here are eight things to know from the report:
1. High burnout and low fulfillment among physicians are two central reasons they may turn to unionization. According to a 2024 survey by Doximity, 81% of physicians reported they were overworked and 44% said they are considering early retirement or another career due to being overworked.
2. The report notes that an increase in the use of the term “provider” to describe physicians exemplifies a “lack of understanding and appreciation” for physicians’ unique clinical expertise, contributing to a sense of dejection in the profession.
3. Physician independence has also shrunk, as many physician practices have become consolidated by large health systems, hospitals and other corporate entities. From 2012 to 2022, the share of physicians who were self-employed dropped by 9% –– from 53% to 42%. At the same time, employed physicians grew from just under 42% to almost 50%, according to a 2023 American Medical Association release.
4. According to a 2023 survey by NORC at the University of Chicago and the Physicians Advocacy Institute, employed physicians found that 44% would opt for labor union representation, with physicians younger than 50 more likely to report they would consider joining a labor union.
5. During 2023 to 2024, there were 33 petition filings for bargaining units that included physicians compared with just 44 in 2000 to 2022, and most recent unionization efforts were driven by noncompensation issues such as working conditions and lack of voice in management, according to a 2024 study by JAMA.
6. According to the American Medical Association, the number of U.S. physicians belonging to a union increased from 46,689 in 2014 to about 67,673 in 2019, representing 7.2% of practicing physicians
7. In a 2001 position paper, the American College of Physicians–American Society of Internal Medicine expressed preference for the term “joint negotiations” over collective bargaining, arguing that the former describes “a process in which physicians meet and communicate among themselves for the purpose of negotiating about specific issues that affect quality and access,” whereas collective bargaining “implies an adversarial relationship between employers and unions.”
8. However, the ACP contends that this position should be reassessed to reflect the “consolidated, corporatized” healthcare environment and the current status of physician employment and autonomy, opting for the term “collective empowerment.”
