- Throughout the pandemic, millions of workers across the US have demanded more from work.
- Doctors have faced especially tough conditions on the forefront of the pandemic.
- One group hopes to change the fact that their profession is not often unionized — and are pushing for more.
When the pandemic hit, Dr. Amy Zhang was roughly halfway through her first year as an anesthesiology resident at the University of Washington in Seattle.
“We’re the ones who would most likely be exposed to individuals who may need intubation as a result of COVID-19,” Zhang told Insider.
Zhang, 31, is now a fourth-year resident. As for other doctors around the world, the pandemic suddenly changed her workload and presented a completely different set of challenges. With the pandemic, “we really stepped up,” Zhang said. “So people worked more and people definitely put in more effort to make sure that patients are safe and patients are treated fairly.”
Zhang is also the president and lead negotiator of the Resident & Fellow Physician Union – Northwest (RFPU-NW), which says it represents 1,400 residents and fellows at the University of Washington — about 20% of doctors in the Seattle area.
On February 23, about 350 or more of its union members walked out for a 15-minute “unity break.” The purpose was to support the union as it negotiates for their next contract to include higher wages, caps on how many hours a resident works, staffing quotas to ensure residents are supported, and more equitable practices for recruiting new residents.
“We recognize residents’ and fellows’ right to assemble and to self-advocate, and have asked that participants adhere to our shared goal of professionalism while ensuring the safety of the patients we serve,” the University of Washington said in a statement to Insider . “We value our residents and fellows as important members of our care teams. We are negotiating in good faith on a variety of issues as we continue to support our residents and all of our employees.”
The University of Washington residents are one of the latest groups of workers to push for better conditions. Millions of Americans, including those at Kroger, Starbucks, and in Congress, have been rethinking what they want out of work. Though doctors are not typically a very unionized group, the profession’s demographics are changing, and their demands for equitable and safe workplaces are changing with it.
‘A lot of doctors are scared to be part of a union’
In a year where labor actions seemed more prominent than ever, doctors are still behind their other unionized peers. But that could change.
Joe Crane, an organizer at the Doctors Council, a decades-old doctor’s union affiliated with the SEIU, estimates that about 10,000 attending physicians are unionized — half with the Doctors Council — and over 20,000 residents are unionized with the Committee of Interns and Residents. There were about 700,000 physicians and surgeons in the US as of 2021, according to the Bureau of Labor Statistics.
There are a few reasons why unionization is low. Just in 2020, the majority of patient-care physicians shifted to being employed as opposed to working in their own private practices, according to the American Medical Association (AMA) — the first time since the data started getting analyzed in 2012.
It’s also about perceptions of what a union fights for, some doctors told Insider. It’s not necessarily about more money, but about supporting patients and keeping doctors safe.
“A lot of doctors are scared to be part of a union, because they just think it would look like they’re after monetary increases,” Dr. Frances Quee, a pediatrician who’s been practicing for 29 years and second vice-president at the Doctors Council, told Insider. For Quee, being a part of the union is about having a say in patient care and satisfaction — and improving safety in the hospital.
“As a psychiatrist, I could imagine only seeing eight to 10 or 12 patients a day. I thought, as a union person, I might be able to help hundreds of thousands of other doctors, do a better job, a more efficient job, a more satisfying job,” Dr. Frank Proscia, the president of the Doctors Council, told Insider. “I figured this way I’ll be helping more patients, ultimately.”
‘We’re also realizing that it’s important for us to speak out’
Then there are residents, a younger generation that sees unions differently. Plus, they’re paid a lot less than their older peers.
Residents graduate from medical school, and are essentially sorted into training jobs in their chosen specialty. In 2017-2018, the average age of a student matriculating in medical school was 24, meaning they may head to residency around age 28. In comparison, about 45% of physicians across specialties were over the age of 55 as of 2019.
“Most hospitals would not hire anybody who hasn’t gone through residency. It’s a path that everybody has to take. We’re all kind of funneled into it,” Dr. George Plummer, a neurology resident at University of Washington and membership engagement chair at RFPU-NW, told Insider. “We’re kind of in a weird position. People have slowly realized that if we don’t stick together and look out for each other, the hospitals will continue to take advantage of the work of residents.”
BLS reports that the mean annual pay for physicians was $252,480 in 2021. The average resident salary was $64,000 in 2021, according to Medscape.
“They could tell me that I’m gonna have a pay cut next year and there would be nothing that I could really do about it, because I would still need to finish residency to ever practice,” Dr. Kaley Kinnamon, a second- year neurology resident at University of Vermont Medical Center and a member of the residents’ organizing committee there, said. “I think that’s kind of where a union comes in.”
Kinnamon is on the organizing committee for the residents at University of Vermont Medical Center, who announced the formation of their union in early March. So far, UVM Medical Center has declined to voluntarily recognize the union.
“We respect the right of our residents to decide whether they want to join a union, and believe it is important for every resident to be informed about what joining a union would mean, and to participate in a vote facilitated by the National Labor Relations Board ,” a UVM Medical Center spokesperson said in a statement to Insider.
The face of medicine is also changing. The number of women enrolling in medical school now outnumbers men. The amount of people of color enrolling in medical school has also ticked up, although it still remains small.
The movement from residents comes as doctors more broadly rethink work. A survey by researchers at the Mayo Clinic of 20,665 healthcare workers at 124 institutions found that a third of physicians intend to cut back on their hours — and about a fifth plan to leave altogether within the next two years.
“There’s very much a culture in medicine that you just put your head down and get through, and it’s hard to find the time and energy to take on anything extra when you’re working 80 plus hours a week,” Dr. Becca Merrifox, a 34-year-old second-year pediatrics resident at University of Vermont Medical Center, said. “I think there’s this growing sentiment that we can do better. It is worth the time to form a union.”
“Doctors are becoming more progressive,” Zhang said. “They’re becoming more politically conscious. And we’re also realizing that it’s important for us to speak out.”