A union is an organized group of co-workers advocating to improve working conditions through contract negotiations and collective actions. Forming a union is one of the only ways to negotiate a legally binding contract collectively with hospital management that ensures workers have a voice in our workplaces. 

Yes, and given the reality of our working conditions, more and more are organizing our unions. As medicine becomes more corporatized, an increasing number of physicians are considered employees and are joining together in unions to reclaim our power and advocate for ourselves and our patients. Employment circumstances vary, of course, and may affect a given physician’s eligibility to unionize. But UC doctors are fully eligible. 

By forming a union like UC residents did, attendings can collectively bargain for a legally-binding contract with our employer. This contract will secure specific provisions determined by us, including competitive wages, benefits, a meaningful voice in working conditions, and policies that ensure our safety and well-being. It will help in allowing us to deliver the high-quality care our patients deserve. As individuals, our ideas for improvement are often ignored. As a union, our ideas can become policy. Our contract prevents the hospital from changing our salaries, our working conditions and other contract provisions unilaterally. Management must notify us and negotiate with us first. 

As physicians and faculty, our working conditions can often impact our patients' care conditions. When the quest for revenue pushes hospitals to increase panel sizes, reduce visit lengths and generally expect us to do more with less, it is patients who suffer the consequences. Collective bargaining allows physicians to take control of our working conditions and build an environment where we have the time, space and emotional reserve to deliver high-quality patient care.

Physicians, regardless of specialty, face common challenges and share the goal of providing the highest quality patient care in the healthiest and most sustainable working conditions possible. By joining the largest and fastest-growing union of physicians, we gain the opportunity to compare experiences and share best practices, not only with colleagues at our facility but with other union doctors across the country.

Our collective strength as a union and as physicians and faculty lies in our diversity. Uniting across specialty, race, gender, ethnicity, and years of experience better positions us to raise issues with the administration and collectively bargaining our contract. Physician input and leadership across specialties and departments are not just welcomed but are imperative within our union. 

A union contract can be as long as we need it to be to make sure it includes specialty-specific gains for all of us. Because many organizing committee members later serve as representatives for their specialty/department during contract negotiations, it is crucial that every specialty, no matter its size, is represented on the organizing committee. It’s about unity, not uniformity. 

The reality is we’re all competing with each other right now but we just don’t know it. Contract negotiations bring more transparency and equity to the process. A good analogy is the Major League Players Association. Athletes understand that certain skills generate higher revenues. Some types of players are paid higher than others. Nonetheless, players have stood together in their unions and have been very effective in raising the wage floor for everybody while increasing the overall share of revenue that goes to the players, the people creating the wealth. The players’ piece of the pie has grown vis a vis the owners.  

The six hospitals across the UC system bring in over $25 billion yearly, making up about 42% of the entire University of California system's overall annual revenues. We believe doctors–not administrators, not corporate interests–deserve more of the revenues we generate. 

Many of us know and respect administrators and their work. The problem is that the administration as a whole–along with insurance companies, pharmaceutical companies and others–has become a third-party in the most important relationship in healthcare: the doctor-patient relationship. 

Having a union is the most powerful tool we have to lessen the adverse impact of  third party involvement and restore the doctor-patient relationship to what it was and must be. A union is us and our colleagues collaboratively advocating for improved working conditions. It establishes a formal structure for cooperation, allowing us to negotiate a legally-binding contract that addresses the priorities of each one of us and our coworkers.

Above all, a union contract is an agreement between doctors and management. It is the result of a dialogue that does not have to stop at the bargaining table. For example, some union chapters have successfully negotiated "union-management collaboration councils." These councils enhance the doctor-patient experience and empower supervisors to champion changes that hospital administrators might otherwise overlook.

Under U.S. and California labor law, an employer cannot retaliate against employees for engaging in protected concerted activity to try to improve their working conditions. . It  is illegal for management to surveil us for engaging in protected concerted activity to improve working conditions, promise us new benefits during a union organizing campaign, interrogate us or threaten us. Management does not have the right to see who has signed a union card. Retaliation for union activity is against the law. 

