Becker's Spine Review

35 35 HEALTHCARE NEWS Why more physicians are unionizing By Kelly Gooch W hile labor actions during the pandemic have more oen involved nurses and other healthcare professionals, physicians are increasingly involved in union activities, including votes to unionize. ere are various factors underlying the trend. Physicians are seeking greater investments by hospitals in working conditions, staffing and other resources needed to provide patient care. Hospitals, meanwhile, have emphasized their commitment to quality care and these professionals during a challenging time in healthcare. According to the American Medical Association, there were 67,673 physician union members in 2019. at represents 7.2 percent of physicians actively practicing nationwide — and that 2019 total is up about 26 percent from 2014. Two attorneys and a physician argued in a viewpoint article published July 28 in the JAMA Network online that the pursuit of physician unions is likely to continue amid the consolidation of health systems and medical practices. Data from Avalere in a study sponsored by the Physicians Advocacy Institute shows the percentage of U.S. physicians employed by hospitals, health systems or corporate entities grew from 62.2 percent in January 2019 to 73.9 percent as of January 2022. Residents and fellows at the University of Southern California's Keck School of Medicine in Los Angeles are among those who have recently chosen union representation. ey voted in the spring to unionize with the Committee of Interns and Residents. And St. Charles Medical Group physicians, nurse practitioners, physician assistants and other healthcare workers refiled their petition in August with the National Labor Relations Board, seeking to hold an election to decide whether to join the American Federation of Teachers. St. Charles Medical Group is the employed provider arm of Bend, Ore.-based St. Charles Health System. And the Valley Physicians Group, which represents Santa Clara (Calif.) County's employed physicians, podiatrists and dentists, reached a tentative agreement with the county in October to avert a four- day strike. Members of the Committee of Interns and Residents also reached a tentative agreement with UCSF Benioff Children's Hospital Oakland (Calif.) in October, averting a looming strike. is agreement addressed pay and cost of living issues through measures such as a housing stipend increase starting with $11,000 in the first year of the contract. In instances where a strike is on the table, hospitals have expressed their goal to avert such situations while remaining fiscally responsible in negotiations. Most recently, resident physicians and fellows at Montefiore Medical Center in New York City requested voluntary recognition of their union, according to a news release from the Committee of Interns and Residents. "So many of us chose to do our residency here because we want to work in the Bronx and with the diverse and historically underserved community that lives here — and we know we can do more. Our hope is that through our union, we can advocate for the resources we need to help improve healthcare access in the Bronx," Rex Tai, MD, a second-year internal medicine resident at Montefiore Medical Center, said in the release, which was shared with Becker's on Nov. 1. "An investment in full staffing, Federal judge declines 14 states' challenge to CMS vaccine mandate By Kelly Gooch A federal judge in Louisiana on Dec. 2 declined a case brought by 14 states challenging the Biden administration's rule that requires COVID-19 vaccination for eligible staff at healthcare facilities participating in Medicare and Medicaid programs. In November 2021, CMS announced that healthcare facilities that receive federal funding must ensure workers are vaccinated against the virus, while allowing for medical or religious exemptions. That same month, a coalition of 12 states, led by Montana, sued the Biden administration, arguing that the rule is at odds with the "anti-commandeering doctrine" in the U.S. Constitution, which states that "the powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people." The lawsuit, filed in a federal court in Louisiana, was initially brought by Montana, Alabama, Arizona, Georgia, Idaho, Indiana, Louisiana, Mississippi, Oklahoma, South Carolina, Utah and West Virginia. Kentucky and Ohio joined the lawsuit shortly after. According to the Courthouse News Service, the federal judge in Louisiana found the states' contention that they will experience increased enforcement costs from the CMS rule is "conclusory and entitled to no weight." A spokesperson for Montana Attorney General Austin Knudsen's office told Becker's the states have 60 days to file an appeal and are considering next steps following the Dec. 2 order. A CMS spokesperson told Becker's that CMS is aware of the federal court decision and does not comment on matters involving litigation. A coalition of 22 states — led by Mr. Knudsen — also filed a petition in November asking CMS to withdraw the vaccine rule. n

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