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The union push at Legacy Health gathered steam this month as some 40 nurse practitioners and physician assistants at Legacy Emanuel Medical Center and Legacy Good Samaritan Medical Center petitioned to be represented by the Oregon Nurses Association.
The effort follows a successful one by 200 Legacy hospitalists who last month voted overwhelmingly to be represented by the Pacific Northwest Hospital Medicine Association, an affiliate of the American Federation of Teachers. Hospitalists are physicians that care only for hospital inpatients.
Also last month, 60 registered nurses, social workers, certified nurse-midwives, nurse practitioners, and genetic counselors at Legacy women’s health clinics petitioned to join the ONA.
Increased union participation could lead to higher pay for health care workers and higher costs for a hospital system trying to contain them in the wake of the the pandemic, when revenue declined because fewer patients came in for the high-dollar procedures that buttress hospital operations.
Union activity at Legacy picked up in August after Oregon Health & Science University said it planned to buy Legacy Health, creating the largest employer in the Portland metro area. In September, Legacy employees told top brass that they had “grave concerns about how the proposed merger with OHSU will affect changes to essential services, workflow, and priorities of productivity over patients and staff.”
Unionized health care workers had higher weekly earnings than non-union ones ($1,165 vs $1,042) as of 2021, according to a 2022 study in the Journal of the American Medical Association. They were more likely to have retirement benefits at work and to have full premium–covered health insurance.
“Physician assistants and nurse practitioners at Legacy have been begging for a voice and professional recognition for over a decade,” Leigh Warsing, a physician assistant at Legacy Emanuel and Good Samaritan said in a statement. “Despite the fact that we are critical front line providers, Legacy does not recognize our value. We are hopeful that with a change in our administration, we can have a seat at the table and facilitate changes that we know will optimize patient care.”
As they did when hospitalists organized, Legacy leaders discouraged workers from unionizing.
“Legacy prefers to work directly and collaboratively with all of our provider colleagues,” Legacy Medical Group chief medical officer Lori Farrell and chief operating officer Chuck Bruce wrote to staff in an email obtained by WW. “We have accomplished so much by working together in the past, and we strongly believe that sense of collegiality can continue to drive us toward a stronger future.”
In a statement, Legacy said it would abide by any result of the union vote.
“Legacy respects an employee’s right to choose whether to be represented by a union and will respect the outcome of any petition to unionize,” Legacy said. “We value our people and their contributions to providing the high-quality healthcare that our communities have come to expect from Legacy Health.
Unions are relatively rare among doctors and higher-paid medical workers. Just 13.2% of them were organized as of 2021, according to the JAMA study. But that appears to be changing. The National Labor Relations Board, which oversees union elections, saw a 57% increase in petitions in the first half of 2022, the JAMA study found.
Much of the increase has been driven by “the toll of the COVID-19 pandemic—including struggles obtaining personal protective equipment, inconsistent testing and notification of COVID-19–positive exposures, and inadequate pay with increased work hours,” the JAMA study said.
Kevin Mealy, a spokesman for ONA, said something larger is at work.
“As people try to turn medicine into an assembly line, we’re seeing pushback, and it’s hitting higher up the economic ladder,” Mealy said in an interview. “Under these corporate contracts, workers are seeing the need to push back. They are losing the ability to give patients the care they need.”