Last February, a supermajority of over 1,400 residents and fellow physicians employed by the University of Pennsylvania Health System (Penn) agreed to be represented by the Committee of Interns and Residents (CIR). CIR is a branch of the Service Employees International Union (SEIU). CIR-SEIU represents more than 24,000 residents and fellows nationwide. If Penn recognizes the union, it would be the first group of doctors in Pennsylvania to organize with CIR. The union would join eight other groups of resident physicians in the nation who elected to be represented by CIR in the last year. As Pennsylvania is part of a national trend, a look at costs and questionable benefits of physician unionization is warranted.

Unionization is not available to every physician. The National Labor Relations Act (NLRA) governs the right of employees to unionize and engage in collective bargaining. NLRA section 2(3), codified at 29 U.S.C.A. Section 152, specifically excludes supervisors and independent contractors from collective bargaining. The majority of physicians in the United States fit the definition of supervisors or independent contractors under the NLRA and are consequently barred from union membership. Physicians organized into a group large enough to exert bargaining power may also encounter obstacles under antitrust laws. Consequently, the trend in resident unionization does not presage a wave of unionization among doctors in general.