The Healthcare Workforce Is in Flux—Here’s What Employers Can’t Ignore: LRI INK

Subject: The Healthcare Workforce Is in Flux—Here’s What Employers Can’t Ignore: LRI INK

July 10, 2025

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The Healthcare Workforce Is in Flux—Here’s What Employers Can’t Ignore

by Michael VanDervort

If you’re leading people in the healthcare world right now, go ahead and take a deep breath. The ground is shifting under your feet, and it’s not just burnout or staffing shortages (though those are still very much here). It’s something more profound: a quiet but very real reimagining of what it means to work in healthcare.

You’re not imagining the churn. New data, new expectations, and new workforce tensions are bubbling up across the industry. And while some of the signals feel familiar (unionization, housing concerns, leadership turnover), they’re all pointing toward a simple truth: the way hospitals and systems approach their people is facing some serious challenges in this moment.

Let’s talk about four developments that may not be making the front page but should be on every healthcare exec’s radar.

1. Unionization Isn’t Just for Nurses Anymore

According to a recent study in Medscape (Free account required), about 1 in 10 Physician Assistants in the U.S. are now unionized. That statistic would have been unthinkable a decade ago, but today, it fits right into the broader pattern of organizing among highly educated healthcare professionals.

A recent survey of Physician Assistants (PAs) reveals a growing openness to unionization, despite limited organizing activity for now. While only 7% reported current efforts to unionize at their workplace, nearly half (48%) believe unionization among PAs will increase over the next five years. Additionally, 39% view unions as practical or highly effective in representing their interests, with many expressing confidence that unions understand and support their specialty well.

The push isn’t just about wages (though that’s part of it). It’s about voice, autonomy, and not being caught in the middle between short-staffed clinics and impossible expectations.

The vibe shift? Employers who still see PAs, residents, or support staff as “less likely” to organize are in for a rude awakening. These workers crave a voice in the workplace, and in many cases, they’re taking note of union promises.

Did you know that we can help with risk assessment tools that allow us to identify these issues before they escalate into union campaigns?

2. When the Housing Market Becomes a Workforce Issue

In Atlanta, Emory Healthcare just announced a new initiative: building housing for its healthcare workers.

That might seem like a generous perk until you look at the math. Housing prices in the area have increased by 20% or more in recent years. Employees can’t live near the hospitals they serve. And when you factor in long shifts, unpredictable hours, and brutal commutes? You’ve got a recipe for turnover.

This isn’t charity. It’s a talent strategy. And while not every hospital can go full-on real estate developer, the point stands: employers will have to get creative about meeting basic employee needs or risk losing them altogether.

3. The Leadership Development Wake-Up Call

Burnout is no longer the exception in healthcare; it’s the baseline, which makes it even more urgent that systems stop treating leadership development like a side quest.

Here are seven leadership essentials for "futureproofing" healthcare leadership. Spoiler: none of them involve outdated succession plans or buzzword-riddled retreats. The focus? Creating psychological safety, removing artificial barriers to advancement, and cultivating a culture where people want to grow.

It’s not sexy work. However, it’s foundational, especially if you’re serious about building a team that stays engaged and remains loyal.

4. The Workforce Backbone No One Talks About Enough

Here’s a stat that should give every hospital board pause: 1 in 6 healthcare workers in the U.S. is an immigrant. That jumps to nearly 40% when discussing home health aides.

These workers aren’t just filling in the gaps; they are the system in many communities. And yet, they often face steeper barriers, lower pay, and limited workplace protection.

With immigration policy in constant flux and demand for care continuing to grow, smart employers are thinking ahead. That means not just hiring immigrant workers, but building the kind of infrastructure, support, pathways, and protections that allow them to thrive.

The Takeaway: It’s Time to Rethink the Whole System

None of these trends exists in isolation. They’re pieces of a much bigger shift happening across the healthcare workforce. A shift where old assumptions don’t hold. Where the people powering care delivery are saying, loudly and clearly: We need more. And we’re not afraid to ask for it.

Union drives. Housing fixes. Leadership overhauls. Policy questions. It’s all on the table. And the systems that win in the long run won’t be the ones that resist change; they’ll be the ones that listen, adapt, and lead.

Ready or not, the future of the healthcare workforce is showing up early. Let’s not miss the appointment.

Blog Post

Remarkable Leadership Podcast: Four Keys to Unleashing Your Team’s Potential

by Michael VanDervort

What if the real problem with leadership today isn’t the team... but the leader’s assumptions?

That’s one of several refreshing truths Phil Wilson drops in a recent episode of the Remarkable Leadership Podcast hosted by Kevin Eikenberry.

In this 35-minute conversation, Phil outlines four deceptively simple — but radically effective — mindset shifts that drive real performance. Spoiler: none of them require a training budget or a task force.

