Starting a physician union

  • Legally

  • effectively

  • purposefully

"Agitation without organization leads to frustration." - Jim Hightower
Step-By-Step Plan for Creating a Physicians' Union

    Know that it is your legal right to unionize as an employed physician. Thus, you and your union are protected under federal law.  More info on professionals unionizing and what it can do for you can be found here. Benefits and ethics of unionizing can also be considered here
    Note, NPAC does not make recommendations for or against unionizing. NPAC  follows the Labor Act and the authority for concerted activity in providing information for the creation of unions. It is up to physicians within a health system to decide, with the assistance offered by national unionizing groups, whether a union can and will meet their needs. 



    Contact one of the many national unionizing organizations before you start anything

                       a) You need a PLAN to ensure a positive result and prevent any negative recourse. 
                       b) Also, through contacting a National Unionizing Body, the National Labor Act of 1937 gives legal protections in conversations and efforts moving forward. ​​
                       b) Lastly, there are multiple different scenarios an employed physician can find themselves in. Each scenario will determine how and what method  can be used to legally unionize. Depending on your groups needs, a collective action (demonstration) may be more beneficial than a collective bargaining agreement (official union). Contacting a national union will help navigate these specific questions. They will also help you create a plan of action without any obligations or costs.
    NPAC has vetted the following national organization as a potential group to consider unionizing within. (NPAC has no incentives to promote one group over another. The choice is for each physician group based on their collective's needs. NPAC recommends learning  more about each before deciding. )

    - American Federation of Teachers - they are the largest growing healthcare union. They have experience with physician collective bargaining with some of their contracts linked below. They, will help you through each step of union formation and continuation.Their dues are roughly $20/month per member once a agreement is accepted between your union and the hospital. Until then, they do not charge for any of their support or guidance. They work under the umbrella union group of ALF-CIO, the largest collection of unions representing 13 million professionals, in the US. 

    Contact Eric Lehto, National Lead for Physicians and Healthcare, at for more information and formulating a plan. 

    - more union contacts to come


  3. CARDS

    After contacting a national union and formulating a plan of action, if a collective bargaining unit is decided to be your best approach to meet your needs, pass "cards of interest" discretely to colleagues . This will help determine whom in your health system is interested in participating in the formation of a union. (after clicking the card below, it can be saved or copied to your computer) 



    Expect your hospital system to respond in various ways to these cards. Interest cards are the first official sign that a union is forming and power is shifting. Hospitals systems have been known to publish and promote half-truths, falsehoods, innuendos and even threats. Note that threats are illegal and a strong indication that your demands are warranted and needed. Hospital lawyers may also be deployed to explain that unions are against the interest of their workers. Expect each and plan responses for all accordingly. 


    Contact those who expressed interest (via the interest cards) with a date, time, and location outside of the hospital to hold your first meeting. 


    At one of the first few initial meetings, create a structure with an elected board including president, vice president, secretary, treasurer and general board . You can also form a separate negotiating team at this time or closer to when a bargaining agreement ready. Decide how often you will meet, your own due structure, and any other basic management decisions. This is your group and these decisions are for your team to decide. The national union can help however, by offering different structures to consider. The final decisions are your groups to make. 


    Create your collective list of demands and needs based on priorities. 


    Contact the national union to send representatives and lawyers to help draft contracts and assist in any meetings with hospital administrators. Together, decide strategy and meeting times. Engage in conversation with administration and hospital legal teams with  equal footing knowing you have support from your own union and a strong national network of colleagues.



    Know your needs have been heard, met with a binding agreement, and with each future meeting and member, you are establishing your collective bargaining into a stronger unit for future negotiations. 

Examples of physician contracts drafted through support of the American Federation of Teachers. 

Example of Resident Union Contract coming soon.

6/1/20 - NPAC has now spoken to the largest growing healthcare national union association - American Federation of Teachers. We will present their information here as an option for a network to unionize under. Note that are many national groups to unionize under. The purpose of unionizing under a larger group is to 1) ensure a positive result 2) prevent negative recourse by being protected  under the National Labor Act 3) give weight to demands with union representatives and lawyers assisting in negotiations alongside your local union. NPAC is speaking to the associations that have the largest "punch" and experience in physician-employer negotiations and more national groups will be listed as they are vetted.
5/25/20 - NPAC is currently working on a "toolkit" with two large national unions. This will give physicians the necessary resources needed to start a local union within their health system and the choice of whom to unionize under. 
5/2/20 - Due to legislation restraints, this toolkit will be for employed physicians within a health system. It will allow physicians across specialty to bargain collectively with their employer on their specific needs.  
Interestingly, in our research we have learned many healthcare workers are unionizing under teacher associations to garner the solidarity they want at a national level.  

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