Subject: Gen Z and Unions, Is Healthcare Ready for Physician Union Pressure?: LRI INK

June 19, 2025

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Is Your Healthcare System Ready for Physician Union Pressure?

by Kimberly Ricci

Why Primary-Care Union Activity Demands a Proactive Response


Nursing unions have had their claws in the healthcare industry for quite some time, yet physician organizing didn’t fully take off until a 2022 NLRB ruling opened the floodgates. Since then, SEIU has been off to the races in targeting resident physicians, and by May 2024, the Committee of Interns and Residents (CIR-SEIU) offshoot claimed to represent 32,000 workers. A year later, CIR-SEIU has organized over a dozen more healthcare systems.


We have also previously warned you about another offshoot, the Doctors Council-SEIU, which has been targeting primary care physicians (PCPs) and their unique concerns. Recent activity reveals that Doctors Council is going in hard, and although current “wins” might not sound voluminous, do rest assured that unions remain motivated by doctors’ lucrative salaries:

  • 237 PCPs in the Boston area voted to unionize with the Doctors Council this month. A related dispute involving whether short-term care doctors can organize is on hold at the quorum-less NLRB.

  • 229 PCPs in Madison, WI, are currently embroiled in a protracted organizing campaign, and the NLRB’s lack of quorum has struck again on charges from both the union and company.

  • 600 PCPs at a Minnesota healthcare system are frustrated over contract negotiations after unionizing with the Doctors Council in 2023. A full-on strike has not been called, but some doctors are picketing outside four facilities between appointments. This is also technically the first time that doctors have picketed within the state. 

PCP-specific concerns: As with many other medical professions, the recent wave of unionizing can be attributed mainly to heavy caseloads following a post-COVID workforce exodus. However, PCPs also find themselves in a practice area that isn’t as profitable as specialties, and conglomerates frequently absorb these practices’ costs as part of their overall umbrella. Further, this corporatization has proven to be a double-edged sword in the workplace. On one side of that argument, doctors are pushing back against what they view as faceless “suits” that make financial calls for efficiency. On the other side, companies must remain sustainable, a reality that unions love to ignore.


Will we start seeing PCP strikes? By now, nursing strikes are so commonplace that it’s fair to assume that they contribute to doctors' stress by increasing their workloads. As for whether they, too, will start striking, the American College of Physicians Ethics Manual does pointedly state, “Physicians should not engage in strikes, work stoppages, slowdowns, boycotts [that could] limit or deny services to patients that would otherwise be available.” Yet this directive didn’t stop CIR-SEIU from putting 150 physicians on strike in 2023 for three days in Queens, NY.


Takeaways: (1) Doctors might always feel overworked, burned out, and frustrated with no magic bullet to alleviate such situations; (2) Hospitals are struggling against the loss of federal funding and budget shortfalls, and PCP practices are no exception to financial scrutiny; (3) Strikes are detrimental to patient care and run against medical ethics. 


Nobody disputes that the healthcare industry has become more stressful for workers since the pandemic. Yet, it remains to be seen to what degree doctors’ frustrations will lead them to seek third-party representation. It seems unlikely that we’ll see significant strikes from PCPs, but one can never say never, and it's always best to keep an eye out for union infiltration.


Cary Burke on the Left of Boom Show: Labor Law, LinkedIn Snark, and a Leap into Minuscule Law

by Michael VanDervort

Cary Burke left Big Law, joined the plaintiff’s side, and hasn’t looked back—except when his kids are jumping down the stairs in dinosaur underwear.


Episode Summary:

Cary made partner at Seyfarth—and then left to jump into the chaos of plaintiff-side litigation, a coworking space, and parenting two daredevil sons.


We discuss that leap, what’s broken in labor law, and why Cary’s voice on LinkedIn cuts through the noise. He weighs in on Stericycle’s vibes-based enforcement, state labor boards stepping in while the NLRB is down, and how writing clearly is a lawyer’s secret weapon.


Connect with Cary:

LinkedIn

LeeMeier Bio

 

Surprise! Shawn Fain And His Foul Mouth Received An “F” Report Card From The UAW’s Federal Monitor 

by Kimberley Ricci

UAW President Shawn “Reformer” Fain hasn’t been such a reformer after all. His two-year tenure in fronting a notoriously corrupt organization has been rife with infighting. Fain also pulled off two significant oustings with ex-Stellantis Dept VP Rich Boyer, who “refus[ed] to divert benefits to his fiancée,” and ex-Secretary-Treasurer Margaret Mock, who declined to approve ambiguous expenditure requests “for the benefit of those in the President’s Office.”


