Growing numbers of US physicians are joining unions, seeing them as a way to regain autonomy in the face of the corporatisation of healthcare. Ella Hubbard reports “They somehow found a way to upset every single physician in the hospital,” says Bryan Haimes, explaining why he and several hundred of his colleagues at the Christiana Care hospital network voted to unionise last year. The decision was precipitated by the imposition of a new contract which included the removal of all paid time off. But Haimes emphasises that this was the final insult after a gruelling few years dominated by the covid-19 pandemic. “There were huge surges of patients, and people were stretched as thin as they could possibly be stretched,” he says, describing the moral injury caused by the early waves of the pandemic. “Terrible nursing ratios, terrible doctor to patient ratios, and everybody felt like they were not necessarily practising the best medicine they could at the time.” Physicians felt increasingly excluded from decision making, too—both about their own contracts and about patient care. Haimes says that the rapidly evolving nature of the pandemic demanded quick decisions from hospital managers, without input from physicians. But once the pandemic had receded this approach to management didn’t go away. “They implemented a completely siloed, top down management model, where a lot of the decisions for changes in our working conditions came from above and they were communicated to us by middle management, usually poorly.” It was in this context that Christiana Care imposed the new contract. “Four days before Christmas, they dropped it on us,” says Haimes. “It was such a large unilateral change that we started to research what we could do about it.” Within six months they had voted to unionise. The group is part of a growing movement …

中文翻译：

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美国医生为何加入工会

越来越多的美国医生加入工会，将其视为在医疗保健公司化面前重新获得自主权的一种方式。Ella Hubbard 报告说：“他们以某种方式找到了一种方法来惹恼医院里的每一位医生，”Bryan Haimes 说，并解释了为什么他和 Christiana Care 医院网络的数百名同事去年投票支持成立工会。该决定是由于签订了一份新合同而促成的，其中包括取消所有带薪休假。但海梅斯强调，这是在经历了由 covid-19 大流行主导的艰苦几年之后的最后一次侮辱。“患者人数激增，人们被压得喘不过气来，”他说，描述了大流行早期浪潮造成的道德伤害。“糟糕的护理比例，糟糕的医患比例，每个人都觉得他们当时不一定在练习最好的药物。”医生也越来越感到被排除在决策之外——无论是关于他们自己的合同还是关于患者护理。Haimes 说，大流行病的快速发展性质要求医院管理者在没有医生意见的情况下快速做出决定。但是，一旦大流行消退，这种管理方法并没有消失。“他们实施了一种完全孤立的、自上而下的管理模式，其中许多改变我们工作条件的决定都来自上层，并且由中层管理人员传达给我们，但通常很糟糕。”正是在这种背景下，Christiana Care 签订了新合同。“圣诞节前四天，他们把它丢在我们身上，”海姆斯说。 “这是一个如此大的单方面变化，以至于我们开始研究我们能做些什么。”在六个月内，他们投票决定成立工会。该组织是不断发展的运动的一部分......