I’m a Mass General primary care doctor. And I need a union.
Leading the fight for fair and decent working conditions for primary care doctors
Hi All,
I'm just back from Australia. I was speaking at the United in Compassion Medical Cannabis Conference in Brisbane. Australia was awesome! Liz and I went to rainforests, snorkeled with turtles on a lonely island in the Great Barrier Reef, hung out with kangaroos, and saw Koalas. We even got to see and meet the famous band down there named after my dad (see above)
On the homefront, I am helping lead the fight for fair and decent working conditions for primary care doctors, so that we don't continue to go extinct. It is almost impossible to find a primary care doctor these days because we are dropping like flies due to burnout and mistreatment.
Please check out my recent op-ed in the Boston Globe below.
OPINION
I’m a Mass General primary care doctor. And I need a union.
A union could address a host of issues, including cost-of-living raises, paid sick time, and a definition of ‘full-time work’ that isn’t 80 to 100 hours a week.
By Peter Grinspoon March 3, 2025
Peter Grinspoon is a primary care physician at Massachusetts General Hospital.
In the Boston area, many physicians are unionizing for the first time.
Joining a growing wave across the United States, doctors at Beth Israel Deaconess Medical Center, Cambridge Health Alliance, and Salem Hospital, part of Mass General Brigham, all took steps to unionize in the past year.
I and nearly 300 other beleaguered primary care physicians at Mass General Brigham also filed to unionize last November. That’s most of the primary care doctors employed by Massachusetts General Hospital and Brigham and Women’s Hospital.
The move was immediately followed by MGB taking away a proposed pay increase for primary care doctors. MGB has since hired Littler Mendelson, an aggressive union-busting law firm, to defeat the effort, or at least drag it out as long as possible.
So much for the collegial world of academic medicine.
Why is this happening? What has become so intolerable about being a physician, and particularly a primary care physician, that many doctors are taking such a step — even at such a prestigious system of Harvard teaching hospitals?
I’ve been a primary care doctor for a quarter century; working conditions now are the most dire they have been in my career. It is well documented that a majority of us are suffering from burnout. One recent study demonstrated that it would take 26.7 hours a day for a primary care doctor to get all of his or her work done.
That burnout, the “moral injury” of not being able to adequately care for patients, the many added responsibilities, the declining salaries relative to inflation, and the lonely hours of uncompensated time clicking on the computer late into the night are among the factors leading to an exodus of thousands of doctors.
For many in Massachusetts, it is increasingly difficult to find a primary care doctor. Some MGB hospitals aren’t even accepting new primary care patients.
Some patients, out of desperation, are spending large sums on concierge doctors who can more adequately provide the level of care we all used to provide. This dynamic is disastrous to disadvantaged patients.
I have spent my entire career since medical school working, at a blistering pace, in several Harvard hospitals, most recently at the MGH Chelsea HealthCare Center for the past 17 years. One might imagine that I would be treated with respect.
But over the past decade, I have experienced a 24 percent pay cut via a new compensation model: Instead of paying us for seeing individual patients, we are now paid to manage a panel of patients, which keeps getting larger. This was paired with a subtle but relentless increase in patient-related responsibilities. I now put in the equivalent of 80 hours a week.
To make matters worse, MGB primary care doctors, who get coughed and sneezed on countless times a day and are under great stress, do not get sick days. Any days we must take off because of illness are docked from our vacation days. So if we get sick, we have to choose whether to sacrifice vacation time or to go to work and risk infecting others. The choice may seem obvious, but if there ever were a profession in which one needed time off to recharge one’s batteries, it is ours.
My primary care clinic has lost about half of its doctors in the past several years. This has been a disaster for patient care. An affiliated Brigham and Women’s Hospital practice in Chestnut Hill also recently lost 10 of its 14 primary care doctors, who resigned to join a Wellesley practice affiliated with Beth Israel Lahey Health.
One colleague who left my practice bluntly said, “I want to work somewhere where they give you sick days.” She has two young children and was having trouble making ends meet between child care, paying off her student debt, and ever-increasing work demands.
Meanwhile, decision-makers at my hospital system are apparently prioritizing executive salaries (often in the seven digits), advertising, and ambitious expansion plans, such as the $1.9 billion project to build two new Mass General towers on Cambridge Street.
Every time the MGB system gives primary care doctors a pay cut (real or relative to inflation), makes us see more patients, or imposes time-consuming bureaucratic requirements on us, we are utterly powerless. There is no effective mechanism through which we can push back. Medical leadership offers us “town hall meetings,” “factual updates” in response to the unionization attempt, and “listening sessions,” but responses to our feedback rarely materialize.
We have filed to join the Doctors Council of the Service Employees International Union. (MGB’s lawyers pushed back, arguing before the National Labor Relations Board that doctors at many MGB primary care practices shouldn’t be allowed to form a union.)
Being part of a strong union would open avenues for collective bargaining in which both sides would have a meaningful seat at the table. We could address a host of issues, including cost-of-living raises, paid sick time, a definition of “full-time work” that isn’t 80 to 100 hours a week, sensible investment in primary care staffing and technology, and a reasonable limit to burdensome bureaucratic demands. The hospital system could go back to caring for patients, not just for its bottom line
How would this help patients? To start, it is the only true way to provide for physician retention and recruitment. Patients don’t do well if they can’t find a primary care doctor, or if the doctor is too stressed to listen to them and provide coherent care.
In the end, the health of primary care doctors and the health of their patients are inextricably linked. Our union will help both and deserves widespread support.
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