Should Doctors Unionize? The Story of Why Physicians at Salem Hospital Joined a Union to Take Back Power with Dr. Sean Codier

Key Podcast Moments

• How worsening overcrowding, understaffing, and corporatization left Salem Hospital physicians feeling powerless and why they decided collective action was their only option.
• The surprising reality of physician unions: what they actually do, how they form, and how they’re being used to compel hospital leadership to negotiate.
• The fear tactics and misinformation often used to discourage doctors from organizing and the truth behind myths like “pay leveling” and “third-party interference.”
• The biggest questions and myths about unionization for physicians and what Salem Hospital physicians have seen since they unionized in terms of outcomes.

Dr. Sean Codier is an emergency physician at Salem Hospital and one of the organizers behind the first successful physician union within the Mass General Brigham system. What began as quiet frustration over unsafe staffing and shrinking clinical autonomy grew into a movement to restore the physician voice inside an increasingly corporate healthcare environment. For Sean and his colleagues, unionizing wasn’t about ideology – it was about survival.

On this episode of How I Doctor, Dr. Graham Walker sits down with Sean to understand how Salem physicians successfully organized, what unions offer beyond pay negotiations, and why so many hospitals fight to prevent them. They discuss the myths and fear tactics that often surround physician unions, the personal risks of leading one, and what this growing movement reveals about medicine’s identity crisis between serving corporate goals and serving patients.

Top 4 Takeaways

• Physicians are losing control and unions are one way to take it back.
  Sean describes how corporatization, private equity, and administrative bloat have stripped doctors of decision-making power over patient care. Years of overcrowding, unsafe staffing, and ignored feedback left clinicians feeling powerless. Unionizing wasn’t about politics, it was about restoring a say in how medicine is practiced and protecting the conditions that make safe, ethical care possible.
• The right to negotiate isn’t automatic, but unions do make it legally enforceable.
  While most physicians assume their institutions will listen to reason, Sean explains that hospital leadership often declines or delays any meeting that might challenge the status quo. Under U.S. labor law, a union compels administration to the table. It’s the only legal mechanism that forces those discussions to happen. For many doctors, that leverage is the difference between being heard and being ignored.
• Hospitals use myths and fear to keep physicians from organizing.
  Sean details how administrators spread myths like unions “level pay” across specialties, insert “third parties” between doctors and leadership, or diminish professionalism. These myths, he argues, are designed to protect control, not collaboration.
• Unionization is not just about money.
  Despite the rhetoric, pay wasn’t the top issue for most Salem physicians. What motivated them was the erosion of medicine’s moral core of the ability to do right by patients and communities. Sean believes unions offer a path to reclaim that purpose, ensuring doctors have both the power and protection to advocate for care over profit.

Are you part of a union? We want to hear from you on Offcall

Are you member of a union? We recently added a question to Offcall’s onboarding survey asking whether or not you’re member of a union, so that we can release data showing how joining a union has impacted your job satisfaction, compensation, workload, and job conditions. See a sample for what that looks like here:

Please sign up for an Offcall account (it’s free and anonymous) in order to tell us what your experience has been and so that we can publish data showing how joining a union is impacting physicians nationwide.

Transcript

Graham Walker: Welcome to How I Doctor, where we're bringing joy back to medicine. Today we are tackling one of the most controversial topics in medicine, physician unionization. My guest today is Dr. Sean Codier, an emergency physician with Mass General Brigham, who recently led a successful physician union effort at Salem Hospital where he practices along with his colleagues. That effort represents, I think, a growing trend of employed physicians and resident doctors who are organizing to fight for better compensation and working conditions and reclaim their voice in the workplace. Unionization obviously is not without its critics, so we will use this episode to dive into what pushed Dr. Codier to consider unionizing in the first place. What does unionization actually mean? And where he thinks this movement will go in the future? Dr. Sean Codier, welcome to How I Doctor.

Sean Codier: Thank you for having me. I appreciate the opportunity.

The Healthcare Pressures Driving Physician Unionization

GW: Sean, I've been wanting to talk to you for a while. Maybe just start with, it's October 2025. What trends or pressures in healthcare in your job, in your practice convince you that physician unionization was no longer optional, but necessary?

