As recently as the early 1980s, the landscape of medical practice in the United States was markedly different from what we see today, with approximately 75% of doctors operating as self-employed professionals. During this era, the majority of physicians owned and managed their own small clinics, a business model that afforded them significant autonomy over their practice. This arrangement allowed for more personalized care, as doctors were intimately familiar with their patients and communities. Additionally, the smaller scale of operations typically meant less bureaucratic oversight and more flexibility in patient care. However, this model also presented challenges, such as the burden of administrative tasks, financial responsibilities of running a clinic, and the need to stay updated with the rapidly advancing medical technology and treatments. This period reflects a time in American healthcare when the independent practitioner was the norm, a stark contrast to the more corporate and network-driven structures prevalent in today’s healthcare system.
Today, the medical landscape has undergone a significant transformation, with a large majority of physicians now functioning as employees within hospital systems or large corporate medical groups. This shift from independent practice to employment within larger healthcare entities has been a source of growing concern among medical professionals. Many physicians are worried that this trend is leading to a heavy personal toll, marked by increased stress levels, reduced autonomy, and a feeling of being distanced from their patients. Furthermore, there’s a fear that this shift is contributing to a diminished quality of care. In large systems, doctors often face heightened administrative burdens, stringent productivity quotas, and a one-size-fits-all approach to patient care that may overlook the nuances of individual patient needs.
As a result of these changes and concerns, a sector of healthcare workers traditionally hesitant to unionize is now reconsidering its stance. Faced with growing challenges in their professional environment, these physicians and healthcare workers are exploring unionization as a means to regain some control over their work conditions. Unionization efforts are seen as a way to collectively negotiate for better terms of employment, including more reasonable work hours, improved patient care conditions, and a greater say in administrative decisions that directly impact their ability to provide quality care. This shift towards considering unionization reflects a broader movement within the healthcare sector, as workers seek to adapt to and influence the evolving dynamics of the industry in order to better serve their patients and protect their own well-being.
“The fact that we are seeing physicians unionize is the strongest indicator I can imagine that the US healthcare system is on the verge of collapse and in need of immediate and transformational changes,” explains DoorSpace CEO Sarah M. Worthy.
The change the healthcare industry has undergone is leading many physicians to feel that they have lost autonomy and aren’t able to actually care for their patients, rather insurance companies and other bureaucratic roadblocks are preventing them from taking care of people.
“As these hospitals consolidate under a traditional corporate org chart – physicians are losing their autonomy and the ability to use their training and expertise to do their work of helping patients,” states Worthy.
These roadblocks are not in place to help physicians or people, and are costing people their lives.
Worthy states, “The “higher-ups” often lack medical training and are narrowly focused on quarterly financial reports, failing to provide physicians with the support and environment they need to take care of their patients effectively. I’ve spoken to dozens of physicians and hundreds of nurses – all of them speak to the repeated efforts they’ve made to get things changed internally at their organizations. All to no avail. Unions are the way physicians take back the power to put patient care first.”
The dramatic shift in the U.S. healthcare landscape from independent practices to dominance by large hospital systems and corporate groups has significantly impacted physicians, leading to concerns over diminished autonomy and quality of patient care. This has prompted a sector traditionally reluctant to unionize to reconsider, as emphasized by DoorSpace CEO Sarah M. Worthy. Physicians and healthcare workers are increasingly viewing unionization as a necessary step to regain control over their work environments and advocate for better patient care. Worthy highlights the critical state of the healthcare system, where corporate-driven priorities and bureaucratic obstacles are undermining physicians’ ability to effectively care for their patients, making unions a potential solution to refocus on patient-centric care.