Minnesota's up-and-coming doctors say in order to better care for patients down the road, they need collective bargaining power.
A large group of them has filed to form a union, reflecting an industry shift. This week, a supermajority of nearly 1,000 University of Minnesota resident physicians and fellows submitted their union-creation plans. It follows a similar move by peers at Hennepin Health earlier this month.
Dr. Thomas Schmidt, infectious diseases fellow at the University of Minnesota, said the current work environment for providers advancing through their training in hospitals and other settings is pretty grueling, with up to 80-hour workweeks in some cases.
"It's us making sure that we're having some breaks and making sure that we're able to have some life outside of training," Schmidt explained. "To ensure that we can be good doctors when we're there with our patients."
Schmidt cited burnout, still lingering from the COVID-19 pandemic, as one factor behind doctors embracing unionization. Researchers say the number of newly union-represented doctors could soon double, compared with the past two decades.
Because of consolidation in health care, more physicians are now employees of larger systems, as opposed to independent practitioners. The university said it will be responsive to all necessary parties as the process takes shape.
Doctors still getting their training say the residency system leaves little room to advocate for changes or request a new location. And while established medical professionals might make good money, Schmidt said it is not the case for residents, who are often in the $15 to $20 per-hour range.
"That is not a substantial amount of money to be able to take care of your housing, to take care of your family," Schmidt pointed out. "I'm a parent of two young kids, so it has not been easy to be a trainee."
He added some peers are delaying starting a family because of the limited pay and long hours.
Skeptics fear the union push among doctors will reduce the earnings of specialists. Meanwhile, the Minnesota Association of Professional Employees, which has members working on infectious disease control in the state health department, recognizes the need for providers to have a bigger voice. It said it is vital as public health concerns, such as the bird flu, add to the work demands for the young professionals.
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Coaches in the Renton School District, just south of Seattle, are organizing with the American Federation of Teachers to fight for what they say are "fair wages" in their first union contract.
Buddy Ryan, head boys track and field coach at Hazen High School, said Renton coaches get paid much less compared with neighboring school districts, which contributes to a 45% turnover rate in coaches from year to year.
"I'm not expecting to go buy a new car off a season of coaching, but I'm not expecting to make minimum wage to be responsible for all these kids," he said. "I think the reality is, a fair wage for a fair day's work is what everybody looks for."
Renton School District has proposed a 2.5% wage increase, far below what the coaches asked for. AFT has said the district has the funds to pay coaches fairly. The district did not respond to a request for comment.
Ryan said the low pay and high turnover rate costs the district more money in training and degrades the quality of the sports programs.
"And then what's the cost to the kids that get a different coach every year? Well, you know what ends up happening? These parents get tired of it and they take their kids to private schools, or they move and transfer them to other schools," he said.
Ryan noted that sports, along with other extracurriculars such as band, are what motivate many kids to keep their grades up in order to participate. He said the district should want to keep the programs strong.
"It's just like when you're a kid at dinner," he said, "and your parents say, 'You've got to eat your vegetables or you don't get dessert.' Well, that dessert is the after-school activities."
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Nevada groups concerned about affordability, clean air and health care are speaking out against the "One Big Beautiful Bill Act" recently signed by President Donald Trump.
The new law extends tax cuts from 2017, funded partially by huge cuts to Medicaid and SNAP food benefits.
Dr. Joanne Leovy, steering committee chair for the Nevada Clinicians for Climate Action, noted it also ends the tax credit for electric vehicles on Sept. 30, which drives up the price of an EV by $7,500 while promoting the sales of gas-powered vehicles.
"This bill will dump an extra 2.1 billion tons of climate pollution into the atmosphere over the next decade," Leovy pointed out. "Increasing greenhouse gas emissions by about 7% over prior projections; the equivalent of adding more than 400,000 cars to the road."
The new law also cuts tax credits for rooftop solar and energy efficient home upgrades. Backers said the savings were necessary to fund other administration priorities, such as increased funding for immigration enforcement.
Yolanda Kemp, a member of the American Federation of State, County and Municipal Employees Local 4041, said she worries about job losses in the public sector.
"When states, cities, towns, and schools lose essential federal funding, they will be forced to make cuts to their budgets as well, putting all public services and jobs at risk of being cut," Kemp stressed. "And let me tell you, the 'Big, Beautiful Bill' that is supposed to help hardworking Americans is nothing more than another billionaire giveaway paid for by us."
The change to Medicaid and SNAP are not immediate but will be phased in mostly in 2027 and 2028.
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More than 1,100 caregivers at Portland's Providence St. Vincent Medical Center have voted to unionize, joining the Service Employees International Union Local 49.
Hospital staffers, including certified nursing assistants, cooks, lab assistants, pharmacy techs, environmental workers and patient representatives, will soon begin collective bargaining with management over a new work contract.
Finn McCool, senior food service attendant at Providence St. Vincent Medical Center in Portland, said changes to working conditions in the hospital were a major driver to organize.
"There's a lot that makes St. Vincent a great place to work, but we've also seen just tons of changes over the years around staffing and benefits," McCool explained. "My fellow caregivers really knew that jobs were only going to get harder."
The St. Vincent caregivers will join thousands of other unionized workers at Providence hospitals in Oregon, Washington state and other parts of the country. Providence officials released a statement, recognizing the union and saying they were prepared to work with it toward a new contract.
McCool noted the company made several changes to staffing and work policies without feedback from its employees, with changes to the employees' health care benefits causing a major upheaval.
"It's been a recent change to our health care plan with Aetna switching over, and that was probably a very large reason why a lot of us decided to vote yes," McCool pointed out. "We had our own internal health care system. We changed to a different thing. Co-pays changed. Things were definitely a lot harder with increased deductibles."
McCool stressed political uncertainty, particularly in the government's health care policies, was also a significant concern.
"We're seeing a lot of changes going on with the government with cuts, especially right now," McCool observed. "What threatens us is cuts to Medicare and Medicaid. Our CEO said, 'These cuts are threatening the hospital.'"
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