SC: Boarding, overcrowding, under staffing, working with fewer resources instead of more resources. As corporatization has occurred in medicine, whether we're looking at the private equity world or nonprofit, not-for-profit, academic or private institutions, we are all in some way are experiencing all of the same pressures. And all of the things I just mentioned are things that people can relate to around the country. Part of what I've done since we unionized has been to reach out to groups around the nation, and it's the same story everywhere.

GW: Yeah, it's interesting to hear every time a group unionizes around the country. I think it kind of makes national headlines. Because I have never thought of myself as a physician, as a massive pro-labor, pro-union type of person. I'm not against it, but it just hasn't been, I think the way that traditionally physicians have thought about ourselves as, "We're the boss. We're in charge, we are ultimately responsible." And so, it's really made me think, "Gosh, things must be really bad if even the doctors are starting to talk about, "Should we unionize as well?"

SC: Yeah, I mean, it really requires a paradigm shift on our part that starts with sort of recognizing where we are. But I think there is sort of this shock that we are actually in this place where we have almost no control over our workplace. And you are absolutely right. If you go back 25, 30, 40 years, physicians had a very significant say in how things worked inside a hospital. Emergency physicians were typically in private democratic groups. And they dealt with hospitals in their workplace as a group. It was almost in a sense like we had lots and lots of little tiny unions.

GW: Oh, that's interesting.

SC: It's really how private and independent groups function. They negotiate, they present concerns to administration and ask for things of administration as a group. Non-corporatization has occurred across the board. We all saw the most recent Harvard study that looked at private equity and what the impact of that is. But really these things that are happening in corporate medicine across America, they apply to everybody. And so I think it takes a little bit of getting over the shock of where we actually are, that we are in fact not in charge even of our own domain, even over our own contracts, in order to step forward and take action towards gaining some of that power back. And it's not about a loss of position. I've had people bring up the sanctity of physicianhood and its unionization beneath us and so on and so forth. But in reality, what we're trying to do is just get back to a place where we actually have a say over the patient care that's provided.

What Physicians Really Want: Patient Care Over Compensation

I think it's fascinating to me that when we classically talk about unions, the first thing people think about is really paid compensation. I did a very big portion of our person-to-person recruiting at Salem, so I had well over 200 conversations with physicians. And not a single one of them did they bring up pay as their first concern. It was always about the workplace. It was always about the lack of resources. And the fact that we feel like we are not able to provide the patient care that we feel we should be providing. We have a very rich history in medicine in this country. We have a legacy that we've been born into that says, "We are excellent at this. We're the best at this." And that's the expectation of us, is that we are going to literally provide the best care in the world. And I think a big part of the moral injury that has occurred for us is rooted in the fact that we feel like we're not able to do that. And so, this discussion of unionization and all of that really finds its core and its center as far as an origin, I believe in that loss of power and that inability to provide the care we think we should be providing.

When Unionization Becomes Necessary

GW: And I would imagine that unionization was not your group's immediate first course of action. I would imagine probably for a lot of places it's like the last resort. It's like, "Hey, we've tried to negotiate. We've tried to ask for the things that we think are important for us to deliver that high-quality care you're talking about, that excellent care. And we just are kind of at an impasse. We're not getting anywhere. We don't think we're getting the things that we need and are expected to provide to our patients."

SC: One of the things I tell people about our process, and I think it's important to even unionization once that is in fact your goal as a group, but the process of just re-engaging and looking at what is wrong with our system and how that affects us locally, what's wrong with our local care environment? And starting to talk to our administration, talk to our organization, all of that stuff is an important process leading the unionization. But more importantly, unionization is a very difficult process. It's exceptionally time-consuming, and I'm the first person that knows that. And it's dangerous. Let's be real about it. Organizations do not react well to it. I'm also a great example of that, because I've clearly been a target for my organization, which is upsetting on some levels that we can maybe discuss later. But because I really think it sort of illustrates how far we've come from where we should be in the mission of what we do as medical care providers.

Understanding Union Benefits: Legal Standing and Mandatory Negotiations

GW: What are the pros and cons, the risks and benefits like we all talk about in medicine every day? What does a union bring that existing structures don't, or didn't in your case?

