Tomás, Christian and Rosny interview Michael, an emergency physician and healthcare administrator who founded a major public sector physician union in California. Emphasizing the contrast between public and private legal frameworks, Michael outlines what a union is, the history of unionisation in the US and argues for the advantages of joining one as a physician.
The conversation highlights how physician unions agitate for better working conditions with patient care in mind. The doctors discuss the tensions between professionalism and unionism as well as public perception of unions, citing the Committee of Interns and Residents’ 1970s patient care fund and the 2026 nurses’ strike in New York. They also cover the ethics of strike action and predict growing physician unionization efforts amid the twin economical landscapes of corporate medicine and private equity.
“The meaning of professionalism evolved over the past two centuries, from sacred vocation to secular occupational identity. During the 19th century and most of the 20th centuries, taking up a profession was a socially approved route to middle class status. Samuel Haber puts it this way – a profession in the 18th century was an occupation that a gentleman could take up ‘without demeaning himself and, more wondrously, an occupation that might make someone a gentleman simply by his taking it out’”. – Grace Budrys - When Doctors Join Unions (Cornell University Press, 1997)
This episode was recorded remotely in March 2026. Presented by Christian, Tomás and Rosny. Music by Nylonia. Produced by Ilia Rogatchevski.
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