CONTENTS:

I. Working together to have a greater voice at MGB

II. Facts about our union

III. Managerial strategies during campaigns

I. Working together to have a greater voice at MGB

1. Doctors Council.  What is Doctors Council SEIU?

Doctor's Council is affiliated with SEIU, the most extensive and rapidly expanding union for healthcare workers in North America, boasting over 2.1 million members. The partnership began when they represented a group of NYC Department of Health physicians. Today, they advocate for all attending doctors employed by New York City and the Health and Hospitals System. Doctor's Council has since grown to represent physicians in New York, Illinois, New Jersey, Minnesota, Wisconsin, and Pennsylvania, including those at academic medical centers, hospitals, and various corporations. SEIU is also affiliated with the Committee of Interns and Residents (CIR), which represents over 34,000 trainees across several states, including Massachusetts, California, and New York.

2. Purpose of a union.  What can a union accomplish for MGB physicians?

Answer:  With a union, we have a legal seat at the table to negotiate workplace rules and arrangements that can improve our jobs, the care we provide to our patients, and potentially even create a model for what excellent primary care should be.  Without a union we have no legal say in the policies that are implemented at MGB, many of which have gradually made our jobs as PCP's unsustainable and have reduced the quality of care we provide to our patients.  With a union, we can build a democratic, inclusive, collaborative organization that works to help fix our ailing health care system. Read more

3.  Collaboration with MGB.  What is our vision for how physicians and managers might work together at MGB?

Answer:   A union can give us a unique opportunity to work in a new way with management.  We can benefit from MGB's expertise about the way health care systems work and they can benefit from our expertise as care physicians about how patient care can best be provided.  Together, we can work to solve our institutional problems.  We want to hear management’s perspective and we also want to have a seat at the table to express our own views. Doctors Council members have established collaboration councils across several bargaining units to pursue partnerships with their employers. Read more

4.  Tools to promote our union.  What options and tools do we have available for us to succeed?

Answer:  Many options are available to show our support for our union and to help to move it forward.  Our greatest tool and strength is our unity.  Working together in a supportive, unified way will allow us to build a strong, democratic, collaborative union.  We are strong when we talk with each other to sift through disinformation, identify efforts to split us, and address misrepresentations of what we stand for.  United, we cannot be defeated. Read more

5. Physician retention.  How will a union campaign impact physician retention, which has been an ongoing problem in primary care?

Answer:  We have had problems with physician burnout and retention in our primary care practices at MGB, as was seen in the recent resignation of the majority of PCPs in the Brigham and Women’s Physician Group.  By giving PCP's hope that our work conditions might improve, we believe a union will greatly improve retention of our primary care physicians.

II.  Facts about our union 

1.  Flexibility. Will we continue to enjoy the same kind of workplace flexibility we currently have with management after we form a union?

Answer:  A union can actually enhance flexibility in a number of ways.  After an election, work rules that are already treated flexibly at MGB must remain in place unless changes are agreed to by all parties.  During the pre-contract phase, there's nothing to keep union members and management from agreeing to new policies to improve workplace flexibility.  In our contract, we can also bargain for additional policies that increase flexibility and other workplace benefits. Read more

2.  Agreeing to new innovations. Will we continue to be able to solve workplace problems with management before and after a contract?

Answer:  As noted above, at any point after the union wins an election we can continue to work with management on solutions to workplace problems.  The only difference compared to before is that we have a voice after an election, and so new policies proposed by management that affect our workplace must thereafter be negotiated with us, as a union.

3.  Union dues. Why do we pay union dues?

Answer: Dues are no more than $1080 per physician per year.  A lot goes into building a successful union campaign, conducting contract negotiations, and maintenance of a contract after its ratification with an employer.  Each of these phases requires support from union staff and attorneys.  Dues are a way of paying for all these needed services, and they're also a way of paying forward to the next physician group that Doctors Council will help to organize in the future, before they ratify their own contract. Dues begin only after we ratify a contract.  If we aren't satisfied with all the terms of the contract, we don't have to vote for it.  There are some ways for members who object to dues to opt out of paying them. Read more

4.  Eligibility to vote.  Who's eligible to vote in the election?

Answer: We are organizing the union for primary care physicians across BWH and MGH.  According to labor law, though, PCP's who are also managers can't become members of a union.  In unclear cases, members will be able to file a challenged ballot until their status is fully determined.  Physicians who believe they are eligible are encouraged to vote even if their status hasn't been completely resolved by the time of the election. Read more

5.  Political contributions.  Can members' dues be used to fund political campaigns?

Answer:  No.  Any political contributions are paid for through separate and voluntary funds that union members may choose or not choose to contribute to.

