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The Big Story: ‘The last option’: Why doctor, resident unions continue to grow

“Doctors and support staff are seeking contracts across organizations that ensure reduced workloads and more one-on-one patient care time. However, where doctors want more decision-making power, residents are pushing for better benefits and higher pay.”

Are you truly engaging your workforce?

By Tim Stewart
3-minute read

There are so many “Debates About Work” happening at any given time, with different dominant themes and clickbait catchphrases – quiet quitting, AI coming for everyone’s job, the promotion recession – waxing or waning depending on the whims of whatever chaotic Wizard of Oz lurks behind the curtain of your LinkedIn feed’s algorithm.

One consistent theme of the last several years though, is the success of labor unions across a range of industries and types of workers. This is news that, depending on where one sits on the org chart, is met with anything from standing ovations to deep anguish. But healthcare leaders would be best served to stop wishing labor away and instead focus on why these groups are ascendant.

Healthcare unions, particularly nursing unions, have capitalized on a post-pandemic moment where many of the things they’ve been talking about for years like staffing shortages and workplace safety received sustained attention – most of it negative – since the spring of 2020. These are real issues faced by clinicians, not some inflatable bogeyman created by activist third parties. The job has gotten a lot harder. Clinical burnout is real. The people dealing with the challenges are looking for allies who see them and want to help them.

More broadly, there have also been significant changes to the workforce itself and how people think about the role of work in their lives. No, Millennials and Zoomers are not inherently lazier than the previous generation. But they are more skeptical about their prospects for the future, within an economic system they perceive to be increasingly interested in wringing the most out of them while giving no clear ladder for future success.

Workers in their mid-30s have already been through the two most significant recessions of the last 75 years, so their skepticism is grounded in experience. And the long tail of Reagan-era political and communications strategies that successfully demonized unions has run out of rope when confronted by a younger workforce that has had a more turbulent experience of America and is much more fearful of overreach by capital than they are of Jimmy Hoffa-era tales of waste and corruption in unions.

For healthcare executives of any personal or political persuasion who are concerned about employees looking longingly towards unions and their promises, there are some deceptively simple strategies to implement. But they require significant commitment and buy-in across the entire leadership team:

  • Actually engage. This one’s going to have you rolling your eyes. You’ve heard the word *engagement* from consultants a zillion times. Make it a zillion and You need to create opportunities for genuine, sustained engagement with employees, and create a culture where anyone who is or wants to be called a leader is held accountable for building a culture of engagement with their teams. This starts with fearlessly assessing where the organization actually stands and what the culture actually is. Not where you imagine you should be or, worse, imagine you are.
  • Rethink how the organization communicates. A notable point in the Axios piece was the idea that corporate communicators are not able to respond as nimbly as activists. If that’s true within your organization, you may need to give communications leaders and their teams freedom to focus more on the communications part than the corporate part. In the same way that hospitals should provide a patient experience that matches the good vibes showcased in marketing and ads, the “direct relationship between employees and executives” must mean something real that’s consistent with employees’ experiences interacting with the broader organization. People need to feel like the relationship is two-sided and interactive, not just a line from the 1995 spiral-bound labor playbook that comes out when a union petition gets circulated.
  • Expand the table. When you hear employee complaints, there’s likely a temptation to think, “They don’t know everything we do for them.” And if you do think that, you’re right. They don’t. So, tell them, just maybe not with that tone. Smart organizations recognize and respect their workforce and don’t feel insecure by sharing power. If you don’t want to spend your time sitting at a bargaining table, give your employees – particularly clinical staff – seats at the executive conference table and tangible ways to influence the future of the organization.

It’s easy, understandable even, to become defensive in the face of a rising oppositional force. Like any relationship, a hospital’s relationship with its workforce may have tense moments, sure. Rising conflict, though, is a sign of something different. But, at least in this instance, the better question isn’t “How do we defend?” but, “Why is this oppositional?” Answer that question first to get away from the sense of Us-vs-Them and back to a focus on shared mission and how to achieve it – together.

Contributors: David Shifrin

Image Credit: Shannon Threadgill