By Cheryl Clark

Some doctors are pushing to organize the 10,000 attending physicians within the University of California system, setting in motion what could become the largest union of employed physicians, organizers say.

Factors driving the organization effort include hiring freezes, increasing patient loads, long hours, and clinician burnout, some of the attendings said during a news conference at UCSF Medical Center late last week.

Some of them had been members of the Committee of Interns and Residents through Service Employees International Union (SEIU) Healthcare. Earlier this month, the 6,400 resident physicians and fellow members of that union reached a tentative contract with UC Health.

The attendings would instead be unionized through SEIU Doctors United. A handful of them spoke during the press briefing, alongside residents and fellows.

During her 19 years at UCSF, family medicine physician Erica Brode, MD, said she believed deeply in UCSF's mission and values. But she said she's recently seen her beloved healthcare system "veer away from those shared values and toward a greater focus on revenue generation ... in inadequate staffing ratios, and positions left vacant ... and in insurance negotiations that force patients to wait months for necessary lab work."

She and her colleagues "work hard to hit every metric that the UCSF system imposes, but when additional patient care time is added to our schedules without discussion or negotiation, it sends the message that our expertise and our well-being do not matter."

Max Blumberg, MD, an occupational and environmental medicine physician at UCSF, said he's seeing illness and injuries among his colleagues because of staffing shortages.

"When people feel that they have to run instead of walk to get their work done or to help in an emergency, they're more likely to slip and fall or cut themselves," Blumberg said, adding that he sees these kinds of injuries "every single day."

Pediatrician Radhika Rajan, MD, said UC's funding for treating her patients -- many of whom are publicly insured, recent immigrants, or have housing, food, and financial insecurity -- is at risk.

"We don't have the same support system" that residents and fellows now have, Rajan said. Yet she and her colleagues are being "asked to give 110% every day, no matter what, which can leave us feeling burnt out and overwhelmed. This is not sustainable."

A Doctors United spokesperson said the attending physician unionization effort is "in early stages," currently in the process of gathering representation cards from physicians attesting, "I want Doctors Council to represent me."

The bargaining unit seeks to represent employed physicians within the six state-supported UC health systems -- Davis, Irvine, Los Angeles, Riverside, San Diego, and San Francisco -- which see about 2.5 million patients each year.

If it gets enough support, or representation agreements from about 3,000 physicians, the new UC physicians' labor organization would be eligible to apply for approval from the California Public Employment Relations Board (CPERB), Blado said. The unit would need 50% of the votes of those eligible, plus 1 vote, to get CPERB approval.

UC Health did not respond to a request for comment.

The effort follows similar attempts within other healthcare systems to form labor organizations, such as at Banner Health in Arizona, at Cambridge Health Alliance in Massachusetts, at ChristianaCare in Delaware, and many other locations.