6.  Managerial hiring practices.  During and after the union campaign, who is in charge of the hiring of physicians?

Answer:  Management remains in charge of the hiring of staff, including physicians.  However, whereas management could previously dismiss a physician without clear explanations, union contracts can contain provisions for a more deliberative process for discipline or dismissal.  This is designed to ensure that there will be protections against favoritism, retaliation, and other unfair practices.

7.  Salaries and benefits after the election.  After a union election, what happens to our existing salaries and benefits?

Answer:  After the election, while negotiating for a contract, we continue to have the same salary and benefits that we have before the election.  But there’s nothing to keep MGB from working with us to develop new policies or practices, before a new contract is ratified, including salary increases.  Providing raises solely to non-union employees but not to union employees could be discriminatory and be challenged as an unfair labor practice before the NLRB. Read more

8.  Seniority.  What's the role of seniority within unions?

Answer:  It's completely up to the union membership how they choose to consider seniority issues during contract negotiations.  Some unions include advantages for more senior physicians in a contract; others do not.  Members ultimately decide by their vote on the contract.

III. Managerial strategies during campaigns

Managerial arguments/tactics observed during union campaigns:

1.  We are the union.  Could unions potentially get in the way of solving problems between management and union members, as management sometimes claims?

Answer:  We, the membership, are the union, and so we will be the ones to drive the priorities and decisions that go into our collective bargaining process.  We will vote on what policies, work rules, and other work matters that are in line with our values.  Only the physicians in our bargaining unit will have the right to vote on whether to ratify a contract.  Doctors Council provides us with resources and expertise, like attorneys and organizers, to support us. The union is not a middleman between us, but rather our vehicle to work together.

2.  Campaign environment.  How will members and management likely get along during a campaign?

Answer:  We will be given new rights to work with management if we form a union, and it's always possible for that to create new tensions at work.  But a union also has the potential to help enhance trust and communication between workers and management by giving us a vehicle through which we can all have more honest and open discussions about the needs of our institution, if both parties choose to embrace that.

3.  Our supporters.  Management will sometimes claim that supporters are backing out.

Answer:  Management might sometimes spread rumors that physicians are backing out of unionizing in order to create doubts among the membership, in order for us to question how much support there is.

4.  Opting in.  Will everyone be in the union, no matter what their vote, after the election?

Answer:  Once unionized, everyone benefits from the collective bargaining agreement, regardless of how they voted in the election. Management sometimes frames this universal "opting in" as a loss of control, but it actually gives everyone a voice in decision-making and a vote during negotiations.

5. Strikes. What is the likelihood of the union striking during contract negotiations?

Answer:  Strikes can of course be potentially powerful tools, but are almost always done only as a last resort by union members, after multiple other efforts have failed.  Very few first contracts end up in a strike.  A strike would only happen by the vote of our membership, not the union staff. In the unusual event of such an action, measures could be taken to ensure the protection of patients.  And MGB would need to be notified 10 days prior to a strike.  By the way, no one is obliged to strike and wouldn’t suffer legal or financial repercussions if they don’t. 

6.  We hear you.  After MGB's Salem Hospital launched its union campaign last year, management announced that it had dedicated more time to listening to the concerns of physicians, and they appealed for a chance to start over, without the union.

Answer: The questions during our union campaign are: Why now and not before? Why not negotiate these solutions into a collective bargaining agreement where we have a say?

7.  Retaliation?  Do we need to worry about retaliation by MGB against physicians during the campaign or afterward?

Answer: The National Labor Relations Act (NLRA) guarantees the right of workers to organize without fear of intimidation or reprisal, and retaliatory measures could be challenged by Doctor's Council as unfair labor practices before the NLRB.   Since MGB won’t know the identities of those who sign a union authorization card or those who vote yes, every member will be free to decide how vocal or outspoken they want to be.