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Several hundred primary care physicians at Mass General Brigham (MGB) notified the National Labor Relations Board on Friday that they support unionization, a move they called historic and increasingly common throughout the country.

The petition to link up with the Doctors Council, a labor union for physicians, was prompted by a growing number of factors, said Michael Barnett, MD, an MGB internist and associate professor of medicine at Harvard Medical School and the Harvard School of Public Health.

Through a union, the doctors hope to fight back on what they perceive as too many layers of bureaucracy that hinder physicians' access to leadership to help solve problems, he said.

As examples, primary care doctors are required to work much longer hours than other specialties in order to be considered full-time employees, staff turnover issues are not being adequately addressed, and physicians are being overwhelmed by workloads brought on by patient emails, especially since the beginning of the pandemic, he explained.

Barnett said MGB leaders have failed to recognize the impact of that increasingly unmanageable burden.

"Within both MGH [Massachusetts General Hospital] and Brigham, there has been a collective neglect and series of unfulfilled promises that were accumulating over many years, and it was clear that things were not going to get better," he said. "Corporatization [at MGB] and an increasingly financially-oriented leadership were making it hard to have our voices heard. ... We had to take action, because it appeared it was going to get much worse before it got better."

Another example of increased workload, Barnett said, is that other specialties within MGB have a system that provides float coverage when doctors are out on sick or maternity leave, or on vacation. "Whereas in primary care, we have to cover our colleagues all the time ... and it's like an unfunded mandate for us to carry 10% or 20% more at any time across the year."

A news release about the election petition pointed to "growing corporatization of healthcare, collapsing primary care patient access, and the moral injury caused by systemic challenges."

The effort to unionize at MGB must be approved in an election, expected in several months, and recognized by the NLRB.

Barnett said there are about 400 primary care doctors at MGB, but many of them are in management positions that prohibit them from being in a collective bargaining unit. There are about 300 PCPs who are eligible to be in a union, and the "vast majority" have submitted their desire to unionize, he said.

In response, an MGB spokesperson issued this statement: "Primary care physicians are critical to the health of our patients and community. We know that PCPs across the Commonwealth are facing unprecedented volume and stress as a result of a confluence of factors that are not unique to our organization."

"We share the common goal of offering world-class, comprehensive care for our patients and believe we can achieve this best by working together in direct partnership, rather than through representatives in a process that can lead to conflict and potentially risk the continuity of patient care," the statement continued. "We are committed to continuing our dialogue with our PCPs, supporting them and their practices through this challenging time and investing in ways to reduce burden."

The MGB primary care unionization move is the latest in a series of physicians fighting back with efforts to join labor unions within many hospital systems across the country, reflecting a growing sense of outrage at the conditions that require them to practice as employees, and in ways that conflict with the reasons why they became doctors.

While more than 2,000 physicians-in-training at MGB , more senior doctors across the country have also been organizing.

In August 2023, 550 doctors and other healthcare providers at Allina Health in Minneapolis filed to unionize. More than 400 physicians with Delaware's ChristianaCare health system, Christiana Hospital, Wilmington Hospital and Middletown Free-standing Emergency Department, filed to unionize this spring.

At Legacy Health in Oregon, physicians, physician assistants, and nurse practitioners announced in May they intended to unionize. And some 40 hospital-based clinicians at Skagit Valley Hospital and Cascade Valley Hospital in Washington voted to unionize this summer.

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