SC: I'll give you sort of a brief history of our institution. So, it's a 300-bed community hospital. It's in a very urban type environment. Even though we are a suburb of Boston, we have a huge immigrant population. We have inner city problems, we have over boarding, et cetera, et cetera. So, I spent the first part of my career in the military. Once I got out of the military I joined my group here in Salem in 2018, and I was actually one of the first employees that was hired as a pure hospital employee from the independent group. So, we had just made that transition. The hospital was still trying to figure out how to assimilate these groups into the hospital. And so they negotiated our first contract with us. In the years that followed we made attempts to, I should say, I didn't, this was actually some of my colleagues that have been there for much longer. They put a lot of effort into trying to talk to our administration, trying to negotiate a contract, trying to have input into how our workplace works. And point after point they just met a lot of difficulty doing that. COVID hit, and that of course really changed the environment for all of us, but things did not get it better for us through that. We did not find ourselves getting more resources. We in fact saw resources be dropped off through that time period, which was really depressing to watch. As we came out of COVID we realized we need to start speaking up. There was some early reference to unionization sort of in comments like, "Oh, we should just unionize." We recognized how much effort was going to be put into that, how little it had been done up to that point, and how difficult it is to really chart a new path, so to speak. So, we put a lot of effort into trying to work out our issues with our administration in any way possible, all the way up to the point of dropping cards and announcing that we wanted a union vote. So, it's a process, but I tell groups the same thing like, "You must go to your administration first. If there's a way to solve your problems before it gets to that point, you should engage those efforts." But really at the end of the day it's all useful work in terms of unionization, because it's a chance for your staff to rally around each other. It's a chance for staff to talk to each other about these problems. I mean, it's amazing how the interest specialty fights and perceived competition or lack of goodwill just goes away entirely once you start sitting down in rooms together and talking about the problems you share in common. And then once you reach the point where you have to unionize, you've had all of these discussions. You know exactly what you want and what's wrong with your care environment and what things need to be addressed.

Cross-Specialty Collaboration: Finding Common Ground in Shared Problems

GW: Interesting. So, the surgeons are hearing from the ER doctors about why boarding is so bad, and the ER docs are hearing from the surgeons about why OR rooms are too slow or not getting staffed or not turned around or something like that. Is that the idea that you're both finally sharing the pain points that you've both been frustratingly quietly dealing with just as your own specialty?

SC: Absolutely. Yeah. I mean, we all have individual manifestations of the same problems, but my lack of staffing at that time was also their lack of staffing. Their lack of OR availability, their lack of subspecialty care access. I mean, we all share the same patients with the same problems. They just access different things from each of our departments, but it turns out the root cost is the same.

The Power of Union Leverage: Forcing Mandatory Discussions

GW: So Sean, the ER docs and the surgeons could have gone to the administration without a union and said, "Hey, here are our problems." But what does the union structure itself give you in terms of leverage and negotiating power that you wouldn't have had otherwise?

SC: As a group for cross specialties, in fact, more specialties that are even included in our bargaining unit, and the surgeons are not in our bargaining units. They actually belong to the larger organization. They're more closely tied to MGH itself. But-

GW: Oh, interesting.

SC: We approached our administration with those pain points. We actually presented letters of concern to our board of trustees, our administration. We made attempts to meet with them and discuss these issues. The fundamental thing that a union gives any group of laborers is sort of the legal standing to force those discussion. What we're seeing across the country, across organizations of all varieties is a lack of desire to even talk to the practitioners that are providing the bedside care.

GW: Got it. So, they just decline the meeting, or they push it off, or they say, "Yeah, we don't really want to talk. There's nothing to talk about here." And you're saying the union makes those mandatory negotiations that those discussions have to come up?

SC: Absolutely, yeah. I mean, it's either we don't want to talk about it or my favorite, the acknowledge and roll over. But as far as actually taking action, we realized that unless there was some kind of leverage that would force those discussions and actually require administration to negotiate with us about these things. Really the only legal lever you have to pull on is unionizing in this Country.