The latter ejection became a particular focus for UAW federal watchdog Neil Barofsky, with whom Fain is no stranger to clashing. Surely, Fain is not thrilled about how the UAW’s website must provide a link to the monitor’s counterpart with a dozen reports full of Barofsky’s observations. And Fain must be roaring mad because the twelfth report is a 93-page doozy.


Granted, Fain does not have a mild-mannered reputation, but this report unveils a foul-mouthed loose cannon who recently popped off during an International Executive Board (IEB) meeting attended by around 300 UAW officers and members. During the event, Fain pulled strings to strip Mock of her “oversight of 11 union departments and two external board positions.” That and more eyebrow-raising revelations from the report are as follows:


‘Slit [Their] F-ing Throats’ And Other Outbursts:

  • Several UAW international and regional officers corroborated how Fain used his IEB remarks to proclaim that he would “slit” or “cut” the “f***ing throats” of those who “messed” with his inner circle. Those who confirmed this verbal explosion took these “words as a serious threat” of retaliation, but Fain has insisted that he was “laughing and smiling” while ranting. Zero interviewed witnesses agreed with him.

  • Mock had previously pushed back on relinquishing monies while citing her “fiduciary responsibility to the organization.” Fain didn’t handle it well: “Your only responsibility is to sign the f***ing check.”

  • During a “Print Shop incident,” Fain went on a “tirade” over Mock’s photo on a publication while shouting, “This is my motherf***ing membership.” This left a worker “crying” and “visibly shaken,” with Fain later admitting that his behavior “got sh*tty.”

Fain’s racially-charged maneuvering against Mock: 

According to witnesses and evidence gathered by Barofsky, Fain pressured Regional Directors Laura Dickerson and LaShawn English “to move and second the motion” to remove Mock. What was Fain’s reason for asking them to do so?

 

Well, as Barofsky further wrote:


“Fain acknowledged that he did so to make it appear as if they were the ones driving the motion, justifying his efforts to conceal his role by stating that he believed having Black women present the motion against Mock, who is also Black, would shield him from potential accusations of racism.”


Of this tactic, Fain later admitted, “I thought it would be better coming from [them] than me, a white guy.”


The monitor’s directive for Mock to be reinstated:

Barofsky concluded that Mock was “falsely accused of misconduct,” and that Fain ousted her with “illegitimate and retaliatory intent.” The watchdog further ordered that Mock’s removal should be “immediately reversed.”


The aftermath with hints of more fallout to come:

The report closes by explaining that criminal charges aren’t on the table yet since Barofsky “continues to investigate various other allegations concerning a retaliatory pattern of conduct concerning Fain.” He added that another report will be forthcoming.


Mock has responded with relief while hoping that the union could gain a “fresh start from the previous scandals and bad practices.” Good luck?


Meanwhile, UAW attorney Harold Gurewitz countered that Barofsky’s conclusions are “far removed from allegations of corruption and instead enmesh the Monitor into the heart of internal union affairs.” This, of course, does nothing to dispel the UAW’s reputation for dishonest dealings.


Gen Z Is Changing the Union Game—But the Rules Haven’t Kept Up

by Michael VanDervort

This week, one thing became clear: the labor conversation is shifting fast.

A post I shared on LinkedIn, The Kids Are Organizing—and the Law Can’t Keep Up, racked up over 33,000 impressions in 24 hours. Why? Because employers, labor leaders, and HR professionals are all facing the same quiet disruption:


younger workers are redefining what it means to have power at work.

They're not doing it with picket signs and union halls—they're doing it through values, identity, and a desire for a meaningful voice in how decisions are made. And while their organizing efforts aren’t always traditional, the challenges they present are very real.


The Real Disconnect: Strategy vs. Structure

Gen Z and younger Millennials are approaching labor issues with a level of urgency and clarity that feels new, but they're forced to work within a faltering 90-year-old legal framework.


The National Labor Relations Act (NLRA) was built for the industrial era. It wasn’t designed to handle decentralized workplaces, social media campaigns, or fluid job structures. As a result, both employers and unions are stuck playing chess on a checkers board:

  • Employers face legal ambiguity and drawn-out campaigns

  • Workers face frustration and red tape

  • Unions cherry-pick points of worker frustration and often promise results that cannot be achieved during collective bargaining

This mismatch creates instability, not solutions, and no one benefits from that.


