A study published in JAMA documented increased physician unionization activity between 2000 and 2024, with union petition filings rising from 44 in 2000-2022 to 33 in just the first five months of 2023-2024.

The research examined National Labor Relations Board (NLRB) data, which showed 77 total union petitions representing 7,064 healthcare workers during the study period. The annual rate of union petition filings was 2.1 in 2000-2022 and increased to 23.3 in 2023-2024.

Among petitions with completed dispositions, 62% received certification overall, with 54% receiving certification between 2000 and 2022, and 77% in 2023-2024.

The bargaining units varied in composition: 34% contained only physicians and doctors of osteopathy, 40% included physicians and advanced practice clinicians, and 26% represented broader coalitions with nurses and administrative staff. Units ranged from 4 to 560 employees, with a median of 45.

Geographically, 43 of 77 petitions originated from California, Oregon, and Washington. The petitions targeted various employers: 49% hospitals, 38% community health centers, and 13% nonhospital corporate owners, including private-equity-backed companies.

Press coverage of 26 petitions filed in 2023-2024 listed working conditions (85%), management voice (81%), and patient care (54%) as stated reasons for unionization. Compensation appeared in 4% of reports.

The researchers noted limitations including the exclusion of public-sector physician unions under state law and voluntarily recognized unions. In mixed-employee units, physicians sometimes represented only a portion of members.

Conflict of interest disclosures can be found in the letter.