The Real Costs of Unionization: Time, Leadership Risks, and Negotiations

GW: Sean, let me give you the opposite. Because honestly, this podcast is, I'm just kind of curious, I'm learning so much from you. What are the downsides to being in a union? What are the costs of deciding this? You mentioned all the time, the time and the investment to do that whole labor organizing process, but are there other downsides that you expected or didn't expect now that you're in a union?

SC: When you become a leader of a union project, especially inside a big organization, you anticipate that you're going to face personal backlash. Now, for public institutions that organize under state law, that state law tends to replicate the National Labor Relations Act. There are provisions, whether at the NLRA or state level that protect workers like me legally against retribution, things like that. However, you still anticipate that you're going to face that backlash, and so leadership is exposed to that and should expect that. For normal rank and file members of a union drive, you're looking at a prolonged period of time, which is a lot of negotiations, a lot of legal footwork, things like that. And during that time your pay may not change, your benefits may not change. You may have to deal with bad behavior towards those things on the part of an organization. I mean, these are all possibilities. So it's not ... And I think we come into any activity like this and sort of expect the final outcome to be universally beneficial and optimal as an outcome. It turns out with any negotiated process, it's never how real life works.

GW: Go figure.

SC: So, I mean, entering into any process like that, it's important that you have an appropriate mindset that, "I'm going to start to make progress here. That's my goal. I'm going to start to make headway and make some gains and hope to continue that process by continuing to be engaged as a physician and as a physician group."

Choosing the Right Union

GW: What are the biggest fears you heard from people when they were deciding if they wanted to ... I think they sign a card or they sign on that they say they want to want to join this unionization effort. Is that how it works?

SC: Usually it starts with a group of individuals who have identified a problem and started to engage it. We had several dozen physicians that were involved in that process across specialties prior to entering the point where we unionized. But after trying those things and not meeting success, you decide, "Okay, we're going to start talking to union." We started working with one group, ultimately ended up going with AFSCME, which is American Federation of State County and Municipal Employees, primarily because they had a very robust local service. They have a very large group unionized here.

GW: So, you pick the union that you want to join, essentially? Is that what you're saying?

SC: Yeah, so I describe it as an interview process. I try to explain to physicians, "The best way for us to look at a large union, an AFL-TIO, an AFSCME, a Doctors Council, UAPD, is really to look at them as service providers. And so, you should enter into this exploration about who I want to represent my union, but you really have to engage that interview process, so to speak, looking at what you want out of that service provider. For us, we were looking for unity and mission. We were getting that out of AFSCME. We were looking for robust resources locally, especially given the size and margins of our institution, and AFSCME provided all of those things. But each group really should engage multiple unions and look at what they have to bring to the table locally. Because your union is going to be local to where you are. My union is local to Salem, Massachusetts, so I need people that understand my organization, my local politicians, my environment, and I got to be honest, it doesn't hurt that they receive care from us. So, they actually care about the mission, which maybe I'm a little pessimistic by nature, but I didn't expect that. Them to really latch onto the idea that what we do as a community service, we protect the community. That's all calculus that goes into how you try and pick a union.

Union Dues Explained

GW: So we'll fast-forward just for a minute through all the ups and downs and stressors you've had of joining the union. What changes for me if I'm now a physician in the union? I think I pay a union due, and then what do I get? What do I give as a new member of a union?

SC: I was actually surprised that we've had as much conversation about union dues as we did.

GW: I think that's the one thing that doctors know. I think doctors work with a lot of other people in our healthcare system who are already in a union, so I know very little, but I know one of the things is like, "Oh, part of your paycheck is union dues."

SC: It turns out that unions are an interesting creature in this country, and there is a huge mosaic in how they operate. And one of the most fascinating pieces of that is dues. So, there's a great variety to ways in which dues are charged. Some unions charge a percentage of your salary, which for physicians becomes a little bit of a point of contention because of the variety to our salaries.

GW: Yeah, sure.

SC: Most of the unions charge some kind of flat fee. AFSCME just historically has always been remarkably effective economically, so our union fees are exceptionally low. I think the last, I believe the last fee was $56 per month. Don't quote me on that, but it's been between 40 and $50 per month, which most of us spend more on DoorDash every month.