What We’re Seeing in the Field

This week’s labor news reflects the trend:

  • Over 40% of NYC’s independent bookstores are unionized—not because of strikes, but because workers are tired of “passion jobs” with no pay transparency. LitHub

  • Campus staff at Macalester College unionized after years of informal talks went nowhere. MSN

 A national boycott of McDonald’s tied labor issues to DEI rollbacks and tax practices. TCPalm

  • Gen Z is leading the rise in union support, not just for better wages, but for consistency, respect, and inclusion, even though none of these issues are items that are required to be addressed by collective bargaining. MSN Money

  • Jaz Brisack’s “uneven” new book paints a “cautionary” tale that urges organizers to take inspiration from and imitate their headline-making salting campaign against Starbucks. People’s World

This isn’t about a “labor movement”—it’s about worker expectations shifting underneath legacy systems. And employers who treat this as business as usual will find themselves out of step and out of time.


What Employers Should Be Doing Right Now

Forget the slogans. Here’s what matters:

  • Audit your frontline communication—are your managers equipped to handle tough conversations, or do they tend to avoid them?

  • Training leadership to develop strategy plans–both for communication and to handle potential conflict, empowering them to lead confidently and forge stronger relationships with their teams.

  • Assess employee trust—do your people believe leadership is listening?

  • Understand the legal gaps—because the NLRA isn’t just outdated; it’s under fire in the courts.

  • Update your strategy—if your playbook hasn’t changed since 2015, it’s already stale.

Let’s Be Honest

The organizing activity we’re seeing today isn’t a flash in the pan, nor is it a full-blown movement. It’s something in between: a slow-burning realignment of expectations arranged around voice, fairness, and accountability.


And here’s the bottom line:
You can’t wait for the law to catch up before you act.


What Do You Think?

Are your frontline strategies keeping pace with changing worker expectations?
Is the NLRA still workable—or just a legal trap for everyone involved?

Drop your thoughts in the comments, shoot me a DM, or tag someone who's navigating this firsthand.

I'm especially interested in hearing from:

  • HR pros dealing with first-time organizing

  • Labor strategists who are trying to modernize their playbook

  • Leaders who’ve seen Gen Z’s influence up close

Let’s make this a real conversation, not just another headline.


Whether you're a labor leader wondering how to stay relevant or an employer navigating this new organizing wave, the question isn’t if change is coming; it’s how you’ll respond.


Did You Know?

Most union campaigns don’t start with a petition—they start with a breakdown in leadership trust.

  • Weak relational skills of frontline leaders

  • Inconsistent communication

  • Gaps in frontline manager readiness

  • Missed warning signs in key departments

At LRI Consulting Services, we help clients spot these early organizing hotspots using proven assessment tools, heat mapping, and real-time workplace diagnostics. We strengthen relational connections of front-line leaders with their teams. Then we coach leaders—at every level—to respond with confidence, credibility, and clarity.


Let’s Talk Strategy

If you're wondering whether your workplace is vulnerable—or if your managers are prepared to lead in today's high-trust, high-scrutiny environment—we can help.


📌 Message me on LinkedIn
📌 Or visit LRI Consulting Services to explore how our leadership coaching and ER risk assessment/mitigation tools can help you stay ahead of what’s coming.


Because in this labor climate, the best defense isn’t fear. It’s prepared leadership.

GAO to DOL: Your Union Watchdog Is All Bark, No Bite

by Michael VanDervort

The Office of Labor-Management Standards (OLMS) is supposed to be the Department of Labor’s enforcement arm for union transparency. Think of it as the group that ensures unions handle their finances properly, hold fair elections, and protect members from internal abuse. That is the theory, anyway.


According to a June 2025 report from the Government Accountability Office (GAO), OLMS has treated union oversight more like a handshake deal than a compliance program. The GAO did a deep audit, and what they found should concern anyone who believes that union members deserve basic financial integrity and accountability.


What OLMS is getting wrong

Let’s start with the numbers. OLMS conducted 221 compliance audits in 2023. In 96 percent of those audits, violations were found. That’s not a typo. These were not minor errors either. Common issues included underreporting officer payments, missing bylaws, inadequate documentation for credit card charges, and failure to track lost wage reimbursements properly.