Here’s the quick hit:

The Four Leader-Shifts

1. Believe You Make a Difference (Because You Already Do)

Phil calls it the Placebo Effect of Leadership: when people think you believe in them, they show up differently. Want more trust? Believe your leadership matters. People can feel it. Even through email.

2. You Have Everything You Need — Right Now

Waiting for the perfect team, the perfect quarter, or the perfect job title before you show up like a leader? That mindset is holding you (and your people) back. Phil’s advice: stop trying to earn leadership. Start practicing it.

3. Assume Your People Want to Win

This one hits hard. Phil calls it the Hero Assumption: believing your team is full of people who want to succeed. Not slackers. Not saboteurs. When leaders adopt this view, it fundamentally changes how they coach, communicate, and correct.

4. Invest in Relationships

You don’t build a high-performing culture on processes. You build it on people. That means listening more, judging less, and making the time for real connection. “People don’t care how much you know until they know how much you care” — cheesy, but also... annoyingly true.

Why This Matters for 2025

We’re leading through a weird moment — AI uncertainty, workplace polarization, and some serious disengagement fatigue. These mindset shifts are more than motivational posters — they’re tactical frameworks to rebuild trust, reset expectations, and reignite commitment at every level of the org chart.

Phil’s new book, The Leader-Shift Playbook, goes deeper into these ideas. But if you want a free preview with zero fluff and a few solid laughs, this podcast is a great place to start.

Let’s face it — there are enough “thought leaders” telling managers what they’re doing wrong. Phil’s approach? Tell leaders what they can start doing right — today. And that’s the kind of leadership we can all get behind.

Listen to the full episode: http://remarkablepodcast.com/episode491

View Podcast

The Federal Mediation And Conciliation Service Goes Quasi-Private: An Anything-But-Straightforward Process

by Kimberley Ricci

In mid-2025, employers are being asked to roll with shifting goalposts as labor law morphs. A quorum-less NLRB has left little guidance to resolve unsettled disputes involving ULPs, and that’s not the end of the labor limbo.

Back in April, we told you about how an executive order (EO) instructed the reduction of a small but pivotal agency, the Federal Mediation and Conciliation Service (FMCS). This move meant throwing a wrench in the Big Labor machine, but employers will also face potentially costly changes due to the loss of FMCS’ free mediation and arbitration services. To that end, a quasi-private sector model is emerging.

Current state of FMCS: A few months after the EO, the agency was reduced from 143 mediators to five. Then in July, a federal judge ruled that mediators must be reinstated. However, the feds’ planned fiscal year 2026 budget has delivered what could be the final blow by only including funding for a total of 18 workers.

Clearly, the existing case load cannot be serviced by a skeleton crew, which would leave employers, and especially small businesses, without federal support for collective bargaining disputes. For reference’s sake, the agency’s claimed 2024 case load included 2,300+ negotiation sessions for collective bargaining impasses and almost 800 cases that required alternative dispute resolution (ADR) methods.

A new model: Cornell University is now launching the Cornell ILR National Conflict Resolution Service (NCRS), which will offer mediation related to collective bargaining disputes and training for seasoned and newbie mediators. The precise costs associated with NCRS’ forthcoming mediation for employers currently remain a mystery, but Cornell’s ILR School has a roster of mediators with advertised fee schedules that provide an idea of what could carry over into the official NCRS program.

Additionally, ex-FMCS Deputy Director of Field Operations Javier Ramirez will co-lead NCRS. And for those companies in need of ADR, NCRS will provide referrals to the American Arbitration Association (AAA), which is technically a non-profit organization but operates on its own fee schedule.

As well, some states will attempt to pick up some of FMCS’ duties, and that would probably include a ramping up of the California Public Employment Relations Board’s services, but with 50 states and 50 different methods, expect plenty of confusion on government-run offerings.

How employers can prepare: Unfortunately, companies will be opening their wallets to access private mediation and arbitration services during scenarios where they would previously look toward FMCS. And until now, FMCS was the go-to resource for employers to request termination or modification of collective bargaining agreements, so going forward, expired union contracts could likely stay that way, and more strikes could happen.

The toll could be significant on the economy, too. A recent op-ed by U.S. Air Force vet and former Director of Congressional and Public Affairs Greg Raelson argues, “Every dollar invested in FMCS returned over nine dollars in economic benefits” that kept workplaces including hospitals and factories running by preventing strikes and expensive closures.

What remains unknown is how Cornell’s federal funding could potentially have strings attached on how NCRS will operate. What is more certain, however, is that FMCS’ shuttering will at least temporarily create a vacuum that unions will exploit, likely leading to more strike threats and contract disputes that will require mediation, a service that is no longer a federal responsibility.

Blog Post

States Are Throwing Down The Gauntlet On The Quorum-Less NLRB

by Kimberly Ricci

Federal agencies remain in a state of flux following the first 100 days of the Trump administration, with no clarity on the horizon for those who like their labor law to arrive with predictable guidance.

