Resident physicians and employees at Children’s Hospital of Philadelphia voted against unionizing a month after more than 3,000 medical residents from across the region announced plans to form a union.
In behind schedule December, 178 CHOP residents voted to unionize and 195 voted against joining, a margin of 17 votes, said Natalie LaBossier, a second-year pediatrics resident at CHOP who worked to organize the vote. Residents sought to join the Intern and Resident Committee, a branch of the Service Employees International Union.
In a statement, a CHOP spokesman said the hospital believes that “the best employee experience can be achieved through direct, two-way communication and collaboration, and will continue to work with our residents and colleagues to find ways to improve or enhance this experience.”
“We remain committed to developing positive and productive relationships with all of our employees, regardless of their union status,” the spokesman said.
In November, CHOP residents joined resident physicians at Temple University Hospital, Thomas Jefferson University Hospitals, Jefferson’s Einstein Healthcare Network and Delaware-based ChristianaCare to announce plans to unionize. Organizing residents said intense work hours, burnout and a lack of support from supervisors at hospitals led them to form unions.
CHOP was the first hospital in this cadre to hold a union vote. Residents of the remaining hospitals will vote in mid-January, said Melissa Uribe, spokeswoman for CIR. Another group of residents at the University of Pennsylvania Health System, which is affiliated with CHOP, successfully voted to unionize in 2023.
“Ultimately, when CHOP residents are ready to try again, we will be here for them,” Uribe said.
Matt Eiman, a second-year pediatrics resident at ChristianaCare, said he was surprised by the CHOP vote and felt sorry for residents there who “deserve a say in their contract and work-life balance.”
Still, he added that he was confident about the upcoming vote at his hospital.
“It gave me a sense of urgency [about] have the widest possible reach. Our numbers have shown that this is a very popular initiative and many residents and others support it,” he said. “But this election is not guaranteed, and we are making sure we do everything we can to ensure the vote is recognized.”
Campaign for a union
Uribe said CHOP officials used “anti-union tactics” before the vote, but he did not explain what those tactics were. LaBossier said votes are private, so it’s complex to know exactly what prompted some residents and co-workers to vote against the union, but said “some of the language” used by CHOP during the campaign “focused more on discouraging residents from voting.” Yes.’ “
Fellows are physicians who have completed a residency, which is the initial part of medical training, and are undergoing additional training in a specific medical specialty, such as pediatric endocrinology.
“Pediatrics in general is in a difficult moment due to government disinvestment,” LaBossier said, “and CHOP has really exploited trainees’ concerns about future employability to discourage unionization.”
LaBossier said that while she was disappointed with the vote, she said residents who want to unionize will continue to organize.
“Even after the election results were announced, I have spoken to several people who feel even more motivated to engage with our efforts,” she said. “I’ve had several conversations with people who were disappointed in themselves and asked me when we could try again.”
How the incoming Trump administration is affecting union drives
The union drive happened relatively quickly. The process can typically take years, although some residents have been working on formally proposing to join the union for some time. LaBossier said residents had been organizing at CHOP for “well over a year” before announcing their plans last fall.
Union officials said in November that they wanted to keep the union vote in organizing hospitals in Philadelphia before Republicans take control of the White House.
CIR President A. Taylor Walker said officials are concerned about President-elect Donald Trump’s attitude toward unionizing graduates, including medical residents. In 2019, Trump’s National Labor Relations Board, a presidential appointee that enforces national labor laws, proposed that graduates should not be considered employees.
This would mean that graduate students would lose the right to unionize, and universities would be free to allow or reject the formation of a graduate union without involving the NLRB.
In 2021, the NLRB – while still operating with a majority of Republican nominations – announced that would withdraw this proposal. Currently, two candidates from the Democratic Party and one person from the Republican Party serve on the board.
“You will see Republican presidents install a board that is more pro-manager, and Democratic presidents install a board that is more pro-worker. “I think we’ve been able to double the size of the CIR because of our pro-worker policies over the last four years,” Walker, who is also chief resident in family medicine at Cambridge Health Alliance in Massachusetts, said in November.
Still, Uribe said it is “not true that the Trump administration will in any way impede our efforts” to organize residents, including CHOP residents.
“It’s no secret what’s at stake for the NLRB,” she said. “But we will continue regardless of who is in office.”
National trend towards unionization
In recent years, more and more residents across the country have begun to join unions, with about 20% doing so currently in a relationshipdespite entering an occupation that has not historically been part of organized labor.
However, residents in particular cite grueling working conditions and relatively low wages in their efforts to form trade unions. During residency, the final phase of medical training, doctors can work up to 80 hours a week for an average of about $61,000 a year. That’s less than other professionals who require special training, such as flight attendants and electricians, according to the New England Journal of Medicine’s Resident 360 site reported.
Even outside of residency, most physicians are now employed by health systems rather than running their own practices, making collective bargaining more attractive to some – including in the Philadelphia region.
Last year, ChristianaCare physicians became the first group of unionized physicians in the region to complete training.
This fall, residents of Penn and the Rutgers University Health System finalized their first contracts with their health systems. These successful efforts have galvanized residents at CHOP and other health care systems, the group said in November.
