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More than 550 doctors and healthcare providers working for Minneapolis-based Allina Health have filed to unionize, which could ultimately create the largest private-sector union of clinicians in the U.S.

The group, to be represented by Doctors Council SEIU Local 10MD, with the National Labor Relations Board last week. Its goal is to take a vote within the next 2 months, according to Chris Antolak, MD, a family medicine physician who has been working at Allina's Blaine outpatient clinic in Minnesota for 6.5 years.

While most unionization efforts thus far have focused on residents and fellows, this filing is different in that it involves doctors, nurse practitioners, and physician assistants employed by Allina's primary and urgent care clinics in Minnesota and western Wisconsin.

Allina clinicians said a number of concerns prompted their move to unionize, including patient safety concerns due to understaffing and inadequate resources; limited input and decision-making power in matters affecting patient care, provider safety, and professional autonomy; the threat of corporate influence on medical decision making; and moral injury caused by pressure to prioritize productivity and profit over patients, .

"Coming out of the pandemic, we saw clinical support staff were at terrible levels, and [clinicians] didn't have enough support," Antolak told 乌鸦传媒. "The administrative work that we have to do after clinic hours has increased significantly over the years, leading to clinician burnout and a struggle to maintain a healthy work-life balance."

Antolak noted that over the last several decades, more primary care clinics have been bought out by larger corporations, and that's led doctors and clinicians to have a "non-existent voice to advocate for our patients and staff."

Primary care has been hit particularly hard, he said, because "we're not the revenue-generating area of the healthcare business such as you might see with surgeons or other subspecialists whose procedures drive a lot of revenue for our organization. To that end, it's easier to trim staffing [for primary care] and lessen support because those roles aren't generating as much revenue."

In a statement, Allina Health told 乌鸦传媒 that its healthcare providers are "critical members of our teams and integral to our mission to provide exceptional care to the communities we serve. We deeply value and share their commitment to providing high-quality care to our patients."

It said it will continue to "identify ways to increase provider engagement through operational improvements, new communication tools, additional well-being resources, and enhanced employee benefits to improve the provider experience."

"Allina Health remains focused on delivering on our caring mission and continuing our efforts to foster a culture of collaboration with all our employees," the statement concluded.

This is the second physician-led organizing campaign involving Allina. The first was brought by about 130 doctors at Allina's Mercy Hospital in March. Antolak said those physicians recently voted to unionize, but their union has not been recognized by Allina.

Jessica Boland, MD, a critical care physician at Mercy Hospital and a member of the organizing committee for their mixed specialty union, told 乌鸦传媒 that Allina alleged some members were supervisors, which isn't allowed under federal labor rules.

The group is currently awaiting a verdict from a hearing that was held regarding Allina's allegation, she said.

"From the organizing committee's perspective, we are still looking forward to negotiating and collaborating with Allina administration on our contract," Boland added. "We continue to think of ourselves as having unionized, and at any point Allina can honor this and say they will participate with our contract."

Allina caught negative media attention in June that it was withholding care from patients who have unpaid medical bills. While Allina would treat all patients in emergency departments, it could cut off services from indebted patients, including children and people with chronic illnesses, according to the Times.

Allina told KSTP-TV that it has paused that practice.

Allina also made headlines in 2020 when it fired a nurse for reportedly speaking out about pandemic-related safety issues. That nurse, Cliff Willmeng, was eventually reinstated.

According to the Times, the health system runs more than 100 hospitals and clinics in Minnesota and Wisconsin and brings in $4 billion per year in revenue.

Antolak emphasized that unionization is not about clinicians "asking for a raise. This is us asking to have a voice within our healthcare leadership, to be able to help steer our organization. We want to try to re-focus our commitments down at the patient-care level."

"We know the needs of our communities and they're different clinic-to-clinic," he said. "We need support from our organization to be able to support our community health."

Mitch Li, MD, an emergency physician who runs the physician advocacy group Take Medicine Back, echoed Antolak's concerns about the corporatization of medicine, noting that most physicians are now employees of corporations, even though 34 states -- including Minnesota -- have laws prohibiting the corporate practice of medicine.

"These corporations are more consolidated, more profit-driven, and less accountable to their communities than ever in history," Li told 乌鸦传媒. "This is a public health crisis. While physicians can take the practice of medicine back by once again owning their practices, unionization is another approach and one thing is clear: inaction is not an option."

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