How to reduce threat of collective bargaining
January 31, 2000 2 minutes read
How to reduce threat of collective bargaining
When the National Labor Relations Board (NLRB) overturned a 23-year-old precedent last month that prohibited interns and residents at private hospitals from organizing and bargaining collectively, it opened the floodgates for residents at private hospitals to exercise that option.
Residents at one hospital already have. Boston Medical Center became the first private hospital in the country to face a federally sanctioned union of interns and residents when those factions voted 177-1 to unionize Dec. 21. Thomas Smith, managing partner with the Boston office of Jackson Lewis, says it is not likely to be the last hospital affected.
Smith says the NLRB has given hospitals a wake-up call to take action now to avoid the pressures of intervention by outside organizations. But he adds that hospitals can take specific proactive steps to avoid the pressures of intervention by outside organizations.
For example, Smith says hospitals can educate medical staff executives and program directors on their legal rights and restrictions with respect to union organizing by staff physicians and interns.
He says they should also consider establishing a policy on unionization that clearly delineates the hospital's position and the reasoning behind it.
Among the other steps Smith recommends:
- In cases where joint residency programs exist, evaluate the terms and conditions of those programs and the potential for finding a joint employer status, including collective bargaining obligations.
- Conduct an internal vulnerability audit to identify legitimate concerns and issues among salaried physicians and interns and assess the effectiveness of existing communications vehicles.
- Encourage participation by physicians on governing committees and emphasize the importance of having a voice on operational, financial, and patient care issues.
- Conduct training for physicians on the financial implications of operational and patient care issues and their connection to the hospital's long-term viability.
Smith says private hospitals should also consider giving interns and residents managerial prerogatives consistent with the standards set by the American College of Graduate Medical Education, including the authority to determine work schedules and assignments, resolve grievances, recommend and administer discipline, review work performance, and grant time off.
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