Nearly 3,000 residents from major Philly health systems are unionizing

Newly graduated doctors completing their medical training at several of the Philadelphia area’s major health systems said Thursday that they plan to unionize.

A combined 3,000 resident physicians and fellows will vote on whether to unionize at Children’s Hospital of Philadelphia, Temple University Hospital, Thomas Jefferson University Hospitals, and Jefferson’s Einstein Healthcare Network, the Committee of Interns and Residents, a union affiliated with SEIU, said in a statement.

Another 300 residents at ChristianaCare in Delaware are also seeking to form their state’s first union of residents. The health system’s attending physicians formed a union earlier this year, becoming the first group of post-training doctors to do so at a Philadelphia-area hospital.

A. Taylor Walker, CIR’s president and the chief resident in family medicine at Massachusetts’ Cambridge Health Alliance, said residents from separate health systems announcing their plans to unionize on the same day was unprecedented.

“It’s hugely impressive. I’ve never seen anything like it at one shop, much less five,” she said.

The Philadelphia area is a national hub for medical education, with dozens of health systems employing thousands of resident physicians and fellows, who spend three to seven years after obtaining their medical degrees completing their training in their chosen clinical speciality. Last year, about 1,400 new doctors were placed in residency programs in the region.

Residency has long been a grueling phase of hands-on medical training, when training doctors work up to 80-hour weeks for relatively low pay. Residents earn on average about $61,000 a year, which is less than other professionals who require special training like flight attendants and electricians, the New England Journal of Medicine’s Resident 360 website reported. A growing number of residents have launched union drives at their hospitals in recent years, and about 20% of the 162,644 active residents in the country are in a union.

Better working conditions for residents would improve patient care at hospitals that serve some of Philadelphia’s most underserved communities, the union said.

“Due to chronic understaffing, extreme hours, and an endemic lack of support, the physicians say it is currently impossible to maintain their own well-being in their roles caring for the majority of patients at safety-net hospitals across the city,” the union said.

The concern is shared by other unionizing doctors. When Penn Medicine’s 1,400 residents last year formed the city’s largest new union in half a century, they spoke about how they had struggled to provide effective care during long shifts, while stressed about their own ability to pay for child care, housing, and parking.

Penn residents’ negotiation of their first contract in September — giving them raises between 25% and 28%, eight weeks of parental leave, and other provisions to combat burnout and fatigue ― galvanized residents at other hospital systems. Unionized Rutgers University residents also reached their first contract with the university last year.

“Seeing how successful Penn’s unionizing attempt and their contract were, that helped us pick up some steam,” said Trishya Srinivasan, a second-year resident in internal medicine at Thomas Jefferson University Hospital who has been working with other residents to unionize. “Philly is such a huge city when it comes to medical training. We all feel we want to set a new standard.”

In a statement, Jefferson Health said that its residents receive “competitive wages and benefits” and “exceptional medical training.”

“While we respect our residents’ right to explore unionization, we believe that a direct working relationship between our health system’s team members and our leaders results in the most empowered and productive teams,” a spokesperson for the health system said.

The other Philadelphia health systems where residents propose to unionize did not immediately return a request for comment.

Walker, from the CIR, said that typically, it takes years to organize residents to vote for a union. The residents in Philadelphia made their decision in eight days — in an effort to vote and certify the union before Republicans take control of the White House.

The National Labor Relations Board, which interprets federal law around union organizing, is appointed by the president. “You’ll see Republican presidents install a board that is more pro-management, and you’ll see Democratic presidents install a board that is more pro-worker. And I think our pro-worker policies over the last four years is why we have been able to double in size at CIR,” Walker said.

» READ MORE: Philadelphia doctors are riding the medicine unionization wave

Philadelphia is part of a national trend toward unionization among doctors, who have historically not been part of organized labor but are now mostly employed by health systems, not running their own practices. Amid union drives at other hospitals, doctors have cited burnout, an increasing administrative load, and long hours on fixed salaries without overtime pay.

The trend reflects a broader restructuring in the practice of medicine, from residency training to how doctors are employed.

In the early 1980s, three-quarters of doctors nationwide owned their own medical practices. But by 2022, those figures had flipped, with 74% of physicians employed instead by hospitals, health systems, and other corporate entities.

The unionizing residents held a news conference outside of the former Hahnemann University Hospital in Center City on Thursday night. CIR said in its statement that the location is symbolic: Hahnemann closed in 2019, shocking the city, forcing patients to seek care elsewhere, and sending residents scrambling to finish their training at other hospitals.

Srinivasan, who spoke at the news conference, said that the closure of Hahnemann still resonates with doctors finishing their medical training.

“We live in a world of increasingly corporatized health care, and part of unionizing is protecting us and our patients from the harms of corporate greed,” she said.

Tammarah Sklarz, a hematology and oncology resident at Temple, told a crowd of residents at the news conference that she often works 12-hour shifts, six days a week, caring for up to 30 patients with cancer.

“When you’re talking about resident working conditions, you’re talking about patient care,” she said. “Residents across Philadelphia are united, not just for ourselves, but for patients and the health of our community.”

Editor’s note: This story has been updated to add ChristianaCare’s union drive, and comment from Jefferson Health and one of its residents.