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Teaching doctors to unionize

The ideas and innovators shaping health care
Jun 21, 2024 View in browser
 
Future Pulse

By Daniel Payne, Carmen Paun, Toni Odejimi, Erin Schumaker and Ruth Reader

WORKFORCE

Randi Weingarten.

Weingarten recently convinced Maryland doctors to join her union. | AP Photo/Damian Dovarganes

The American Federation of Teachers is making the case that doctors belong in a union.

How so? The teachers union (which has for decades also represented health workers) led the unionizing effort at the University of Maryland Medical Center that prompted more than 600 doctors to vote to join the union last week.

“We’ve gotten lots more inquiries than we can handle in the last few months,” AFT President Randi Weingarten said. “We’re growing in health care by leaps and bounds.”

Weingarten told reporters her union has increased its organizing budget by around $4 million this year, part of which will go toward getting more doctors to sign up.

Weingarten argues that doctors’ corporate employers have disrespected their physician employees, leaving them overworked and burned out.

The backstory: Once mostly self-employed or part of physician-owned groups, doctors are increasingly employees of hospitals or private equity firms.

And, as employees, they have a right to organize, prompting unions of all stripes to make the case.

Doctors who’ve joined say they’re persuaded by a desire to reclaim control over their lives, and to bargain for better pay and work conditions that they believe private equity and hospital ownership threaten.

The Service Employees International Union, which represents primarily lower-paid workers, organized doctors at Allina Health in Minnesota and Wisconsin last year, part of a broader national trend that includes physicians from Salem Hospital in Massachusetts and Cedars-Sinai Medical Center in Los Angeles, which are both in unions affiliated with the American Federation of State, County and Municipal Employees.

It’s also part of a growing shift in which unions have sought to organize more highly skilled and white collar workers. The United Auto Workers, for example, has led efforts to organize non-tenure track faculty at universities as well as fellows — typically recent graduates of doctoral programs — at the National Institutes of Health.

 

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Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, Erin Schumaker at eschumaker@politico.com, or Toni Odejimi at aodejimi@politico.com.

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WORLD VIEW

Vaccine administered in South Africa

Donors are helping Africa make more of its shots at home. | Alet Pretorius/AP Photo

​​Vaccine manufacturers planning to produce shots in Africa have access to a pot of at least $1 billion to support their efforts.

How so? Gavi, the Vaccine Alliance, an international humanitarian group that procures vaccines for the world’s poorest countries, launched the African Vaccine Manufacturing Accelerator on Thursday in Paris.

The initiative offers incentive payments to African manufacturers when they get a World Health Organization endorsement to produce vaccines for diseases that Gavi sees as a priority, including cholera, malaria, measles-rubella and yellow fever.

Why it matters: The accelerator was formed to help the continent take charge of its own health by producing the shots it needs instead of importing them from abroad. Reliance on others left African countries at the back of the line during the Covid pandemic.

Even so: Setting up manufacturing facilities is easier than making the facilities sustainable over the long term, as producers in Africa will have to compete with cheaper shots from India.

The accelerator will offer subsidies of up to 50 cents per vaccine dose to help African manufacturers compete.

What they’re saying: The accelerator “will be a catalyst for the pharmaceutical industry in Africa,” said Moussa Faki Mahamat, who leads the African Union Commission, which brings countries together to solve regional problems. “It will create an environment conducive to technology transfer, technological assistance, innovation and cooperation among states,” he added at the accelerator’s launch event, hosted by French President Emmanuel Macron.

The European Union is the largest contributor to the initiative, Macron said. That’s on top of the EU's separate nearly $1.1 billion contribution to bolster manufacturing and access to vaccines, drugs and other health products in Africa.

Macron said the accelerator was a building block toward a genuine African vaccine market. “Global health has become geopolitical, and health cooperation is a proof of mutual trust,” he said.

 

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POLICY PUZZLE

BROOKLYN, NEW YORK - JANUARY 2:  People run on treadmills at a New York Sports Club January 2, 2003 in Brooklyn, New York. Thousands of people around the country join health clubs in the first week of the new year as part of their New Year's resolution. Many health clubs see a surge in business of 25 percent immediately after the new year, only to see those numbers level off by spring.  (Photo by Spencer   Platt/Getty Images)

The college educated are more likely to hit the gym, a new study found. | Getty Images

Targeted interventions could help Americans get in shape, a new study from the Centers for Disease Control and Prevention suggests.

How’s that? Researchers found that people who didn’t graduate from college are much less likely to get adequate exercise.

On average, young people 25 and under with a bachelor’s degree are nearly three times more likely to be active than those with a high school degree or less, the study found.

Socioeconomic background and race can help explain why those with less education tend to be less physically active, said Loretta DiPietro, professor of exercise and nutrition sciences at George Washington University’s Milken Institute School of Public Health, told Toni.

Some people might live in unsafe or rural areas with little access to paved sidewalks or have shift jobs that don’t leave much time to walk around, said DiPietro, who wasn’t involved in the CDC study.

Even so: The study didn’t look specifically at those factors and found that most young people — regardless of education — aren’t active enough. Only 22.5 percent of young people surveyed met the CDC’s standard of physical activity: at least 150 minutes of moderate aerobic activity or 75 minutes of intense activity a week.

Those with a bachelor’s degree far outpaced those without, with 33.6 percent of them hitting the standard, while only 12.2 percent of people with a high school degree or less did.

Why it matters: Following the CDC’s physical activity guidelines can boost cognitive function and reduce heart disease and diabetes risk, to name a few.

What’s next? “It really is an issue of access to ways to be able to be physically active,” DiPietro said, pointing to some ideas that could help:

— Develop more walkable areas in cities that are easily accessible.

— Encourage doctors to prescribe physical activity for patients.

— Establish workplace policies to promote movement.

 

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