Doctors are joining unions in a bid to improve working conditions and raise wages in a stressful health care system

The share of doctors who belong to unions is rising quickly at a time when organized labor is losing ground with other professions. The Conversation U.S. asked Patrick Aguilar, a Washington University in St. Louis pulmonologist and management professor, to explain why the number of physicians joining unions is growing – a trend that appears likely to continue.

How long have there been health care unions?

U.S. nurses first joined labor unions in 1896. Today, about 1 in 5 registered nurses are union members, twice the rate of unionization in all professions.

The first physicians’ union formed in 1934, when hospital residents – doctors in training who tended then, as now, to be paid relatively little and forced to work long hours – organized to demand higher pay and shorter shifts. For the next eight decades, those unions grew slowly.

But the pace has picked up. The share of doctors who belong to unions rose from 5.7% in 2014 to 7.2% in 2019. By 2024, an estimated 8% of physicians were union members.

This swift growth contrasts with declining union membership overall. The share of American workers in unions fell by more than half, from 20.1% to 9.9%, between 1983 and 2024.

Residents and interns are particularly interested in joining unions. Nearly 2 in 3 have said they might want to join one. Membership in the Committee of Interns and Residents, a chapter of Service Employees International Union, rose by nearly 14% to 37,000 between late 2024 and early 2025. By September 2025, the union was saying that its ranks had grown to more than 40,000.

Several other U.S. unions also represent physicians. Doctors Council, which is also affiliated with Service Employees International Union, represents physicians, dentists, optometrists, podiatrists and veterinarians. The Union of American Physicians and Dentists, part of the American Federation of State, County and Municipal Employees, says it has at least 7,000 members.

Aren’t doctors too rich for labor organizing?

Just like labor unions that represent electricians or teachers, unions that represent doctors seek better working conditions, higher pay and better benefits for their members. While the typical U.S. doctor earns nearly US$240,000 a year, about four times what the typical American worker makes, their compensation varies widely depending on their medical specialty. A pediatric surgeon, for example, can earn twice as much as a pediatrician.

Despite their high wages, according to a poll of over 1,000 physicians, as many as 15% of physicians said they had cut back on their personal expenses, and 40% expected to delay retirement for financial reasons. The education and training required to become a doctor is lengthy and expensive, often leading to large amounts of student debt.

Additionally, many physicians are compensated for patient visits and not for work done outside of the exam room. The extra hours needed to document work, address patient concerns and maintain continuing education are often uncompensated, significantly reducing physicians’ effective hourly earnings.

Other unions advocate for higher wages and better conditions in well-compensated professions.

The National Football League Players Association is an example of a union with highly paid members that still advocates for their increased compensation. NFL players now earn a median salary of $860,000.

Baseball players earn even more. They have a median salary of $1.35 million, and all of the players are represented by the Major League Baseball Players Association, a union.

Why would doctors join unions?

An American Medical Association survey conducted in 1983 found that 75.8% of physicians were owners of their primary clinical practice. Four decades later, nearly 80% of physicians are employed by health care systems or other corporations.

As employees, physicians are now eligible to unionize and may have an interest in doing so to bargain with employers who set working conditions and compensation.

Residents and fellows, on the other hand, have been employees for much longer because of the structure of their training programs. Residents work longer hours, are paid significantly less and are obligated to complete their training programs in order to attain specialty certification.

These differences help explain the longer history of labor organizing for physician trainees.

Surveys point to several other possible causes besides concerns about employers.

An American Medical Association survey of 13,000 physicians, nurse practitioners and physician assistants in 2022 reflected rates of burnout exceeding 50% in several key specialties. More than half of those responding said they felt undervalued by their employer.

In 2023, the University of Michigan’s Center for Health and Research Transformation surveyed over 29,000 Michigan physicians. About 85% of them said administrative and regulatory requirements were a significant source of workplace stress.

The widespread adoption of electronic health records over the past 25 years, which has improved some aspects of medical diagnosis and treatment, has also given doctors more administrative responsibilities. Doctors spend nearly two additional hours updating electronic health records or doing related administrative tasks for every hour they spend with patients, according to one estimate.

Keeping the records up to date can contribute to burnout.

Are doctors worried about job security?

In recent years, nurse practitioners and physician assistants have taken on responsibilities previously reserved for doctors. Nurse practitioners or physician assistants saw patients for about 1 in 4 medical appointments, according to a 2023 study, up from around 1 in 5 a decade earlier.

Given significant differences in compensation between physicians and other kinds of health care providers, this trend raises concerns about the potential for health care employers to employ fewer doctors to save money on staff salaries.

Separately, there are growing concerns about the potential for the use of artificial intelligence and automation to replace some of the tasks that doctors do today.

Can labor organizing harm patients?

In April 2025, the American College of Physicians, which has 160,000 members, released a position paper with recommendations for responsible collective bargaining for doctors.

This group felt compelled to encourage the ethical engagement of its members in the midst of labor organizing because their work is often lifesaving and can be dangerous to disrupt due to strikes or other labor actions.

No study has empirically evaluated whether a doctor’s union membership affects their patients’ health. However, a 2022 meta-analysis of 17 studies found no significant impact on death rates when health care workers go on strike.

Despite the potential benefits, some doctors remain concerned that unionization may create divides among physicians, interfere with their ability in some cases to negotiate directly with their employers, and add layers of bureaucracy that don’t do patients or medical professionals any good.

Do doctors ever go on strike?

It’s historically been rare in the U.S., but that could be changing.

In January 2025, 70 doctors who belong to the Pacific Northwest Hospital Medicine Association joined thousands of nurses in a strike against Portland, Oregon-based Providence Health after more than a year of failed contract negotiations.

The strike lasted 27 days, delaying some elective procedures and making some emergency room wait times longer. Some patients had to go to other hospitals. The agreement the hospital ultimately reached with physicians boosted pay, expanded sick leave and included a commitment to change staffing models.

In June 2025, picket lines formed outside of four Minnesota health clinics for the first time in the state’s history. Members of the Doctors Council SEIU union were protesting after more than 18 months of failed negotiations for a new contract. The doctors, who all work for the Allina Health chain of hospitals, health clinics and urgent care sites, are seeking higher compensation, smaller workloads and more support staff.

Although no timeline has been announced, union members have authorized a strike if negotiations continue to fail. As of early September 2025, those negotiations were ongoing.