Primary Care Physicians at Mass General Brigham Vote to Unionize Amid Representation Dispute

Primary care physicians at Mass General Brigham voted overwhelmingly in favor of forming a union on Friday amid a dispute with the hospital system over their bargaining unit’s size.

Of the 237 eligible physicians, 209 participated in the mail-in election earlier this month, with 88 percent of voters in favor of unionization. If certified, the union — representing all full-time, part-time, and per diem primary care physicians at Mass General Hospital and Brigham and Women’s Hospital — will join the Doctors Council, an affiliate of the Service Employees International Union.

But the union will be unable to begin negotiating a contract until it resolves a legal battle with the hospital system over the size of its bargaining unit.

After the group initially filed to unionize in November, MGB alleged that more than 150 of the included doctors who work at hospitals that provide short-term care should not qualify as part of the unit, citing a rule that requires physicians at those hospitals to unionize in hospital-wide units.

A regional labor board director sided with the union in April and allowed the election to take place. But the case is now indefinitely delayed after MGB appealed to the National Labor Relations Board — unable to hear cases without a quorum of its judges.

MGB is Massachusetts’ largest health care system and employs 7,500 physicians. The newly unionized primary care physicians join around 2,700 residents and fellows at MGB, who unionized in 2023 and recently finalized their first contract with the hospital system.

In an email to primary-care physician employees announcing the appeal, MGB officials wrote that the unit went “against long-standing legal precedent” by excluding physicians that do not specialize in primary care at the 18 locations.

The NLRB is not currently hearing appealed cases after President Donald Trump dismissed one of its board members, Gwynne Wilcox, in January, and the Supreme Court temporarily blocked her reinstatement. The case is still pending a final review by the D.C. Circuit Court, keeping all appealed cases in a holding pattern.

L. Elizabeth “Liz” Lincoln, a primary care physician at Mass General Hospital and union organizer, said physicians were “really frustrated” by MGB’s decision to appeal.

“We know that we are a separate bargaining unit — we are the division of primary care, and we do not belong with other hospital employees,” she said.

If the board rules against the physicians and excludes the 18 contested locations, the bargaining unit could shrink from around 250 to fewer than 100 employees.

The vote comes less than a month after MGB CEO Anne Klibanski announced that the hospital system will invest $400 million into primary care over five years in an email to employees — even as the hospital implements mass layoffs in the face of federal funding cuts.

According to Lincoln, primary care physicians want to have a say in how the $400 million is allocated. Workers are also hoping to strengthen staff retention amid a nationwide shortage of primary care physicians.

While Lincoln is a part-time employee, she said she regularly works 45 to 50 hours each week — and still receives requests to work more.

“Every single week, two to three people ask me if I can be the primary care doctor for their friends or their family, and I have to say no, because I just don’t have capacity to see more patients,” she said.

In an emailed statement, Mass General Brigham referenced the request for the NLRB to review the case and wrote that the hospital system “respects the rights of employees to organize under the National Labor Relations Act.”

“We deeply value our physicians and have been working since fall of 2023 to improve the primary care experience based on direct physician feedback,” they added. “Our ongoing investment in primary care reflects this long-term commitment to improving the experience of both our physicians and the patients they serve.”

—Staff writer Amann S. Mahajan can be reached at amann.mahajan@thecrimson.com. Follow her on X @amannmahajan.