The National Labor Relations Board dealt an unequivocal victory to primary care doctors seeking to unionize at Mass General Brigham, ruling that the proposed bargaining unit of about 400 physicians can proceed with an election next month.
The health system, the state’s largest, had tried to pare down the size of the bargaining unit vying to join the Doctors Council. In December, lawyers for MGB argued before the National Labor Relations Board that 18 of the 29 locations in the proposed bargaining unit were actually part of MGB’s acute-care hospitals, rendering those doctors ineligible to join the primary care physicians unit with the rest of their colleagues.
But in its Friday ruling, the NLRB came down on the side of the clinicians. It found that most of the contested locations — spanning practices from Downtown Boston to Revere to Norwood — were not part of acute-care hospitals and therefore should be represented in the bargaining unit. The board also found that a handful of facilities adjoining MGB’s acute-care hospitals were eligible to be included under “extraordinary circumstances.”
If the NLRB had sided with the health system, the bargaining unit would have shrunk to about 100 physicians, said Gabrielle Hanley, a lead organizer with the Doctors Council, a New York-based union that is an affiliate of the Service Employees International Union.
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In her ruling, NLRB regional director Laura A. Sacks also set a date for a union election. Ballots are due to be sent to doctors May 6, and will be counted at the end of the month.
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“We’re thrilled that the Labor Board basically sided with everything that we asked for,” said Michael Barnett, a primary care doctor affiliated with Brigham and Women’s Hospital. “It does make me disappointed that MGB went forward with this objection, when really it was just about delaying the process, because their arguments were very weak to begin with.”
The organizing physicians are seeking stronger pay, staffing, and resources to support their mounting workloads and to reduce turnover, Barnett said. They also want more of a say in how the system operates.
”We deserve a seat at the table for decisions that affect our clinics and our work-life balance and our patients,” he said.
In a statement, an MGB spokesperson said the health system was “reviewing the NLRB’s decision,” and reiterated previous comments in regards to the doctors’ union drive, which began in November.
“We know that [primary care physicians] across the Commonwealth are facing unprecedented volume and stress as a result of a confluence of factors that are not unique to our organization,” the spokesperson said. “We share the common goal of offering world-class, comprehensive care for our patients and believe we can achieve this best by working together in direct partnership, rather than through representatives in a process that can lead to conflict and potentially risk the continuity of patient care.”
Hanley, the Doctors Council organizer, said in an email that MGB “can still appeal the decision,” but in all likelihood the election will “occur as ruled.”
The move is the latest organizing effort to emerge from the Mass General Brigham system. Last year, more than 100 physicians at MGB’s Salem Hospital voted to unionize, following residents and fellows throughout the system doing the same in 2023. Unionization is on the rise at hospitals across the region, from clinicians at Cambridge Health Alliance to resident physicians and fellows at Brown University Health in Rhode Island.
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The unionization comes at a time of flux for Mass General Brigham. The system, which has a workforce of more than 82,000, is coming off its largest-ever batch of layoffs, letting go of hundreds of employees in a bid to save at least $200 million annually as it girds itself for a gloomier financial picture. When the system announced the layoffs in February, an official said MGB expects to see “a projected budget gap of a quarter of a billion dollars within the next two years.”
The cuts focused on administrative and managerial roles in the system, though some patient-involved staffers were among those who lost their jobs.
MGB’s hospitals have also lost millions in research grants under Trump administration funding cuts in recent weeks — though Mass General Hospital and Brigham and Women’s, both teaching hospitals of Harvard University, have so far sidestepped the federal funding freeze hitting the Cambridge school since it refused to comply with a list of demands from President Trump’s antisemitism task force.
Meanwhile, MGB is also in the midst of integrating the clinical operations of its two flagship hospitals, Mass General and Brigham and Women’s, and is investing $400 million to launch a new cancer institute ahead of its divorce with longtime oncology partner Dana-Farber Cancer Institute in 2028.
Dana Gerber can be reached at dana.gerber@globe.com. Follow her @danagerber6.
