The Buzz This Week 

Labor strikes in the healthcare sector continue to make headlines. In October, Kaiser Permanente and the Coalition of Kaiser Permanente Unions reached a “tentative agreement” following a 3-day strike involving more than 75,000 healthcare workers—the largest-documented healthcare strike in U.S. history. Employees, represented by the coalition, asserted Kaiser did not adjust wages for inflation and had inadequate staffing levels. Kaiser argued that it is hiring aggressively—onboarding more than 10,000 people for coalition jobs this year while also providing leading compensation packages. The strike, which began on October 4, reached a tentative deal on October 13 as the parties continue to work on various issues to resolve the labor dispute. If a new labor deal is not reached, a “significant work action” is planned for early November.  

The healthcare and social assistance sector has witnessed 109 strikes since January 2021, with 39 recorded strikes in 2022, and a continued increase in 2023, with 37 strikes so far, showing a trend of growing labor actions in the industry.  

As the healthcare industry experiences a surge in organized labor efforts, the primary concerns of healthcare workers center around fair compensation, adequate staffing levels, and improved working conditions—all of which have a direct impact on the quality of patient care. Recent examples include more than 1,200 nurses at Allegheny General Hospital in Pittsburgh voting overwhelmingly to authorize a strike, demanding increased investments in nurse pay and staffing. Meanwhile, approximately 1,500 healthcare workers at Prime’s St. Francis Medical Center in Los Angeles staged a 5-day strike in early October, protesting staffing shortages and unfair labor practices.  

Organized labor efforts are impacting a wide range of healthcare roles, reflecting a multifaceted movement across the nation. Historically, doctors and medical residents have not been unionized. But recently, more than 550 Minneapolis-based Allina Health System doctors, physician assistants, and nurse practitioners voted in favor of unionizing, forming one of the largest collections of unionized private-sector physicians in the U.S. This move is an effort to address concerns about understaffing, burnout, heavy administrative workloads, and patient care—all of which were exacerbated during the COVID-19 pandemic. In addition, at Boston Medical Center, resident physicians and fellows recently achieved a major victory, securing a tentative agreement that offers substantial raises, living stipends, paid vacation, and initiatives for diversity and inclusion. 

Why It Matters

The frequency and scale of labor strikes reflects growing discontent within the healthcare workforce, emphasizing the need for healthcare organizations and policymakers to address these concerns. California has recently taken significant steps to address healthcare workers’ wages. Gov. Gavin Newsom signed a bill on October 13 that will gradually raise healthcare workers’ hourly minimum wage to $25. The bill comes after union and hospital representatives reached an agreement, aiming to strike a balance between improving wages and safeguarding jobs. Simultaneously, in Ohio, lawmakers have introduced nurse staffing legislation that seeks to establish legally enforceable minimum staffing standards in state hospitals. This initiative, known as the Nurse Workforce & Safe Patient Care Act, is designed to address Ohio’s nursing shortage, which was exacerbated by the pandemic.

The Committee of Interns and Residents (CIR), affiliated with the Service Employees International Union, has seen an increase in new chapters added at teaching hospitals. While pay is still part of the concern for residents, their move to unionize has been more focused on patient safety, working conditions, administrative load, and benefits. Although research indicates that the residency experience isn’t dramatically improved by unions, the increasing unionization of residents reflects their growing desire to advocate for their rights and ultimately deliver better patient care.

The impact of labor strikes on patient care quality is evident, with research indicating a significant decrease in admissions and care visits during strikes, accompanied by broader care delivery changes dependent on the striking group. Moreover, healthcare workers’ concerns related to understaffing, burnout, and adverse working conditions have a direct impact on patient care, as well as the healthcare industry’s ability to retain and attract talent, a pivotal factor in addressing these labor issues. The future trajectory of this trend depends on various factors, including the effectiveness of strikes in addressing workers’ concerns and the dynamics of labor negotiations in the industry. 


Thousands of Medical Residents Are Unionizing. Here’s What That Means for Doctors, Hospitals, and the Patients They Serve

Healthcare Dive: 
Kaiser and Unions Reach “Tentative Agreement” After Historic Strike

Healthcare Dive: 
Tracking Healthcare Worker Strikes 

Modern Healthcare: 
Resident, Doctors Unions See New Interest, Membership 


Editorial advisor: Roger Ray, MD, Chief Physician Executive.


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