Generally, , employees  can be fired “at-will” absent an employment contract with alternate provisions. As doctors seeking to form a union, we have the protection of not just the law but also each other. Coming together across race, gender, country of origin and experience, acting together on behalf of our patients and our profession, we have strength in numbers. We have each others’ back.

Doctors have the legally-protected right to:

• Form, or attempt to form, a union in our workplaces.

• Discuss improving our working conditions with our co-workers during breaks, meal periods, or other nonworking time.

• Organize without intimidation or retaliation by our employer

Employers often try to suppress doctors' voices, even though doctors have these rights. This is a key reason why attending physicians throughout the UC system are forming a union—they are no longer willing to be silenced.

The vast majority of union contracts are settled without a strike, but there are moments when collective action, including strikes, can be a powerful tool to show solidarity and the significance of our labor. , A strike is usually the very last resort, used only when all other options have been exhausted. 

Residents have bargained contracts with the UC without having to strike and we’re hopeful our employer will not force a strike of attendings. Like all important decisions in our union, the decision whether or not to strike will only be made by a majority vote. No one is obliged to strike and the employer is given ten days advance notice to ensure measures are taken to protect patients. 

By law, union dues are not used to support political candidates. However, members may voluntarily contribute funds to SEIU’s non-partisan political action committee and hundreds of thousands of members do, which allows workers to have a stronger voice in politics. 

As healthcare professionals, we know that who we elect and what they do in office affects our practice of medicine, our patients’ access to affordable care, and the services our communities need to thrive. Therefore, SEIU’s member-led endorsement processes focus on selecting candidates who will actively champion members’ advocacy goals.

Political power is an important part of our vision to transform the University of California system. SEIU’s political advocacy has secured major victories, such as AB729, which expanded access to fertility treatments, and the elimination of mental health disclosures on California licensing applications. SEIU also successfully legislated due process rights for UC housestaff and established a $25 minimum wage for healthcare workers across the state. These wins demonstrate how, through SEIU and Doctors United, we can leverage our unified strength to directly enhance our professional and personal lives.

Each year hundreds of resident and fellow physicians become attendings in the UC system. Part of our reasoning in choosing Doctors United is that it allows us to create a single path of representation from med student to resident, to fellow, to attending. Residents will benefit knowing they will have an effective voice and access to union resources throughout their medical career. Attendings will benefit from having experienced union members entering our ranks each year. 

After winning union recognition, we will begin preparing for bargaining. This entails soliciting bargaining surveys from the entire membership to shape our bargaining priorities. Members will then nominate colleagues to represent each specialty at the bargaining table. The bargaining team will not be alone, however. It will have full access to Doctors United experts–professional negotiators, researchers, labor lawyers and more. It is an incredibly powerful and often transformative experience for doctors to sit down with management–as equals–and negotiate job and care improvements. 

Doctors Council dues are capped at $98.33 per month. The cost of dues is offset by the economic gains made by unionizing and winning our contract. No doctor would ever vote for a contract that yielded less than $98.33 a month, of course. Dues cover the cost of organizing, negotiating and legally enforcing our contracts. 

Unlike other unions, who may start charging dues immediately upon recognition, before ratification of the first contract,  no member of the Doctors Council pays a penny in dues until eligible doctors vote to approve the first union agreement.

Here are things our fellow UC doctors—interns, residents, and fellows—have won through the Doctors United movement:

• 16.8% total raises in our current contract (34.8% over the last two contracts)

• $1000 in backpay in 2025

• 8 weeks of parental leave

• $30,000 in fertility, healthcare benefits, and wage increases

These CIR victories include campus-specific wins such as:  

• Meal benefits at UCLA and UCSD

• Safe rides home at UCLA and UCSF

• 8% pay increase at UCSD in 2024 alone

But the Doctors United movement seeks to transform not just healthcare in California, but across the country. Here are some Doctors United victories outside our state:

• 288 hours of PTO in Minnesota, after having started with 0 hours of PTO

• Negotiable RVU-based bonuses and 40 minutes for new patients at NYC Health and Hospitals

• Doctors in NYC kept a facility from closing in the Bronx

• 8% raises in 2026 in Cook County, Illinois

Those contracts were reached without physician representation during the negotiation process. We are forming a union for doctors, by doctors because physicians deserve a direct voice in decision making. We want to champion the specific priorities that affect our profession, the future of medical training, and the quality of care our patients receive.

