Subject: First Contracts, UAW Monitor, Physicians Unions, Strikes

August 6, 2026

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Don't Ignore UC Doctors United: Unions Are Climbing The Physician Career Ladder

by Kimberly Ricci

Union contagion has become a familiar refrain in many industries. When the coffeehouse down the road organizes, this activity can cause a chain reaction that spreads to nearby retail and food service establishments. We’ve noticed similar effects for white-collar workers, and increasingly, physicians are becoming union targets. Of course, the healthcare industry has long been plagued by unions going after nurses, but physician organizing is accelerating in a way that employers can’t afford to ignore.


Mind you, none of this happened overnight. The opening of the floodgates for resident organizing began after a pivotal 2022 NLRB ruling. Fast forward to now, and the Committee of Interns and Residents (CIR-SEIU) claims to represent 40,000 resident physicians and fellows, up from a reported 17,000 members a few years ago. The recruitment of attending physicians was logically bound to be next for SEIU, and it’s happening.

The Chain Reaction In Motion

Unionization of attending physicians is still relatively rare. As of the most recent National Institutes of Health (NIH) data, cited in the Healthcare Financial Management Association’s (HFMA) reporting, only about 8% of attending physicians nationally were unionized in 2024. That’s part of what makes a 10,000-physician organizing push landing in the same summer a warning signal that can't be ignored.


Case in point: in mid-July, news broke on a tentative deal for 6,400 University of California residents and fellows represented by CIR-SEIU. Reportedly, the deal included an 18% wage boost, increased benefits, and assurances regarding ER overflow. That deal capped a year of negotiations, but what came next is of even more interest for employers.

Eight days later, SEIU announced a new affiliate, which plans to mass-organize physicians at the University of California’s medical centers. In effect, this was the launch of UC Doctors United as a Doctors Council-SEIU offshoot with the mission of unionizing 10,000 UC physicians.


This also isn't the only attending-physician development this year. In June, Doctors Council-SEIU ratified a first contract for 500 attending physicians at ChristianaCare in Delaware.

Unions Are Climbing The Physician Career Ladder

Most industry watchers know that residents and fellows' workplace concerns revolve around their relatively low pay and grueling schedules, as is customary for doctors-in-training. These fledgling doctors frequently lock into multi-year agreements with a specific institution, which they depend on for licensure. In contrast, attending physicians have cleared the licensing hurdle and theoretically have more freedom for jumping to a different healthcare system if they're not happy with their current employer.


Yet the attending physicians who are organizing have not chosen to go elsewhere. Instead, they’re turning to unions, which will attempt to brute-force contract demands, regardless of whether the resulting agreements are financially sustainable. Any employer in healthcare knows that hospitals aren’t sitting on an endless pile of money, no matter what tall tales a union rep will tell during an organizing drive.

Now Is The Time To Be Proactive

Attending physicians aren’t organizing purely over pay, mobility, or other concerns that are typical of residents and fellows. We flagged this last year with Doctors Council-SEIU’s targeting of primary care physicians because doctors have valid concerns about heavy caseloads and burnout. And whether a physician is in-training or licensed, they’re now an organizing target, because unions want the dues from this profession’s high salaries.


As it turns out, doctors are as susceptible to union contagion as the retail workers watching that coffeehouse down the road. Hospital systems tracking resident and fellow organizing should assume their attending physicians are watching right along with them. A resident’s tentative deal, ratified or not, can become the template for the next round of negotiations, or the reason SEIU announces its next 10,000-doctor campaign.

Managing During Status Quo: The First 90 Days After A Union Election

by Michael VanDervort

A certified union election starts a clock that many companies have never dealt with. Under the National Labor Relations Act (NLRA), the employer now owes a legal duty to bargain in good faith with the certified union, and the process moves faster than most people expect. This is known as the status quo period, and it creates a unique set of rules that changes how you must manage your business.


The National Labor Relations Board (NLRB) certifies the results about a week or ten days after the vote. Shortly after that, a letter shows up from the union proposing a bargaining schedule and reminding management to maintain the status quo. Two to three weeks start to finish, and employers who spend that stretch figuring out internally who's in charge are already behind before the first session is scheduled.

What Status Quo Actually Means For Employers

Status quo sounds simple until you're the one applying it. The status quo means an employer generally can't make unilateral changes to wages, benefits, or working conditions once a union is certified, even if those changes were planned before the election.


Whether a practice was discretionary matters a lot here: a wage bump given at the same time, in the same amount, every year for a decade generally must continue, whereas a merit increase that varied based on management's judgment is a different story. Most management teams encounter this body of doctrine for the first time during the organizing campaign itself and then must apply it correctly while everyone's watching. It’s easy to get things wrong.

Why the First Contract Has No Rewrite Button

The first contract is a blank slate. Neither side has a working understanding of what counts as reasonable for the business. Since we don’t know what we don’t know, many first-time bargainers unknowingly agree to terms that cause downstream problems.


Once a proposal is tentatively agreed to, walking it back later can be treated as evidence that the employer never intended to bargain in good faith. Dave Sapenoff, one of LRI's senior consultants, describes it as toothpaste that doesn't go back in the tube.


