‘Public and Open Boss Fight’: Mass General Brigham, Hospital Trainees Spar Over Union Drive

After beginning to collect union cards for official recognition in November, residents and fellows at Mass General Brigham received a surprise announcement via email: a bonus of $3,500 for the 2022 academic year.
By Cam E. Kettles

Residents and fellows at Mass General Brigham have sought to unionize in recent months, but have faced opposition from the hospital system's administration.
Residents and fellows at Mass General Brigham have sought to unionize in recent months, but have faced opposition from the hospital system's administration. By Jenny M. Lu

After beginning to collect union cards for official recognition in November, residents and fellows at Mass General Brigham received a surprise announcement via email: a bonus of $3,500 for the 2022 academic year.

When organizers launched their public unionization campaign in late February, MGB administrators sent a slew of emails: one on March 2 announcing a 10 percent salary raise, an increase of the annual stipend to $10,000, and expanded benefits; two on March 7 warning against the unionization effort; and one on March 16 disputing organizers’ talking points.

“We respect the fact that some of you have had questions about the union. We are always open to your questions,” read a March 7 email signed by 30 of MGB’s department chairs. “However, it’s our hope that we can move beyond those questions, so that we can focus all our available energy on our educational programs and see what we can achieve by working together.”

In a March 16 email, MGB Interim Chief Academic Officer Paul J. Anderson and Vice President of Education J. Kevin Tucker sent residents and fellows two documents arguing against unionization.

“If there were ever a time not to sign a union card, that time is now,” one handout stated.

MGB leadership have made the case to housestaff that working directly with the administration is preferable to union bargaining.

“Your entire relationship with Mass General Brigham — including program and education leadership – would change, and in many ways you might not like,” their website reads.

The unionization campaign, named MGB Housestaff United, hopes to file for a union election by the end of the academic year.

Mass General Brigham, which includes both Brigham and Women’s Hospital and Massachusetts General Hospital, employs more than 2,500 residents and fellows, otherwise known as housestaff. Many of its member hospitals are teaching hospitals affiliated with Harvard Medical School.

MGB Housestaff United is affiliated with the Committee for Interns and Residents, a local of the Service Employees International Union. The CIR represents roughly 22,000 housestaff nationwide.

“We have shared experiences working for this large hospital system that really led us to want to form a union,” said Kayty E.W. Himmelstein, organizing committee member and Infectious Disease Fellow.

MGB Housestaff United are asking workers to sign union cards that indicate they support unionization and authorize the CIR to act in their interests.

If a majority of housestaff sign cards, MGB Housestaff United can ask hospital administrators for voluntary recognition. If more than 30 percent of eligible workers sign cards, MGB Housestaff can file for a union election conducted by the National Labor Relations Board to be officially recognized even if MGB doesn’t voluntarily recognize them.

Organizers said they did not begin their card campaign until they were confident that they had support from a majority of MGB housestaff.

“We spoke to over a thousand people who verbally told us like, ‘Yes, I think I would support this campaign if you were to get to the point where you had an election,’” said Sascha N. Murillo, organizing committee member and a third-year Internal Medicine resident.

‘A Seat at the Table’

Citing compensation, workplace safety, and burnout prevention as top priorities, MGB Housestaff United organizers seek greater employee representation in decisions that affect them.

“The union was formed out of a desire for us to have a seat at the table to talk about what working conditions we need, what types of pay and benefits we need, and really what our patients need as well,” Himmelstein said.

Organizing committee members pointed to the Covid-19 pandemic as the catalyst of the push toward unionization, saying that many employees had limited access to personal protective equipment and little say over reassignments to treat Covid-19 patients.

“Covid really exposed a lot of the vulnerabilities that residents and just healthcare personnel in general face around workplace safety and just our general working conditions,” said Murillo, the third-year resident.

Compensation is especially important to housestaff due to the cost of living in Massachusetts and rising inflation, she added.

“I’m at MGH, and we’re in Beacon Hill, which is incredibly expensive,” Murillo said. “I know my fellow co-residents are spending over half of their paycheck just to have a place to sleep, which is insane for people who have upwards of $300,000 in debt.”

In April 2020, MGB created the House Staff Council to address concerns from residents and fellows. Elected representatives of each department could bring forward concerns to MGB’s General Medical Education Committee.

Third-year Internal Radiology resident and organizing committee member Diego B. Lopez ’13, who was originally part of the House Staff Council, said that while organizers initially tried to get concerns addressed there, “people just kind of gave up because it wasn’t going anywhere.”

While Brigham and Women’s Hospital has maintained a housestaff council since 2017, the broader MGB council ended after two years.

Lopez says that while some concerns could be addressed through the MGB Education Committee, the majority of concerns were “not something the GME committee can address” because the concerns did not pertain to education.