Ask yourself: given our specific challenges and responsibilities as doctors, would you want a contract that was bargained and voted on by non-physicians and non-faculty? We respect and stand with our co-workers. But physicians have our own specific concerns. 

We agree that being part of a large statewide organization has advantages. The question is whether physicians and faculty will have a strong voice on the issues that are unique to our profession.

Doctors United, with its expertise in bargaining for physician contracts, is building a statewide physician union  where doctors set the priorities and lead the work around patient care, professional autonomy, and the future of medicine.

As part of SEIU, which represents more than 1.2 million healthcare professionals nationwide, we can stand in solidarity with other healthcare workers while maintaining physician-led representation.

The application of certain provisions in an existing CBA only applies to physicians in the event of a successful accretion. Based on existing Public Employee Relations Board (PERB) precedent, it is questionable whether accretion would actually be successful. Only after a successful accretion would provisions in an existing CBA apply to physicians to the extent there is no ambiguity about the application of those provisions to physicians. If it is not sufficiently clear that certain provisions in an existing CBA apply to physicians, the newly accreted employees (i.e. physicians) will have to bargain over physician-specific issues and other terms that may be inapplicable. That’s why the choice of which union matters. It’s about who is negotiating our first contract and whose priorities are at the table. We want us doctors to negotiate for our priorities. 

Legal precedent created by California Public Employee Relations Board (PERB) decisions since 1981 makes clear that a physician only unit is appropriate. See e.g., Unit Determination for Employees of the California State University and Colleges Pursuant to Chapter 744 of the Statutes of 1978 (Higher Education Employer-Employee Relations Act) (1981) PERB Decision No. 173-H p. 10-13; Unit Determination for Professional Patient Care Employees of the University of California (1982) PERB Decision No. 248-H, p. 2,12. PERB has repeatedly declined to place physicians in units with other healthcare professionals, noting that physicians have distinct community of interest factors that warrant a separate unit. These include, but are not limited to, their licensure and regulatory requirements, legal and ethics responsibilities, supervisory authority with respect to patient care, and working conditions. Where a union proposes a mixed professional healthcare unit that includes physicians and other healthcare professionals, such a strategy may be successfully challenged by the employer and other unions. These challenges may lead to prolonged hearings as PERB investigates the question of unit appropriateness.

Accretion is not necessarily more straightforward or faster than creating a new unit. Accretion is a process that enables a union to add additional classifications to an existing unit. Where accretion would lead a unit to increase by 10% or more in size, the union petitioning for accretion has to show majority support from the employees it is seeking to accrete. Additionally, employers or other unions have the opportunity to challenge whether the proposed unit is appropriate under the California Higher Education Employer- Employee Relations Act (HEERA) and legal precedent interpreting HEERA. This can lead to a prolonged Public Employee Relations Board (PERB) investigation. PERB may find that accretion is not appropriate for a variety of reasons, including if the employees the union is seeking to accrete have job duties, educational or training requirements, and supervision that are different from that of the existing employees in the unit (i.e., community of interest factors). Petitioning for a new and appropriate physician-only unit from the get-go may help avoid these potentially arduous pitfalls.

Not necessarily. Even assuming that accretion is successful – a bold assumption given the intricacies of the accretion process – accretion does not mean that all provisions of an existing contract will seamlessly apply automatically to the accreted employees. Although accretion may make things faster when a union is trying to accrete similar occupational groups, the same strategy is likely to fall apart where a union is trying to accrete distinct occupational groups. Differences in pay structures, occupational requirements, advancement process and supervisory relationships may create complexities or conflicts that prevent an existing collective bargaining agreement from applying to accreted employees. These issues will likely need to be addressed through side letters, amendments, and other avenues that may take significant time to bargain. 

