The Future of Emergency Medicine: Dr. Alison Haddock on Physician Empowerment, Unionization, and Survival in the ED

Key Podcast Moments

• Why physician autonomy - not wellness programs - is the real cure for burnout in emergency medicine.
• How ED boarding and crowding expose deep failures in hospital leadership, not physician performance.
• What the “financialization” of medicine means for your paycheck, your contract, and your control over patient care.
• Why more ER doctors are turning to unionization as the next frontier for professional survival.

Dr. Alison Haddock is an emergency physician, educator, and past president of the American College of Emergency Physicians (ACEP). She is one of the most outspoken advocates for restoring physician autonomy in a system that has pushed doctors to the brink. From staffing shortages and violence in the ED to corporate consolidation and shrinking reimbursements, she’s spent her career fighting to make emergency medicine a profession physicians can sustain, not just survive.

On this episode of How I Doctor, host Dr. Graham Walker sits down with Dr. Haddock live at the ACEP annual meeting in Salt Lake City to talk about the future of emergency medicine. They discuss the systemic roots of burnout, why boarding and crowding are symptoms of hospital dysfunction not doctor inefficiency, and how unionization and pay transparency could finally rebalance power in the ED.

It’s an unfiltered, solutions-focused look at how ER physicians can take back control of their profession.

Thank you to our wonderful sponsors for supporting the podcast:

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Top 4 Takeaways From the Episode

• Burnout isn’t a resilience problem, it’s an autonomy problem.

Physicians aren’t burning out because they’re weak; they’re burning out because they’ve lost control. Dr. Haddock argues that true wellness starts when doctors have the authority and resources to do their jobs safely and effectively.

• ED crowding and boarding are hospital failures, not ER failures.

Expanding emergency departments won’t solve systemic dysfunction. Real progress requires hospital-level accountability and federal conditions of participation that tie reimbursement to safe throughput and capacity management.

• The financialization of medicine has eroded trust.

Private equity and profit-first hospital strategies have shifted value away from the bedside and toward balance sheets. Dr. Haddock calls for physicians to push back — through transparency, collective action, and new advocacy models that keep patient care, not profit, at the center.

• Unionization is no longer taboo, it’s a survival strategy.

More physicians are open to organizing than ever before. Haddock sees this not as a radical move, but a pragmatic one: a way to protect clinicians, enforce fair contracts, and ensure that the people delivering care have a real say in how it’s delivered.

Links and Resources Mentioned In This Episode

• ACEP (American College of Emergency Physicians): acep.org
• ACEP Policy on Physician Workforce & Burnout: acep.org/patient-care/policy-statements/
• ACEP 2025 Emergency Physician Compensation Report: acep.org/life-as-a-physician/compensation-report-2025
• Report: The Financialization of Emergency Medicine – Eileen Applebaum, 2021
• CMS Conditions of Participation (Hospital Regulations): cms.gov/regulations-and-guidance
• Offcall Resource on Emergency Medicine Salaries: offcall.com/learn/emergency-medicine-salary-guide

Exclusive for Offcall Members: New Data Reveals How Pay and Work Hours Impact Job Satisfaction and Burnout for Emergency Physicians

Tied to this podcast episode, we are releasing a brand new data set for Emergency Medicine physicians, and making this data available exclusively for Offcall members.

If you haven't signed up for Offcall yet, it's free and you'll get access to our Salary Transparency and Market Benchmark dashboards, along with exclusive members-only content such as the data below.

Based of of thousands of anonymous submissions of salary data from emergency physicians across the country, we wanted to answer a simple yet very important question: How do work hours and salary impact emergency physicians' job satisfaction?

As Dr. Haddock discussed in the episode, there are many reasons for physician burnout, but one thing is clear: employee wellness initiatives and 'pizza parties' are not the panacea to burnout.

Instead, what the data below reveals is two-fold: (1) Physicians who work longer hours are more dissatisfied in their jobs and (2) Physicians who are paid more relative to their expectations are more satisfied in their jobs.

Could a large part of the solution to burnout be among the simplest?

Take a look at the data below.