WASHINGTON April 28, 2025—Patients and physicians’ frustration with the U.S. health care system has been growing in recent years, leading to physicians exploring collective action as a means of improving the health care environment says the American College of Physicians (ACP). In a new policy paper published today in Annals of Internal Medicine, Empowering Physicians Through Collective Action: A Position Paper from the American College of Physicians, ACP is offering recommendations about how physicians can become effective advocates for their patients and their profession through collective action.
“In recent years physicians have shifted away from independent practice and towards employment, while at the same time physician burnout has increased dramatically,” said Jason M. Goldman, MD, FACP, president, ACP. “There is substantial labor organization activity in the health care sector, and interest in unionization is growing among physicians, particularly among physicians in training.”
ACP’s new policy paper details what the goals of collective action should be and how physicians and health systems should approach action. The recommendations start by stating that the primary objective of collective empowerment actions by physicians should be to ensure that patients have access to safe, affordable, high-quality care. The paper goes on to say that practicing physicians must be included in executive positions and on the boards of hospitals and health systems, and that they must have means to collaborate with hospital and health systems leaders.
ACP supports the rights of physicians to engage in protected concerted activity to amplify concerns about health and safety, working conditions, and other issues without retaliation or penalties from their employer. ACP also supports the right of physicians to engage in responsible collective bargaining, including joining a union or bargaining unit. Actions like a refusal to perform administrative requirements, billing duties, or concerted refusals to work should only be considered once all other negotiating tactics have been exhausted, and efforts have been made by all involved parties to ensure safe patient care. Finally, ACP reaffirms that independently practicing physicians should have the right to negotiate jointly with health insurance plans over terms that affect the quality of, and access to, patient care, including payment and administrative policies that adversely affect access and quality.
“We need to ensure that physicians are supported and empowered so that they are able to continue to deliver high quality care to their patients,” concluded Dr. Goldman. “Physicians should use every tool available to them, including advocacy, the reinvigorated organized medical staff, and responsible collective bargaining, to fix the broken health care system.”
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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 172 countries worldwide. ACP membership includes 161,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on X, Facebook, Instagram, Threads and LinkedIn.
Contact: Jacquelyn Blaser, (202) 261-4572, jblaser@acponline.org