Seemingly minor details in the contract can carry unintended consequences. Punctuation in the wrong place or omitted at the end of a clause can turn a closed list into an open-ended list. Vague language that felt harmless in the room gets reinterpreted years later by people who weren't there when it was negotiated, which makes good bargaining notes critical.

How First-Time Bargaining Teams Get Outmaneuvered

Nearly every recurring first-contract mistake comes down to the same thing: a capable management team running into this law and these tactics for the first time, with no prior knowledge to draw on.


A management team starts bargaining without help, and somewhere in the back-and-forth the union slips a job classification into the recognition clause that was never part of what the NLRB certified. Nobody catches it at first, because it reads like housekeeping. It's a permissive subject of bargaining, meaning the employer never had to agree to it in the first place, but by the time someone notices, the language is already tentatively on the table, and pulling it back risks a bad-faith charge. LRI's consultants have been called in mid-negotiation to untangle this kind of problem more than once.

When a union's own contracts contradict its position

The instincts needed at the table are just as hard to fake. In one negotiation, a union insisted it had never agreed to a particular type of layoff provision anywhere. The company's negotiator sent an information request for the union's other contracts and received a box of 16 agreements, several of which contained the exact language the union had just declined.


In another negotiation, a newly certified Teamsters local representing thirty drivers opened bargaining with language lifted almost wholesale from the national UPS agreement, a contract built for a company many times its size. Convincing them that language would cost more than it was worth took a kind of persuasion most first-time bargaining teams have never had to practice.

Why Strike Planning Starts Long Before A Strike

Knowing what to plan for and when to begin matters hugely. One healthcare client  LRI worked with began planning for a strike six weeks after certification, nearly a year before a work stoppage happened. When it did, staffing, security, and system access all held up because the groundwork was already in place, rather than being done on the fly.


The cost of hiring an expert follows a similar logic. A first contract becomes the template against which every renewal is negotiated afterward. The outside help that lands a solid first contract tends to pay for itself many times over across the life of the agreement.

What LRI's Managing During Status Quo Series Covers

LRI has released the complete Managing During Status Quo video series free, covering certification through a signed first agreement. The series contains more than eight hours of expert advice, featuring senior LRI consultants and communications strategist Nick Kalm. Each episode page includes video, audio, a transcript, and downloadable worksheets, no cost, no registration wall.


Watch the complete Managing During Status Quo series free.


If you need help with bargaining, call LRI directly at 800-888-9115.


The UAW's Monitor Made A Clear Request in 2021. It's Still Not Done.

by Kimberly Ricci

No doubt about it, the current UAW election season is entertainment for labor relations watchers. It’s also potentially--to borrow one of this union’s favorite claims--historic, given that a grand jury subpoenaed federal monitor Neil Barofsky over his reports full of allegations against President Shawn Fain. We’ve discussed Fain’s threat to physically fight Barofsky, whose latest report details Fain’s retaliatory firing of VP Rich Boyer, and he is now challenging Fain for his job. Yet the more puzzling story is a budget that the union still hasn’t implemented in five years.


Let’s take a little trip back in time to Barofsky’s first months on monitor duty, when he was tasked with directing the union away from its legacy of corruption. He made a seemingly commonsensical request, which went unheeded, and Fain’s rivals have brought it back for election season.

No Budget? That’s Right

On Nov. 11, 2021, Barofsky declared in his initial report that the UAW “lacks basic governance tools, like a regular and consistent process for budgeting expenses.” He emphasized that budgets are vital for accountability and transparency purposes, and Barofsky wrote of his “hopes” for the union to take seriously his “recommendation to implement a comprehensive formal budgeting process” in order “to fully turn the page on the past,” which was fraught with embezzlement, bizarre “villa” rentals, and other crimes leading to prison time for multiple ex-UAW presidents.


This is a union that, according to its 2025 LM-2 report, claims assets of $1.2 billion and annual dues collection of over $226 million from over 392,000 members. A budget is not an unreasonable request, but nearly five years after Barofsky’s recommendation, it still hasn’t happened. That’s the case not only for the UAW’s international headquarters but also the union’s regional bodies. Now, this is being called out by Detroit publications and presidential candidates as the officer election season heats up.

Challengers Are Pouncing Upon This Issue

Shortly after announcing his candidacy, Rich Boyer declared, “Our budget isn’t right.” He further alleged, “My opinion is they’re taking that money out of the strike fund to run the day-to-day operations.” Likewise, Tricia Geiger pointed out, “Our members run their households on a budget. They deserve leadership committed to do the same.” And during last week’s candidate forum, Brian Keller criticized officers for “voting against” Secretary-Treasurer Margaret Mock’s attempts to pass a budget. In response, Fain accused Mock of “paying vendors millions of dollars to come in and fix the problem because she wasn't competent enough, and nobody in that department was.”


Fain is referring to Deloitte consulting payments that Barofsky referenced in 2022 while doubling down on his request for the UAW to implement a budget by 2023. These payments suggested efforts to move toward the budgetary goal, but Fain seems content to pass the buck to Mock. By the way, she recently participated in her own election debate while agreeing, "You're right, I think it's a shame we don't have a budget." She then declared that the UAW’s executive board has finally approved "a framework for a budget" after her office previously proposed a comprehensive version.