GW: Yeah, sure.

SC: But regardless of which union you go with and how much you're spending, and I've got to be honest, even at this early stage of things any price is worth what AFSCME has provided us.

GW: You're a happy customer essentially?

SC: Especially since it's a tradition within unions in the U.S. They do not charge union dues until you have your first contract.

GW: Oh, interesting.

SC: So AFSCME has represented us for about two years, and we have not paid a single dime to the organization, despite the use of hundreds and hundreds of man-hours of legal services.

The Unionization Process Step-by-Step

GW: So Sean, tell me, because I really, I am learning here, so if you don't have a contract yet, what does that mean? You're obviously working, you're in between shifts right now.

SC: That's true.

GW: So, does that mean the union hasn't taken effect, or what does that mean until you get your first contract?

SC: Getting back to the basic process, so once you have decided that you are unsuccessful in your attempts to solve this at the lowest level and that your group needs to unionize, you'll drop what are called union interest cards. So, every member signs this card that says, "I'm interested in discussing a union."

GW: It's literally a physical card.

SC: It is. For the most part it's an electronic card these days. There are social unions that are using paper cards, but regardless, it's a card that you're supposed to sign that would essentially be sort of like a ballot. It's not a ballot, but basically what it is, it's a card that the union receives so that it can pool all of the people that are in a community of interest, which is the noun that discusses who is actually trying to unionize at this point. And they collect all those cards and they present this collection of cards to the National Labor Relations Board or the State Board, and they say, "Look, we've got, as far as we can tell, 150 members that would qualify to unionize in this group, this collective interest, and 90 of them have signed cards," which there's a minimum threshold that's 30% if you're under NLRB. You have to have 30% of your members that are actually interested in unionizing sign those cards. In reality, unions are focused on actually knowing what the outcome is going to be before they commit all of those resources essentially for free. And as a union organizer, you actually want that as well. You want to know you're going to be successful before you really step out there. So typically, unions are asking for 70% of the people who would qualify in a group of interest to actually sign those cards. Once the National Labor Relations Board or the State Board receives those, they send a letter to the organization saying, "Hey, your employees would like to unionize." They have the opportunity to respond. There is a mechanism. We tried this mechanism to have them just accept it based on overwhelming numbers. It turns out, despite that big organizations don't even go down that road. So, what ends up with their response that, "We reject this," the board will then schedule an election. There's this period between signing union cards and an actual union election where the organization can campaign against the union. You continue your efforts to campaign for the union, and then you get to your vote day where everybody who's in that agreed upon community of interest gets to vote.

GW: And that vote day is three months afterwards, six months, 90 days. Was this a year? What's the general timeframe?

SC: It can be as soon as three weeks. I think ours took about six weeks, if I remember correctly.

GW: Okay.

SC: Been so long, but yeah, it's a period of a few weeks, which it's a painful few weeks. It's a lot of captive session meetings with administration. It's a lot of active work trying to reassure people, and it's the introduction of a contentious environment, so it's a little bit rush.

Hospital Administration Arguments Against Unionization

GW: Of course. Yeah, I could certainly feel that being uncomfortable being in mandatory meetings that your employer has said you must attend and stuff like that. Sean, I'm just curious from your hospital's administration side, and obviously you're not speaking for them, but what were the arguments that they made against the union in those meetings?

SC: There's perpetuation of a lot of myths, things that are designed to inspire fear. There will be a rumor started that it's a pay leveling action. So, your pediatricians and your hospitals and your lowly emergency room doctors are going to try to take pay from people in higher specialties, that somehow everyone's going to end up with the same salary. That there's a finite pool of money, and therefore if your hospitalists get a raise, then your surgeons are going to lose some of their money. None of that stuff is actually true and never going to be the goal of a group of physicians working together. There is sort of this discussion about whether we are beneath the unions as professionals. And then the biggest one that was asserted for us at least, was that it inserts a third party into a process that should be physician and administration. And I found that very interesting, because it demonstrated a real lack of perception about the relationship as it existed. It was a failure to recognize that we had been four years understanding, feeling, and seeing that administration was not interested in talking to us, was not interested in the input of the bedside clinician, and had really devalued us. So, somehow to try to assert over the top of that, that a third party was going to harm a relationship we thought was already fully harmed, I thought just really was short sighted.