For example, we recently discussed how the Federal Mediation and Conciliation Service’s (FMCS) downsizing had prompted a quasi-private model to emerge, presumably to fill part of the void for mediation and arbitration services on existing collective bargaining agreements. More morphing has been underway at the NLRB, a quasi-judicial body with three board-member vacancies that have left the board without a quorum.

As a result, the Board cannot issue rulings or relief for employers. Although earlier this summer, Board Chair Marvin Kaplan claimed that Trump’s picks are “imminent,” it is unclear when this could happen, and states aren’t waiting to find out how that suspense ends.

Lawmakers in a trio of states – California, New York, and Massachusetts – are now attempting to gain jurisdiction over labor disputes involving private employers to bypass the NLRB’s authority for certain functions:

California’s bill would allow the state’s Public Employment Relations Board (PERB) to resolve collective bargaining disputes, adjudicate ULP charges, and apply civil penalties. Those ramped-up duties would also overlap with the Golden State’s attempt to have PERB pick up tasks previously performed by the FMCS.
New York’s bill has already passed and would allow its version of PERB to certify certain representation elections, adjudicate existing union contracts, and handle ULPs. That bill is headed to Gov. Kathy Hochul’s desk for a signature.
Massachusetts isn’t too far behind with the state House considering similar legislation, and we can expect other blue states to follow suit.

Will these laws matter if they pass? Generally speaking, matters covered by the NLRA will preempt state or local laws; however, the issue isn’t entirely cut-and-dried due to a recent case that creates some grey area.

An existing precedent exists with San Diego Bldg. Trades Council v. Garmon, a 1959 Supreme Court ruling that shut down an attempt by California to circumvent federal labor law. Yet this year in June, the Fourth Circuit Court Of Appeals ruled in National Association of Immigration Judges v. Owen that in the case of another quorum-lacking, quasi-judicial agency – the Merit Systems Protection Board (MSPB) – federal courts could gain jurisdiction over matters usually presided over by that board.

Clear as mud? Of course. There’s no way to predict whether the recent case involving the MSPB will potentially sway other courts to rule that state law could preempt a weakened NLRB. If those hypothetical future cases also reach the Supreme Court, more clarity could emerge; however, Trump could always decide to surprise everyone by naming his NLRB nominees without warning and thereby reestablish a quorum pending confirmation.

What these budding state laws could accomplish, however, is to pressure the Trump administration to clarify its stance on matters of federal labor law. Therefore, employers will want to stay informed about developments and remember that anything can change overnight.

Blog Post

Stories You May Have Missed:

How Union Tactics Helped Erase 30,000 Jobs

What happened:
Reason reports that over the past several years, aggressive union strategies across the Teamsters, IAM, and other unions have contributed to more than 30,000 job losses. From blocked modernization efforts at Yellow, to walkouts at Anheuser-Busch, to failed negotiations with companies like Americold and Sprouts, rigid demands and strike threats pushed some employers to cut back or shut down entirely.

Why it matters:
While unions claim to fight for workers, inflexible bargaining and political grandstanding have had real consequences. In these cases, thousands of union members lost their jobs, not despite union action, but in part because of it.

🔗 Full story – Reason

Retaliation Allegations Rock UAW Leadership

What happened:
City Journal reports that UAW President Shawn Fain is under fire for alleged retaliation against union staff. Organizers say Fain targeted employees who pushed for stronger internal worker protections, culminating in the non-renewal of contracts and a wave of unfair labor practice charges from the union’s own employees.

Why it matters:
As the UAW expands its public organizing campaigns and attacks “corporate greed,” these internal disputes expose a growing gap between its messaging and its own workplace culture. The union now faces claims of hypocrisy, union-busting, and silencing dissent from within.

🔗 Full story – City Journal

Alabama Auto Plant to Fight UAW’s Latest Organizing Drive

What happened:
According to AL.com, a large auto plant in Alabama is preparing to resist the UAW’s newest union organizing campaign actively. The move comes after the UAW filed a petition with the NLRB on behalf of approximately 220 full‑time and part‑time manufacturing workers. The company is already gearing up legal and PR defenses to challenge the petition vigorously.

Why it matters:
This development highlights the intensifying rivalry unfolding across southern states, where the UAW is pushing hard post‑strike to organize non‑union plants. For automakers, retaining control over labor strategy is critical, not just for negotiations, but for operational stability and cost predictability.

🔗 Full story – AL.com

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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Subject: The Healthcare Workforce Is in Flux—Here’s What Employers Can’t Ignore: LRI INK

The Four Leader-Shifts

1. Believe You Make a Difference (Because You Already Do)

2. You Have Everything You Need — Right Now

3. Assume Your People Want to Win

4. Invest in Relationships

Why This Matters for 2025

How Union Tactics Helped Erase 30,000 Jobs