Doctors have long organized to promote the science and art of medicine, protect the public’s health and advance social justice. They are concerned about the quality of their work environment, which has deteriorated significantly. They are also increasingly dissatisfied with the status quo. These conditions have created an original moment in history that may lead them to organize differently. One path is unionization.
Organizing medical professionals is a challenging endeavor. Physicians are highly educated and motivated to excel, often pursuing advanced degrees while working full-time. They are in a dual-career situation with significant family and personal responsibilities. They are prone to perfectionism and self-criticism. They are also susceptible to burnout. As a result, many physician organizations are struggling to meet the needs of their members.
A new generation of leaders in healthcare is emerging, recognizing that they need to change how their institutions operate if they want to improve clinical outcomes and patient satisfaction. These leaders are using performance measurement as a tool to motivate their teams and drive improvements. They are replacing traditional leadership styles that seek to buy time and fend off change or maximize revenue under the current payment system while they can, with approaches that focus on advancing clinician well-being.
Physicians are increasingly working in teams with nurses and other providers. Some of these teams are incredibly effective. Others are less so. One example is the case of a widow who complained that her husband’s six-week stay in intensive care was a disaster because her physicians were not communicating with each other. Developing teamwork requires a shift in the way doctors think about their roles and responsibilities, including changing how they view themselves as heroic lone healers.
It also means rethinking their relationships with patients and other colleagues, and learning to be vulnerable and support one another. Physicians are beginning to recognize that they have an Achilles heel in terms of perfectionism and self-criticism. They have also started to realize that they can’t do it alone. They need to have a community of people who are willing to share their stories, provide mutual support and offer feedback. They need to learn how to support one another and to recognize the value of diverse perspectives, especially when it comes to health care.
We have been exploring the international experience of doctor organization, looking at the ways in which medical professional groups are structured in the EU-15 countries, Japan and the United States. There are several axes that can be used to analyze these groups, such as their legal status (public law corporations or independent professional associations) and the way in which they register their members (centralized, indirect or delegated).
Our research has shown that there are commonalities among the most successful medical organizations, regardless of whether they are public law corporations, federations or independent professional associations. We have identified three recurring themes that have emerged from this analysis: the importance of creating and maintaining a strong relationship with members, the need for organizations to recognize their vulnerability, and the importance of focusing on wellness rather than just promoting antiracism and addressing threats and systems factors that undermine diversity, equity and inclusion.