GW: It sounds like maybe not the, for listeners that maybe are looking at physician, their physicians trying to unionize, maybe don't take that as one of your key arguments.

SC: Right. But what I tell people and what I told my members is, remember that we are in fact the union. The union is not AFSCME, it's not counsel-mind [inaudible 00:28:33], it's the Salem Physicians Union. The union doesn't dictate things down to us. They provide us guidelines within the law, but as far as what we're looking to accomplish, they're actually there to back us up. They're there to help us negotiate our contract. It's not an AFSCME contract, it's a Salem physicians contract. So that was a big argument for them that fell very flatly because we had just engaged in this process where we had become the group that was the Salem Physicians Union.

Understanding Union Contracts

GW: Yeah. Sean, let me get back to that question about the contract. So, you're still working, but you guys don't have a union contract. What does that mean? Explain it like I'm five.

SC: So, there's a period in which a lot of research is done. There's a lot of discovery. That's an evidentiary term, but basically where the organization has to be forthcoming about contracts and provide you documentation of compensation, comps, things like that. The two structures sort of start to begin to get into the negotiation milieu. And then you eventually enter main table negotiation. That, especially with a first contract, is a long process, and the success of that is largely based on how the organization responds to the union in general. I'm just going to be very real. Mass General Brigham has not responded well to not just our union, but any of the unions within the organization. Nationwide, we followed how the house staff had gone through their negotiation process.

GW: Yeah, because the residents at Mass General and the Brigham are unionized already, right? Is that correct?

SC: Yes. So they were on a very long negotiation process that was just littered with difficulty. And it was clear the organization was not really interested in the process. We've seen the same thing occur with the downtown primary care group who's organized with doctor's counsel, and we see that very clearly at Salem. We have now been a union for a year and a half, and we are still at the very beginning of our negotiation process. And we continue to see a real reticence to actually deal with the issues on the part of the administration. So we're working hard to get to that point, but it's going to take time, especially with the larger organizations that have a large administrative staff that really perceive unions as a threat. They perceive it as something they're going to lose control of. And so it's going to take time and it's going to take more or less doing it in order to get to a place where this is a little more normalized. One of the things that I always point out is when we started our process, there were only 19 physician unions in the United States. There were at that time several groups that like us were working towards unionization, but these groups were the first groups in a couple of decades really. Most of those original 19 units were from the '70s and '80s. So, when we started our process, it was exceptionally new. It now over the past few years has made a lot more news and a lot more groups have been engaged in the process, but it's going to take time, and it's going to take time for us to complete our negotiation just because the organization's going to have to get used to that new reality.

GW: Sean, do you have a sense how many unions there are now nationwide for residents and attendings, or how many physicians are in unions now in 2025?

SC: So I don't actually have an up-to-date number because it has exploded so much. I got to be honest with you, I can't even keep track of all the groups that I talked to.

GW: Oh, I'm sure. Yeah.

SC: This has become a part-time job for me. And most of these groups, the vast majority of the groups that are organizing right now, they're still doing so in secrecy because they're in that early phase of the process, and it takes time and a lot of effort. I think what we're going to see over the next year especially is an explosion in the number of groups that become public.

What Gets Negotiated: From Benefits to Working Conditions

GW: You mentioned the negotiations. What does that actually look like? What is the thing that when you guys sit at that table, what types of things can you ask for?

SC: So, there's a whole lightning of things that can be asked for in a union contract. The first part of a main table, first contract negotiation are sort of the nuts and bolts, the basic things that make up the structure of the union itself, and sort of the basic things that cover. For us, I think it's up to seven specialties. The very first thing you do are things like the commonalities among all specialties, what our healthcare plan looks like.

GW: Yeah, benefits. Yeah, yeah.

SC: Exactly. Our you retirements, FMLA, maternity, paternity leave. We are very early in that process. We are still discussing who actually is in the union. You start with your community of interest during the campaign and the voting process, but in order to start a first contract you have to have an agreement between the NRB, the union, and the organization itself about who is actually in the union. So, that's ratified and codified in the contract itself. But later on you do get into, what are the things that concern us as a group of employees in the emergency department about our department and how would we address it?

