Physicians employed by a hospital or healthcare system CAN unionize as long as they are actual employees. Typically, this means being paid a salary reported on a W-2 form. Salaried doctors at public hospitals can also unionize.
This necessary status as an employee excludes supervisors. That detail has been repeatedly used (or abused) by hospital employers who do not want their physician staff to unionize.
The “supervisor” issue was at issue in a Washington State case. There, doctors at 46 primary care clinics voted to be represented by the United Salaried Physicians and Dentists Union. Their employer, Medalia Healthcare, argued to the National Labor Relations Board (NLRB) that the doctors were “supervisors” because they were clinic administrators or served on management committees. The NLRB sided with the doctors, concluding they could organize. The reason: they did not have authority to hire, fire or make managerial decisions. Under the National Labor Relations Act, these characteristics defined a “supervisor”. This standard has been upheld in subsequent cases, including in Arizona and New York.
Attempts to shoehorn private practitioners as “employees” by arguing “de facto employment” have failed.
In United Food and Commercial Workers v. AmeriHealth Corp, a blue collar union wanted to represent 450 New Jersey physicians in negotiations with their HMO. The union argued the HMO imposed so many conditions on the practice of medicine and on the doctors themselves, that the doctors were reduced to being employees. However, the NLRB agreed with the HMO that since the doctors made independent medical decisions, provided their own facilities and support staff, and could leave the HMO at any time, they were independent contractors and not eligible to unionize.
