Doctors are a powerful group in our society, and their organizations have long been able to wield substantial influence on the decisions of our elected officials and regulatory agencies. However, doctors have rarely organized themselves to speak out against injustice, even in the face of appalling working conditions and the deteriorating doctor-patient relationship. It may be time for them to do so.

In recent years, it’s become common for large physician organizations to create policies that promote their members’ interests. These policies are often crafted by physicians who have been in the profession for decades, and they tend to focus on areas like improving quality, reducing costs, and developing new technology. These initiatives are often well-intentioned, but they have a tendency to exclude those who are just beginning their careers, which limits their impact.

It’s important for trainees and early career physicians to join these organizations so that their voices can be heard. This will ensure that the future of medicine is represented, and will prevent a major shift in policy when these older doctors retire and leave their positions.

Recently, an article in The New York Times highlighted the fact that doctors are increasingly joining unions, with nearly two-thirds of US doctors now employed by hospitals or health systems. This trend may be especially significant because it is occurring at a time when the overwhelming majority of doctors have seen their employment status shift from independent practitioner to employee.

This is a remarkable development given the long history of anti-union sentiment among doctors, who have traditionally been barred from unionizing by laws based on their status as employees and the legal prohibition against advancing their economic interests through collective action. The New York Times piece highlights one of the most important developments in this area: a doctor organization that successfully won an election to represent physicians working for Allina Health, a multibillion-dollar health system in Minnesota.

In the past, unionization has been viewed by many as a betrayal of medical professionalism. But in this new era, where doctors have seen their working conditions deteriorate to the point of despair, and with burnout rates rising, it may be time for them to organize.

If doctors were to unionize, they would likely form an organization with a very different mission from its forebears: instead of protecting the economic interests of its membership, it would prioritize patients’ interests. It would call out anti-vaccine advocates, challenge predatory drug pricing and direct-to-consumer advertising, decry climate change’s threats to health, denounce false health claims by celebrities like Gwyneth Paltrow and Mehmet Oz, and work to expose the underlying conflicts of interest that undermine public trust in their field.

Studies show that a physician leader brings a unique set of skills to an organization. Falcone and Satiani state that ‘doctor CEOs and board directors bring a more clinical mindset to business problems and can help rebalance the agendas of healthcare organizations from being captured by overly narrow financial objectives’ (Citation: 2008). A doctor-led organization could have a profound impact on the quality of care delivered in the world today.