He added that members of the House Staff Council were never able to meet with the Human Resources department or “anyone in administration that actually handled training” during his time on the council.

In fall 2022, the Mass General Brigham Education Operations Coordinating Committee was created to address operational difficulties related to education.

Anderson, the interim chief academic officer, wrote in a statement that the residency program “provides well-rounded support to ensure a meaningful experience, professionally and personally.”

An MGB spokesperson wrote in an emailed statement on March 17 that hospital administrators view working directly with trainees as the best way to meet employees’ needs.

Himmelstein said the formation of a union is a vital step for improving working conditions for housestaff.

“Unlike a house staff council, a union is a legally recognized body that the employer is required to negotiate with,” Himmelstein said. “I think we feel that in order to have our concerns addressed in a meaningful way, we really need that legal mandate for our employer to meet with us and talk about our concerns.”

Mass General Brigham's hospital network includes Brigham Women's Hospital, pictured, and Massachusetts General Hospital.
Mass General Brigham's hospital network includes Brigham Women's Hospital, pictured, and Massachusetts General Hospital. By Naomi S. Castellon-Perez

‘A Really Coordinated Effort’

MGB Housestaff United began quietly collecting cards in November, months before launching publicly in late February.

“Mostly we’ve just been trying to talk to as many residents as possible,” Murillo said. “Our unit would be like 2,600 people, so we wanted to make sure we had a good base of support.”

On their website, MGB described organizers as “encouraging or pressuring others to join their effort.”

Since October 2021, according to Lopez, housestaff have been receiving emails from hospital administrators expressing appreciation for residents.

“It’s very, very common to see these kinds of things during this phase of the campaign when things are still technically underground, although the employer is very obviously well aware of what’s going on,” said Annie Della Fera, a communications coordinator for CIR, MGB Housestaff United’s parent union.

In addition to the $3,500 bonus, the increased annual stipend, and the 10 percent salary raise — which includes a 7.5 percent market adjustment and 2.5 percent wage increase — the hospital system also offered other benefits, including an expansion of their employee health insurance, a contribution of 2 percent of annual base pay to a retirement savings plan for each resident, and an extension of their existing disability insurance for clinical fellows to residents.

“Most housestaff have understood that this is a clear response to us unionizing and to us having more power,” Himmelstein said.

On their website, MGB denied claims that recent raises were in response to the ongoing union push.

“We do not need anyone else to tell us that competitive and attractive wages and benefits are important to our Trainees — we already know that,” the website reads.

According to the site, recent compensation increases are part of a broader “multi-year process to assess and adjust the compensation and benefits of our entire workforce based on the market.”

MGB Housestaff United organizers said the recent compensation increases prove that a formal union would further improve benefits for housestaff.

“They’ve already been able to pressure MGB and make them uncomfortable enough that they’re starting to see a response from the employer,” Della Fera said.

The March 7 email signed by MGB department chairs stated that recent compensation increases and benefits “demonstrate that the needs of our trainees and our training programs are a top priority, and that our voices together have been heard.”

“We ask for your support to allow us to continue to do this with you directly,” the email concluded.

In its March 16 email, MGB also distributed information on what unionization means for housestaff, including telling them that between contract negotiations, “new or unique and individual needs could not be addressed directly between you and your Program or Fellowship director.”

“What we’ve seen has been a really coordinated effort by MGB to stop us from forming a union,” Himmelstein said.

Members of the MGB Housestaff United organizing committee said department chairs and program directors began holding meetings with residents and fellows during working hours in January to “try to convince us that forming a union would be bad for us,” Himmelstein said.

“It’s very coercive,” she said. “These are people who are not only our current bosses, but also, we are in training programs, and we rely on these people for letters of recommendation and for references for us to get our first attending jobs.”

On its website, MGB said it is “committed to providing factual information for Trainees and others who have questions about the union organizing activity” and the collective bargaining process as a whole.

While MGB’s site says it is not “anti-union,” MGB Housestaff United organizers said their decision to launch publicly was a response to what they felt was “anti-union activity.”

“Now because we’ve been facing a very, very public and open boss fight, we had to come out and be public so we could respond,” Murillo said.

Should the MGB Housestaff United reach the 30 percent threshold needed to request voluntary recognition, MGB is expected to deny it; the hospital system’s site states that it “would insist on an NLRB election so every voice can be heard.”

Organizing committee members said they expect to conclude their card campaign in the coming weeks and file for an election by the end of the academic year.

“We are at this incredibly powerful and wealthy institution, and we need to help have a say in how the power and resources here are directed to improve the lives of workers and the lives of patients,” Himmelstein said.

—Staff writer Cam E. Kettles can be reached at cam.kettles@thecrimson.com. Follow her on Twitter @cam_kettles.

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