6 ways to respond if your practice staff start organizing

Union activity in health care picked up fast in early 2026. Becker's Physician Leadership counted at least 17 organizing petitions, strikes and contract developments in a single month, and advanced practice providers at Mass General Brigham's Cancer Institute filed to unionize among them. The trend is not confined to hospital systems either. Primary care doctors, nurse practitioners and physician assistants at Cleveland's MetroHealth voted to unionize this spring over scheduling and staffing concerns that will sound familiar to any independent practice administrator.

The pressure driving these campaigns hits smaller practices too. The 2026 MGMA DataDive Management and Staff Compensation Report found medical assistant hiring remains the toughest staffing problem practices face, and wage compression means a staffer with 20 years of experience often earns barely more than a new hire. Add chronic understaffing and long hours, and the ingredients for organizing exist well outside the hospital sector.

None of this means a union drive is inevitable at your practice. But administrators who wait until a petition arrives to think about labor relations are already behind. Here are six places to start.