250 Health Care Workers File for Union Recognition Across Legacy Health Systems


Workers would join the Pacific Northwest Hospital Medicine Association, and add to the considerable union activity sweeping Oregon’s healthcare sector.

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Approximately 250 doctors, nurses, and physician assistants at all eight Legacy Health hospitals across Oregon and Washington filed union authorization cards with the National Labor Relations Board last week, per a press release from the Oregon Nurses Association.

“Legacy Health has received a petition for representation from the Pacific Northwest Hospital Medicine Association on behalf of hospital-based providers,” said a statement from Legacy issued Monday morning. “We respect our providers’ rights to determine union representation through processes overseen by the National Labor Relations Board.”

Eduardo Serpa tells Oregon Business that when he began working as an internal medicine doctor at Legacy Salmon Creek Medical Center four years ago, Legacy administrators were better about listening to workers’ concerns.



Now that’s changed, says Serpa, who spoke with OB in his capacity as a member of the PNHMA, which already represents hospitalists in Sacred Heart Medical Center in Springfield and which is serviced by the Oregon Nurses Association.

“There has always been great collaboration historically, between the providers and the administrators [at Legacy], and I always felt like our voice was heard. Over the last few years, though, we’ve seen more unilateral decision-making out of the administration and changes to how we deliver care,” Serpa says. “One of the biggest concerns as health care providers, when we work these seven-day stretches, is keeping away burnout. I think the pandemic really showed us that the priorities we had of putting patients first, the hospital second, and ourselves third, is just not a sustainable practice.”

The news comes on the heels of a merger announcement between Legacy and Oregon Health and Science University, which was a point of contention during the negotiations with the Oregon Nurses Association. ONA members voted to authorize a strike against the healthcare system before reaching a tentative agreement last week.



Serpa says the news that Legacy, which posted $172 million in losses in its 2023 fiscal year,  was being purchased wasn’t a surprise to him or many of the people he works with, but that maintaining bargaining power is increasingly important to providers moving forward. 

“Any change that might be perceived from being acquired by OHSU, we want to be a considerable part of that discussion and really pursue that equity through deliberation as a union,” Serpa says.

The health care providers will meet in the coming weeks to confirm details and schedule an election date. If approved, they will join nearly 700 Legacy nurses and mental and behavioral health professionals represented by the ONA, which has more than 16,000 members across the state.



Kevin Mealy, communications manager for ONA, says that the NLRB has been approving unions more quickly in recent years, and says the organization could return the decision in a matter of weeks.

The filing follows a flurry of union activity across the state, notably in the health care sector  – including strikes at Providence Health Systems in Portland and Seaside this summer and a strike authorization vote at Oregon Health and Science University in September. In July, 57 employees at Legacy’s Unity Center for Behavioral Health in Portland filed for union recognition with the National Labor Relations Board, voicing concerns about staffing and safety.

Last year 15 health care providers — including doctors and nurse practitioners — at four Eugene-area clinics announced plans to file for union recognition in partnership with the PNHMA. It’s unclear how many Oregon doctors belong to a union, but PNHMA says it has 200,000 members nationwide, and ONA says U.S. physicians are increasingly drawn to unions as “health care systems have become larger and more corporate.”



Mealy says the growth in union activity among Oregon health care workers is part of a larger movement of organizing around the country. He says President Biden’s visit to Michigan to stand with workers striking against the big three automakers last week was a sign of increasing momentum for the labor movement, and that Oregon workers are setting an example for the rest of country.

“I do think this is a historic moment. ‘Historic’ is an often overuse term, especially these days, but seeing elected officials stand together with active unions is a crystallizing moment in this growth of union activity that we’ve seen over the past few years, and certainly healthcare workers are leading the way in Oregon and across the country,” Mealy says. “We’ve seen renewed healthcare organizing and different types of professions that haven’t traditionally been union-profession positions. And it goes the other direction, too. We’re seeing Starbucks workers organize. I think there’s a new wave of unionism coming because people see a union as a way they can have a voice at work, and make work better for them, and for the people they serve.”