There are two issues that are taken into consideration to determine whether existing contract terms may be applied to physicians: (1) whether accretion into an existing bargaining unit will actually be successful; and (2) whether existing contract terms are clear and unambiguous in its application to the newly accreted employees. See, e.g. Regents of  the University of California (2025) PERB Decision No. A525H, p. 19;  Regents of California (2023) PERB Decision No. 2884-H.  “In resolving a petition for . . . unit modification, we [PERB] normally approve a petitioner’s proposed unit if it would constitute an appropriate unit.” Regents of  the University of California (2025) PERB Decision No. A525H, p. 19.  The appropriateness of a bargaining unit is based on  community of interest factors found in HEERA (Cal. Gov. Code §3579), including the internal and occupational community of interest shared by the physicians in comparison to non-physician professional patient care employees. Unit Determination for Employees of the California State University and Colleges Pursuant to Chapter 744 of the Statutes of 1978 (Higher Education Employer-Employee Relations Act) (1981) PERB Decision No. 173-H p. 10-13.

Even assuming that accretion is successful – a bold assumption given the intricacies of the accretion process – accretion does not mean that all provisions of an existing contract will seamlessly apply automatically to the accreted employees. Although accretion may make things faster when a union is trying to accrete similar occupational groups, the same strategy is likely to fall apart where a union is trying to accrete distinct occupational groups. Differences in pay structures, occupational requirements, advancement process and supervisory relationships may create complexities or conflicts that prevent an existing collective bargaining agreement from applying to accreted employees. These issues will likely need to be addressed through side letters, amendments, and other avenues that may take significant time to bargain. The Employer is required to engage in post-accretion bargaining for physician-specific issues and over provisions in the existing contract that did not clearly apply to newly accreted physicians. See Regents University of  the University of California (2023) PERB Decision No. 2884-H. Post-accretion bargaining may be protracted, which is consistent with any collective bargaining negotiations. Id. at 11. 

Yes. Labor unions must ensure they are not behaving in ways that “interfere with, restrain, or coerce employees” in their right to “form, join and participate in the activities of employee organizations of their own choosing.” Deceptive conduct that interferes with workers’ ability to freely exercise their rights is considered an unfair labor practice and may be legally challenged by workers, employers or other employee organizations. For example, a labor union may not obtain a union authorization card from an employee using deceptive tactics or decline to recognize a revocation of a card by creating arbitrary revocation procedures. 

Yes. Employers are legally prohibited from acting in ways that “[i]mpose or threaten to impose reprisals on employees, to discriminate or threaten to discriminate against employees, or otherwise to interfere with, restrain, or coerce employees” in their right to “form, join and participate in the activities of employee organizations of their own choosing.” For example, employers may not state or imply that organizing will be futile or automatically result in reduced compensation or benefits. Such statements may amount to an unfair labor practice that can be legally challenged by employees or employee organizations. 

Forming a union and negotiating a contract is never easy. It takes effort but it is doable. Proof of this is that many workers in the UC system have a union, including more than 6,000 interns, residents, and fellows who are already members of CIR and part of the Doctors United movement. 

The movement will be even stronger when attendings join it as members of Doctors Council. What matters is whether physicians and faculty have a strong, unified voice at the table. Doctors United is physician-led, so every bargaining priority centers physicians, assuring our voice is not diluted by competing priorities.

Yes, you have the right to revoke your authorization card. It’s best to email the other union  and respectfully ask to revoke your card, requesting a confirmation receipt. Many doctors are using an e-mail template with specific language if that makes it easier for you. Ask your organizer or any member of the organizing committee. 

Which union you choose to organize with is a very important decision. Our colleagues are choosing to form a union dedicated to doctors and led by doctors because they believe that doctors coming together as one profession, similar to how nurses are organized, is the only way to make real change over the things that matter to us. If you have not done so, please sign a union card with the Doctors Council and join with us in the Doctors United movement.