Washington State Hospitalists Set to Unionize

A group of hospitalists in Washington state is poised to become the first physician union to earn joint-employer status, sources told MedPage Today.

Some 30 clinicians — including 25 physicians and five nurse practitioners — working at two PeaceHealth facilities under a contract with Sound Physicians filed with the National Labor Relations Board (NLRB) in March to unionize with the Union of American Physicians and Dentists (UAPD).

During a 3-day NLRB hearing in April, the group won the right to a mail-in vote with a June 11 deadline, and also won joint-employer status, according to Joe Crane, UAPD’s organizing coordinator.

“Many physicians are employed by these contract [management] groups. This opens them up to unionizing and being protected in ways that didn’t exist previously,” Crane said. “It’s a small group, but there are big ramifications.”

Meghan Lelonek, MD, a hospitalist who helped lead the unionization efforts, said a number of factors contributed to the group’s decision to unionize, including increased administrative burden, a recent disappointing contract negotiation, and the unionization of a group of advanced practice providers (APPs) at PeaceHealth.

“It feels like we’re being asked to see more and more patients in less and less time, with less autonomy and control over the ways we’re able to provide care to them,” Lelonek told MedPage Today.

Since the group hadn’t had a raise since 2017, they asked for one last year. While they eventually received a raise, Lelonek said, they were also given an increased number of shifts as well as an increase in the number of patients they must see in one shift.

“It doesn’t sound like as much as we feel it is,” Lelonek said. “That one patient for us feels like it puts us over a breaking point.”

She added that the clinicians “had no place at the table during any of the contract negotiations. We didn’t have any ability to say what we wanted or negotiate the things that we thought would be good for our working conditions and our patients.”

After the APPs had unionized with UAPD, Lelonek said her group reached out to UAPD as well to get the unionization process going.

Crane said the union covers the 30 clinicians working for Sound Physicians at two PeaceHealth facilities in Washington state: St. Joseph Medical Center in Bellingham and a small rural hospital in the state.

Crane confirmed that St. Joseph’s is the same PeaceHealth facility from which emergency physician Ming Lin, MD, was fired during the early days of the COVID pandemic for speaking out about alleged safety concerns. Lin was not part of a union.

The hospitalist group is “unionizing because they can’t take care of their patients,” Crane said. “At the end of the day, [private equity-owned labor management groups] are here to make money off our family members being sick, and that’s a position that doesn’t sit well with the overwhelming majority of physicians.”

Sound Physicians is jointly owned by UnitedHealth Group’s Optum and by private equity firm Summit Partners.

Lelonek and colleagues join a rising tide of other physicians who have opted to unionize to fight what they see as diminishing autonomy and increasing corporate control over the way they practice. In just the last year, many physician groups have moved to unionize, including 400 doctors at Delaware’s ChristianaCare and more than 550 clinicians at Minneapolis-based Allina Health — along with many other smaller groups.

Lelonek noted that since the group filed to unionize in March, corporate leadership has put on the pressure, sending executives from headquarters and labor management consultants to observe the clinicians, and sending “email after email saying things like, ‘We want you to vote no to unionization and this is why.'”

“We’ve all stood together as a group, it’s just been a lot,” she said. “We’re already trying to take care of more patients and meet these expectations, then all of a sudden we have these meetings and emails on top of things.”

She said Bellingham is home for the majority of healthcare workers in the group. “This is the only hospital in the county,” she said. “We’re not here because we want to work for Sound Physicians. We’re here because we want to serve our community in our local hospital.”

Neither Sound Physicians nor PeaceHealth responded to a MedPage Today request for comment as of press time.

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