As a reminder, Fain previously ousted both Boyer and Mock, only for Barofsky to order their reinstatement. And Fain isn’t even trying to hide his ire about this situation, especially after another Barofsky report alleged that Fain pushed Mock out because she refused to approve his spending requests. In other words, Fain is blaming the person he ousted for the very problem that her removal probably made worse.

Where The Issue Goes From Here

Several points of suspense persist. First, a UAW attorney previously emphasized that the union “broadly is not the subject of a grand jury investigation,” which suggests that the investigation target is Fain himself. So a potential indictment is lingering in the background regardless of whether Fain manages to fend off his several challengers for president, and officer election results will be tabulated in early October.


In the meantime, employers will want to watch this for more than humorous value. Only a few months ago, it seemed impossible that Fain could be booted from office, but grand jury talk and Rich Boyer’s candidacy have raised the prospect of Fain losing his job to above 0%. And if he’s pushed off the union officer stage, then employers will want to know whether his 2028 general strike plans would go with him.


That is a fine question for another day.


Friday Five: Summer Dog Days Are Hot For Labor Strikes

by Michael VanDervort

July is ending with labor strikes looming for flight attendants, California state workers attending strike school, and nearly 1,000 hospital employees on the picket line.

The NLRB and the American Hospital Association also found ways to keep things interesting. So much for taking the summer off.

WestJet Faces A Labor Strike Or A Lockout

About 4,400 WestJet flight attendants issued a 72-hour strike notice Thursday. They could walk out as early as Aug. 2. WestJet responded with a lockout notice and began preparing for flight disruptions.


CUPE wants flight attendants paid from check-in through clock-out. Current compensation is still largely tied to the time the aircraft is in motion, leaving some groundwork unpaid.


Both sides say they are still bargaining. WestJet passengers should probably keep checking their phones.

California State Workers Go To Strike School

SEIU Local 1000 is holding virtual strike schools for California state workers after its contract with the state expired June 30.


The union represents nearly 100,000 employees. Additional sessions are scheduled for Aug. 12 and Aug. 27, covering strike rights, the bargaining process, and strike preparation.


Local 1000 is seeking a 20% general salary increase over three years, along with changes involving healthcare, retirement, and teleworking. It has also accused the state of failing to bargain fairly.


No strike vote has been announced. But teaching 100,000 workers how a strike works is not exactly a subtle bargaining tactic.

Mount Nittany Hospital Workers Hit The Picket Line

About 950 workers at Mount Nittany Medical Center began a five-day strike Monday after negotiations stalled over wages.


SEIU Healthcare Pennsylvania says employee pay has fallen behind the cost of living in Centre County. Mount Nittany says it offered a one-year extension with a 3% across-the-board raise, a $1,000 ratification bonus, and wage adjustments for 18 classifications.


The hospital remains open. This is its first strike since 2004.


The striking unit includes employees across hospital operations. Healthcare employers that still treat organizing as primarily a nurse issue are overlooking a growing share of the activity.

The NLRB Allows Some Bargaining-Table Bluntness

A divided NLRB reversed a finding that Inland Waters Pollution Control unlawfully threatened employees over their use of the grievance procedure.

During bargaining, the employer complained about excessive and “bullsh*t” grievances. The Board majority found that the general counsel had not proven that those comments threatened employees with discipline.


The decision noted that bargaining can involve a “frank, and not always complimentary exchange of views.” Anyone who has spent time at a bargaining table already knew that. Still, it is useful for the Board to put it in writing.

The ruling does not protect employees from actual threats for filing grievances. It does give employers some room to criticize how the process is being used.

The AHA Wants The Health Care Rule Applied As Written

The American Hospital Association filed an amicus brief in an Essentia Health case involving advanced practice providers across nine acute-care hospitals and roughly 51 non-acute clinics.


An NLRB regional director approved the proposed unit. The AHA says that decision sidesteps the Health Care Rule, which generally limits acute-care hospitals to eight recognized bargaining-unit configurations.


The AHA’s concern is that unions could circumvent the rule by adding non-acute facilities to a petition for integrated health systems, resulting in more narrowly defined units within the same organization.


The association also argues that the Board cannot change a binding regulation through one representation case. If the rule needs to change, the Board needs to go through rulemaking.


Apparently, even federal labor regulations can get a little slippery in the summer heat.


About Labor Relations INK

Labor Relations INK is published weekly and is edited by LRI Consulting Services, Inc. Feel free to pass this newsletter on to anyone you think might enjoy it. New subscribers can sign up by visiting here.


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Contributing editors for this issue: Greg Kittinger, Michael VanDervort, and Kimberly Ricci.


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About LRI Consulting Services, Inc.

LRI Consulting Services, Inc. exists to help our clients thrive and become extraordinary workplaces. We improve the lives of working people by strengthening relationships with their leaders and each other. For over 40 years, LRI Consulting Services, Inc. has led the labor and employee relations industry, driven by our core values and our proven process, the LRI Way.

 

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