State of Physician Unionization.

OBJECTIVES: To provide an overview of the current state of physician unionization, potential factors surrounding increased unionization, and the ethical and financial issues that may arise. DESIGN: Review article. SETTING: Not applicable. PARTICIPANTS: Not applicable. RESULTS: Over the last few years, there has been a recent surge in physician unionization. Union membership among residents and fellows is also at an all-time high and continues to increase, as seven residency programs voted to unionize in 2023. The resulting threat of strikes has grown considerably over the last year as residents across 6 hospitals have threatened to strike, resulting in New York's first physician strike in over three decades. As physician practice continues to shift from private to corporate health system-based employment, more opportunities for unionization will arise. Globally, these trends have been comparable, with thousands of physicians striking across the United Kingdom, Germany, Italy, Nigeria, and New Zealand in the last year. CONCLUSION: The current state of physician unionization is of increasing significance as more physicians are presented with opportunities for unionization. Physicians perceive a lack of autonomy, and the demand to deliver high level outcomes with diminishing resources is becoming an insurmountable challenge. Additionally, physician satisfaction with their workplace has decreased with increased burnout rates. Thus, it is important to understand the current state of unionization, potential reasons for unionization among physicians and residents, and its future impact on the field of medicine.

Correcting misperceptions of the material benefits associated with union membership increases Americans' interest in joining unions.

How accurate are Americans' perceptions of the material benefits associated with union membership, and do these perceptions influence their support for, and interest in joining, unions? We explore these questions in a preregistered, survey experiment conducted on a national sample, representative of the US population on a number of demographic benchmarks (n = 1,430). We find that Americans exhibit large and consistent underestimates of the benefits associated with unionization, as compared to evidence from the Bureau of Labor Statistics and peer-reviewed academic research. For example, 89% of Americans underestimated the life-time income premium associated with union membership, 72% underestimated the percentage of union members who receive health insurance from their employer, and 97% overestimated the average union dues rate. We next randomly assigned half of the participants to receive a brief, informational correction conveying results of academic and government research on the material benefits associated with union membership, or not. Those who received the correction reported 11.6% greater interest in joining a union, 7.8% greater support for unions, and 6.9% greater interest in helping to organize a union in their workplace, as compared to the control group. These results suggest that, overall, Americans tend to underestimate the material benefits associated with unionization, misperceptions of these benefits are causally linked to Americans' support for unionization, and correcting these misperceptions increases a range of pro-union sentiments in the American mass public.

Principles for Worker-Driven Remedy.

Workers in global supply chains face forced labour, hazardous working conditions, excessive overtime, violence, union busting, and other abuses. They may be cheated of wages and bonuses promised by recruiters or dismissed without due process. They need remedy and, in fact, have a right to an effective remedy, but remedy for business-related harms in global supply chains is rare. The Principles for Worker-Driven Remedy offer a framework for making remedy a reality for workers when their rights are violated and when they are harmed in global supply chains. Developed by Electronics Watch in consultation with trade unions, labour rights organizations, and public buyers, the Principles put affected workers at the heart of the remedy process. Electronics Watch will develop tools and procedures to help public buyers to use the Principles in supplier engagement, tenders, and contract management. We encourage companies and other organizations to adopt and adapt them to address harm to workers in supply chains.

Demandas e recursos para predição da síndrome de burnout em psicólogos clínicos / Demands and resources for burnout syndrome on clinical psychologists / Demandas y recursos para la predicción del síndrome de burnout en psicólogos clínicos

O modelo de demandas e recursos foi utilizado para identificar o poder preditivo do estilo pessoal do terapeuta e do trabalho emocional (demandas), e da inteligência emocional e autoeficácia profissional (recursos) sobre as dimensões da síndrome de Burnout (SB), em uma amostra de 240 psicólogos clínicos brasileiros. Os dados foram coletados por meio de plataforma online, tendo como instrumentos de pesquisa um Questionário de dados sociodemográficos e laborais, o Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, o Cuestionario del Estilo Personal del Terapeut, o Questionário de Avaliação Relacionado a Demandas Emocionais e Dissonância da Regra da Emoção, Medida de Inteligência Emocional, e Escala de Autoeficácia Geral Percebida. Os resultados obtidos revelaram um modelo preditor das dimensões da SB, constituído pelas variáveis dissonância emocional, automotivação, demandas emocionais, instrução, envolvimento e autoeficácia. Ressalta-se a relevância de estratégias voltadas para a prevenção da SB nessa categoria profissional, bem como a necessidade de ações que visem a promoção e o desenvolvimento da inteligência emocional e da autoeficácia como fortalecimento dos recursos emocionais para atuação na prática clínica.(AU)

