Clinicians at Legacy Health Move to Unionize

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Physicians, physician assistants, and nurse practitioners from Oregon-based Legacy Health announced that they intend to unionize, following in the footsteps of other doctors from Legacy hospitals over the past year.

Roughly 150 primary care providers plan to unionize with the Pacific Northwest Hospital Medicine Association (PNWHMA), a hospitalist-specific labor union affiliated with the American Federation of Teachers.

The group submitted union authorization cards to the National Labor Relations Board (NLRB) on May 8, and the agency will hold a hearing to set an election date in the coming weeks, according to a press release.

The announcement comes amid a potential merger between Legacy Health and Oregon Health & Science University (OHSU), another large health system in the Portland area, according to the press release. Earlier this year, more than 600 NPs and PAs at OHSU announced their own intention to unionize.

Angela Marshall Olson, DO, of Legacy Health at Raleigh Hills Primary Care in Beaverton, Oregon, who is one of the physicians leading the efforts, told MedPage Today that she and her colleagues are organizing to help protect providers’ work-life balance while continuing to ensure high-quality patient care.

“It is very difficult to access primary care,” she said. “As front-line workers, we can provide the best feedback to our administrative teams on all of these care solutions. Because sometimes … it takes somebody who actually does the job to help provide the best problem-solving solutions.”

These clinicians will join nearly 200 hospitalists from six Legacy hospitals who voted to unionize with PNWHMA last year, as well as 17 physicians from Legacy Women’s Clinic who voted to unionize earlier this year, according to press release.

Marshall Olson noted that the doctors and advanced practice providers (APPs) decided to unionize together because they do the same types of work and they share the same challenges.

Chris Stamatakos, PA, of Salmon Creek Primary Care, who also is involved in the unionization efforts, echoed those comments in the press release.

“I’m participating in the Pacific Northwest Hospital Medicine Association because a provider’s need for representation has never been greater,” Stamatakos said. “Provider satisfaction should be a central tenet to helping achieve organizational goals, despite the many challenges in healthcare today.”

Legacy Health said in a statement that it “respects the rights of our employees to choose whether or not to be represented by a union.”

“We appreciate the continued hard work and dedication of our primary care providers, who play a vital role in delivering high-quality care to our patients and communities,” the statement said. “We are committed to establishing a productive dialogue with the union representatives who will be working with Legacy on behalf of these providers.”

Legacy Health is a non-profit health system that operates six hospitals and more than 70 primary care, specialty, and urgent care clinics in the Portland and Vancouver metro areas. The organization claims to employ more than 3,000 healthcare providers. Neither Legacy Health nor OHSU commented on the status of the potential merger between the two health systems.

Marshall Olson noted that the decision to unionize should be viewed in light of recent organizing efforts among doctors across the U.S.

“There’s been a hesitancy for physicians to unionize in since the 70s,” she said. “Recently, we’ve seen kind of an uptick in interest in unionization. I think it’s a direct response to what is happening in healthcare, which is a more corporate approach.”

While the potential merger between Legacy Health and OHSU has had some effect on interest in creating the union, Marshall Olson said efforts began before any providers were aware of a potential merger. She added that the challenges posed by the COVID-19 pandemic also played a key role in spurring action.

“It’s a very critical time in primary care right now, because people are so burned out at this point,” Marshall Olson said. “What we’re looking to do is combine our voices to help with a strategy for provider retention and provider happiness in order to help avoid further shortages for primary care.”

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    Michael DePeau-Wilson is a reporter on MedPage Today’s enterprise & investigative team. He covers psychiatry, long covid, and infectious diseases, among other relevant U.S. clinical news. Follow

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