Despite the volume and seriousness of these violations, OLMS required amended reports in less than half of the cases. For recordkeeping violations, often a precursor to embezzlement, OLMS accepted verbal promises to do better in 85 percent of cases. The agency does not follow up and has no system in place to confirm whether these promises lead to corrective action.


GAO called it out directly. OLMS cannot say whether its voluntary compliance model actually works. It is measuring success based on promises rather than proof.


The guidance gap

OLMS has more than 50 compliance publications meant to help unions follow the law. These include resources on documenting expenses, holding elections, filing financial reports, and more. However, according to GAO, OLMS routinely fails to reference this guidance in audit findings.


Take credit card expenses. Forty-six closing letters flagged violations in this area. None of those letters cited OLMS’s own publication on credit card policy. At the end of an audit, a closing letter is issued by the OLMS investigator to the union officers, including any points of recommendation and required changes noted from the audit. Of the 41 letters that noted problems with meal expenses, only one included a relevant reference. If the agency cannot consistently point unions to the help it already offers, it is not serious about preventing future violations.


Training no one shows up for

OLMS offers compliance assistance sessions both in person and virtually. The content varies by region, and so does the execution. Some regional offices collect feedback forms. Others do not. There is no central system to track attendance, satisfaction, or what topics resonate with participants.


Participation is low. Only 2 to 3 percent of local unions attended training in one district in a given year. The agency has no strategy to increase turnout, and no evaluation process to determine why so few are showing up.


Union members are not in the loop

OLMS claims to work on behalf of union members. However, the agency does not communicate with them directly. All compliance notices and session invites are sent to union officers. If those officers choose not to share the information, the members never see it.


GAO noted that OLMS has made limited attempts to engage members by partnering with other federal agencies. None of those efforts significantly increased awareness. The agency admits most members do not know what OLMS is or what it does.


Seven recommendations from GAO

GAO offered seven recommendations to fix OLMS’s audit, enforcement, and education practices. The Department of Labor agreed to implement them. Time will tell if that actually happens. Here’s what GAO wants OLMS to do:

  1. Set clear rules for when amended reports are required

  2. Track whether voluntary compliance leads to corrective action

  3. Monitor repeat violators and follow up when necessary

  4. Reference relevant compliance materials in audit letters

  5. Update compliance publications based on real-world violations

  6. Standardize participant feedback from training sessions

  7. Create a direct outreach strategy to reach union members

Why this matters to employers

The GAO report makes it clear that OLMS oversight is inconsistent, reactive, and overly reliant on goodwill. For employers, that means you cannot rely on the agency to hold unions accountable. If unions are mishandling money or running questionable elections, OLMS is unlikely to catch it. Even when they do, they rarely require a fix.


If you are in labor relations, you are already familiar with this, but now you have a 100-page federal audit to prove it.


Read the full report here: GAO-25-107297.


Stories You May Have Missed:

UAW’s $80 Million Investment Blunder

What happened:
Reuters reports the UAW lost an estimated $80 million on risky private equity investments between 2014–2021. Internal documents cite poor oversight, lack of financial expertise, and failure to inform trustees.


Why it matters:
While pushing bold organizing campaigns, UAW's financial missteps raise serious questions about leadership accountability and dues stewardship. Members are now facing staff cuts and reduced services.

🔗 Full story – Reuters

NLRB Backs Fired Applebee’s Workers in Union Case

What happened:
The NLRB ruled that Applebee’s unlawfully fired two NYC workers for supporting unionization efforts in 2022. Management allegedly surveilled and interrogated employees before terminating them—violating the National Labor Relations Act.


Why it matters:
This decision reinforces the NLRB’s aggressive stance on employer retaliation and surveillance. It also signals heightened risk for service-sector employers facing grassroots organizing in high-turnover environments.

🔗 Full story – The Chief

NY Lawmakers Move to Replace NLRB Amid Quorum Crisis

What happened:
The New York Assembly passed a bill allowing the state to adjudicate private-sector labor disputes when the NLRB lacks a quorum. The move comes as the NLRB faces a looming shutdown without confirmed appointees.


Why it matters:
Critics say the bill risks federal preemption violations under the NLRA. If enacted, it could spark constitutional challenges and create a patchwork of labor law across states—especially if other blue states follow suit.

🔗 Full story – Labor Relations Update


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.


If you use content from this newsletter, please attribute it to LRI Consulting Services, Inc. and include our website: http://www.LRIonline.com 


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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