Physician Unions Supporting Each Other

GW: Yeah, I love that. At Offcall we're going to be compiling a comprehensive data set to look specifically at unionization for a couple of reasons. One, like you said, it's growing. Two, I don't think there is a ton of information, and certainly a lot of the groups that are maybe thinking about are doing it privately and quietly. How do you think some transparency about who is in union or who's even thinking about a union might help just discussions for physicians in general?

SC: Well, so groups that are engaged early in the process, they have to maintain their secrecy in order to guarantee success. And a lot of that has to do with the inherent dangers of your organization reaching back to you. So, it's been difficult early on, because we were also questioned and not talking to each other. But as these groups have been successful, we've started to coalesce and talk to each other. We have about four or five different unions currently in the Boston Metro area, and we all talk to each other all the time now, because we're now out and fully public. We discuss our problems across multiple organizations, including mine. And we share information and we support each other, and that's a huge deal. Getting to that point, you feel like you're alone up to that point that you go public, and then you start finding allies that have gone before you or going forward at the same time. And we're starting to get to that critical mass where there's a lot more support out there, a lot more people like me who are willing to talk about this and help other groups out.

Hospital Leadership Perspective

GW: Yeah, I mean, Sean, thank you so much for, as you said, your part-time job just doing this, explaining to me. I mean, I've learned a ton. To anybody listening, if you're in a union, you can make an account on Offcall, answer some anonymous questions about your experience so that we can build more, "Are you in a union?" questions into our data set. Sean, I guess my last question for you, say the whatever, the CEO of MGB or whoever it is, say they want to come on the podcast and talk with me next, what do you think they would say, their thoughts about unionization? Why is it bad for their organization? What would be their talking points?

SC: I mean, I can tell you what they presented us during our captive audience sessions during the campaign. But as far as predicting what they would say now, I actually have no idea. I have had a total of zero discussions with our hospital president. I've been, and we as a leadership group have been rebuffed by our board, and our administration at higher up at the MGB level will not even talk to us. So, I got to be honest, I have no access to what their thoughts are on this process, except what seems to be apparent coming through their lawyers. I believe in my heart that most of us really want what's best for the people that we protect and we serve. And I have that expectation of our administrators. And so, when I see a reaction of an organization like MGB that has such a rich history of medicine in our country, it's just disappointing that we don't seem to share that in common. And I wish we did, because an organization like MGB is so powerful, and at such large as that they have the ability to affect how things go in medicine in this country. They have a physician to say something, but instead, we seem to be as an organization unified around corporate goals and the bottom line. And that statement may come back to bite me in some way, shape, or form. But the truth needs to be said, and that's what providers feel. And I have that expressed to me by providers all over this country who work for all different organizations. And the commonality is that we seem to have rallied around corporation as opposed to the provision of medicine to our communities.

Resources and Contact Information for Physician Unionization

GW: I think that is perfectly said. Sean, thank you so much for joining us today. Sean, where can people find you, reach out to you if they have questions?

SC: So, our union has its own website, which one of my colleagues took up the mantle to be our web designer and do our technology, and she has done a great job with it. There's a lot of frequently asked questions. There's a full description of the process, what we do and why we did it as physicians.

GW: Oh, great.

SC: There are multiple points of contact for my leadership. Maybe we can put my email address in the show notes.

GW: Sure. Yeah. Happy to. And Sean what's the website?

SC: salemphysiciansunion.org.

GW: .org, perfect. Dr. Sean Codier, thank you so much for joining me today. I've learned a ton about unions and unionization and just the physician perspective on negotiating to help support our colleagues and our patients as well, and our communities.

SC: Absolutely. It's my pleasure, and thank you so much.

GW: Thanks for joining me today for interviews with Physicians Creating Meaningful Change, check out offcall.com/podcast. You can find How I Doctor on Apple, Spotify, or wherever you listen to podcasts. We'll have new episodes weekly. This has been and continues to be. Dr. Graham Walker. Stay well, stay inspired and practice with purpose.