ChristianaCare physicians voted to unionize, creating the first union for attending physicians in a Philadelphia-area health system

Physicians at Delaware’s largest health system voted to unionize, becoming the first group of post-training doctors to do so at a Philadelphia-area hospital.

Over 400 physicians at ChristianaCare voted in the weeklong election administered by the National Labor Relations Board. The ballot asked if the physicians wished to be represented by Doctors Council, an affiliate of the Service Employees International Union, for the purposes of collective bargaining. Nearly 70% approved creating the union.

The new union will represent nearly 500 doctors, making it the largest U.S. union of attending physicians in the private sector, Doctors Council said.

The ballots were tallied Thursday night in a conference room at Christiana Hospital in Newark, Del. There, Bryan Haimes, a ChristianaCare physician, and fellow organizers listened to the vote count as they waited for the number of “yes” ballots to cross the 50% mark.

“Once we hit 251, we let out a big cheer,” Haimes said.

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Physicians at ChristianaCare said their desire to unionize reflects frustration with the load of administrative tasks they are required to carry out, which erodes the time they can spend with patients.

ChristianaCare respects the rights of physicians to choose whether or not they want to be represented by a union, the system said in a statement.

“As always, our focus remains on our mission of serving our neighbors,” it said.

The doctors are the first health-care workers to form a union in ChristianaCare’s 136-year history. In the period leading up to the union vote, the hospital had argued that a union would interfere in the relationship between managers and physicians. Administrators also warned that a union would make it harder for the health system to attract top talent in competitive specialties.

The attending ChristianaCare physicians join the growing interest in unionization among doctors still training as residents and fellows, including at the University of Pennsylvania, where last year’s trainees formed Philly’s largest new union in half a century.

The trend is tied to a shift in how most doctors are employed.

Three out of every four physicians in the U.S. owned the medical practices where they worked in the early 1980s, according to the American Medical Association. In 2022, an estimated 74% of practicing physicians in the U.S. were employed by hospitals, health systems, and other corporate entities — a complete reversal from the rate of physicians who were self-employed just four decades ago.

Advocates for physicians’ unions hope that by unionizing a large, private-sector health system, the ChristianaCare doctors will be a model for doctors in other hospitals.

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“This historic win will pave the way for physicians around the country to organize to regain control of their practices and fight for their patients,” Frances Quee, president of Doctors Council, said in a statement.

As the news spread, Haimes received messages Thursday night from former medical school and residency classmates now working elsewhere.

He wants the ChristianaCare physicians’ union to set a standard for patient safety and the well-being of their physicians when they negotiate in their first contract.

“Today, we celebrate,” Haimes said. “Tomorrow, we get back to work on how can we make this union to be as meaningful as possible.”