The Model of Demands - Resources was used to identify the predictive power of therapist's personal style, emotional work (Demands), Emotional intelligence, and professional self-efficacy (Resources) over the Burnout syndrome dimensions in a sample of 240 Brazilian clinical psychologists. The data was collected by an on-line platform using a Labor and social demographic data questionnaire, a work Burnout Syndrome Evaluation questionnaire (CESQT - Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo), the short version of the Therapist Personal Style Questionnaire (EPT-C Cuestionario del Estilo Personal del Terapeuta), an Evaluation questionnaire related to emotional demands and emotion rule dissonance, and the Emotional Intelligence Measure (EIM) and Perceived General Self-Efficacy Scale (GPSS) as research instruments. Results showed a predictor model of Burnout syndrome constituted by the variables Emotional dissonance, Self-motivation, Emotional demands, Instruction, Involvement, and Self-efficacy. We emphasize the relevance of strategies to prevent Burnout Syndrome in this professional category and the need for actions to promote and develop emotional intelligence and self-efficacy as a strengthening factor of the emotional resources to work as a clinical psychologist.(AU)

Se utilizó el modelo demandas y recursos para identificar el poder predictivo del estilo personal del terapeuta y del trabajo emocional (demandas), y de la inteligencia emocional y autoeficacia profesional (recursos) sobre las dimensiones del síndrome de Burnout (SB), en una muestra de 240 psicólogos clínicos brasileños. Los datos se recolectaron de una plataforma en línea, utilizando como instrumentos de investigación un cuestionario de datos sociodemográficos y laborales, el Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, el Cuestionario del Estilo Personal del Terapeuta, el Cuestionario de Evaluación Relacionado con Demandas Emocionales y Disonancia de la Regla de la Emoción, la Medida de Inteligencia Emocional y Escala de Autoeficacia General Percibida. Los resultados obtenidos revelaron un modelo predictor de las dimensiones de SB, constituido por las variables disonancia emocional, automotivación, exigencias emocionales, instrucción, implicación y autoeficacia. Se destaca la relevancia de las estrategias dirigidas a la prevención del SB en esta categoría profesional, así como la necesidad de acciones dirigidas a promover y desarrollar la inteligencia emocional y la autoeficacia como fortalecimiento de los recursos emocionales para trabajar en la práctica clínica.(AU)

Estresse ocupacional entre psicólogos atuantes na atenção primária à saúde no contexto pandêmico / Occupational stress in psychologists working in primary health care in the context of the pandemic / Estrés laboral entre los psicólogos que trabajan en atención primaria de salud en el contexto de la pandemia

Este estudo analisa o estresse ocupacional entre psicólogos que atuavam na Atenção Primária à Saúde durante a pandemia ocasionada pela covid-19, assim como as características sociodemográficas e laborais dos participantes e sua relação com o estresse ocupacional. Participaram da pesquisa 70 psicólogos atuantes em 51 unidades básicas de saúde das regiões Oeste e Extremo Oeste catarinense. Para coleta de dados, um questionário sociodemográfico e a versão reduzida da Job Stress Scale (JSS) foram aplicados. A análise dos dados foi realizada por meio da estatística descritiva e inferencial. Identificou-se que 35,7% dos psicólogos apresentaram alto desgaste no trabalho; 28,6% baixo desgaste; 27,1% se mostraram em trabalho passivo; e 8,6% em trabalho ativo. No modelo de regressão linear, os fatores associados à dimensão Demanda da JSS foram: possuir filho (a) (coeficiente -1,49; IC 95% -2,75 a -0,23) e afastamento do trabalho nos últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Os psicólogos com hipertensão arterial sistêmica autorreferida apresentaram, em média, 3,96 pontos a menos no escore de Apoio social (IC 95% -7,06 a -0,85), quando comparados aos não hipertensos, e entre os psicólogos que trabalhavam no turno da manhã identificou-se aumento de 4,46 pontos, em média, no escore de Apoio social (IC 95% 0,90 a 8,02) em relação aos profissionais do turno manhã e tarde. Evidenciou-se que um número significativo de psicólogos apresentava-se em alto desgaste no trabalho, com potenciais implicações para sua saúde e atuação profissional.(AU)

This study analyzed occupational stress among psychologists who worked in Primary Health Care during the COVID-19 pandemic and participants' sociodemographic and work characteristics and their relationship with occupational stress. In total, 70 psychologists working in 51 basic health units in the West and Far West regions of Santa Catarina participated in this research. A sociodemographic questionnaire and the short version of the Job Stress Scale (JSS) were applied to collect data. Data were analyzed by descriptive and inferential statistics. In total, 35.7% of psychologists showed high stress at work; 28.6%, low burn out; 27.1%, passive work; and 8.6%, active work. The factors in the linear regression model that were associated with the JSS demand dimension referred to having children (coefficient −1.49; 95% CI −2.75 to −0.23) and absence from work in the last 12 months (coefficient 1.88; 95% CI 0.60 to 3.15). Psychologists with self-reported systemic arterial hypertension showed, on average, 3.96 points lower in the Social Support score (95% CI −7.06 to −0.85) than non-hypertensive ones and psychologists who worked in the morning shift, an average increase of 4.46 points in the Social Support score (95% CI 0.90 to 8.02) in relation to professionals working in the morning and afternoon shifts. A significant number of psychologists had high stress at work, with potential implications to their health and professional performance.(AU)

Este estudio evalúa el estrés laboral entre los psicólogos que trabajaron en la atención primaria de salud durante la pandemia provocada por la COVID-19, así como las características sociodemográficas y laborales de ellos y su relación con el estrés laboral. En la investigación participaron setenta psicólogos que trabajan en 51 unidades básicas de salud en las regiones oeste y lejano oeste de Santa Catarina (Brasil). Para la recolección de datos se aplicó un cuestionario sociodemográfico y la versión corta de la Job Stress Scale (JSS). El análisis de los datos se realizó mediante estadística descriptiva e inferencial. Se identificó que el 35,7% de los psicólogos presentaban alto estrés en el trabajo; el 28,6% tenían poco desgaste; el 27,1% se encontraban en trabajo pasivo; y el 8,6% en trabajo activo. En el modelo de regresión lineal, los factores asociados a la dimensión demanda de la JSS fueron: tener hijo (coeficiente -1,49; IC 95% -2,75 a -0,23) y baja laboral en los últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Los psicólogos con hipertensión arterial sistémica autoinformada presentaron un promedio de 3,96 puntos más bajo en la puntuación de apoyo social (IC 95% -7,06 a -0,85) en comparación con los no hipertensos, y entre los psicólogos que trabajaban en el turno de la mañana, se identificó un aumento promedio de 4,46 puntos en la puntuación de apoyo social (IC 95% 0,90 a 8,02) con relación a los profesionales que laboran en el turno de mañana y tarde. Quedó evidente que un número significativo de psicólogos se encontraba en situación de alto estrés en el trabajo, con posibles implicaciones para su salud y desempeño profesional.(AU)

Psychological screening, providing social security or strengthening training? How can government and labor unions protect the mental health of young employees.

As the mental health problems of young employees become more and more prominent, the government and labor unions need to take measures to protect the mental health of young employees. Considering that the main mental health safeguard measures are divided into psychological screening, providing social security and strengthening training, this article constructs a differential game model under these three modes. The balanced efforts and social benefits of the government and labor unions under the three modes are obtained, and the applicable conditions of various mental health protection modes are compared. The results show that if the government pays a lower cost, the government gets the highest economic benefit under the training mode, followed by the security mode, and the government gets the lowest economic benefit under the psychological screening mode. If the reputation of the labor unions improved by its efforts is low, the equilibrium benefits of the labor unions under psychological screening and providing security are the same, and greater than the equilibrium benefits under the intensive training mode. If the labor unions have a higher reputation enhanced by its efforts, the balance return of the labor unions under the guarantee mode is the highest, followed by the balance return under the intensive training mode, and the balance return of the labor unions under the psychological screening mode is the lowest.

Effect of trade unions on the mental health of UK workers before and during the COVID-19 pandemic: a longitudinal analysis using Understanding Society data.

BACKGROUND: Although trade union membership rates have continuously decreased over the past 30 years, about 50% of UK employees are still represented by a union. Yet, studies on the association between collective bargaining and workers' mental health are sparse, especially in the pandemic context. This study examines differences on UK workers' mental health due to trade union presence and membership between pre-pandemic and pandemic periods. METHODS: In this longitudinal study, we analysed Understanding Society panel data in which the same participants are followed over time. The data concerned individuals aged 16 years and older and were collected biannually before COVID-19 pandemic (Waves 8-10: 2017-2020) and on a more frequent basis during pandemic (all COVID-19 surveys from 2020 [April, May, June, July, September, November] to 2021 [January, March, September] periods). The primary outcome was General Health Questionnaire-12 (GHQ-12) caseness (GHQ-12 score ≥4: probability of caseness). Two exposures were used separately: trade union presence and trade union membership, interacting with a binary variable splitting time periods between before and during the pandemic. Our analytical sample included 49 915 observations from 5988 individuals. 3341 (56%) individuals worked in unionised workplaces. We fitted mixed-effects logistic regression models adjusting for age, gender, ethnicity, UK residence, educational level, financial situation, workplace size, and survey interview date. We then replicated the analyses including a 3-way interaction with industry. All Understanding Society participants gave written informed consent. Ethics approval was not required. FINDINGS: In our sample, approximately 41% were male and 59% were female, and the mean age was 47·2 years (SD 11·4). Comparing pre-pandemic and pandemic periods, we found that the odds of GHQ-12 caseness for those in non-unionised workplaces increased by 45% (odds ratio 1·45, 95% CI 1·17-1·80), whereas in unionised workplaces odds increased by 28% (1·28, 1·05-1·57). When analysis was confined to unionised workplaces, the odds of GHQ-12 caseness for non-union members increased more (1·40, 1·07-1·83) compared with members (1·18, 0·91-1·53); however, with wide CIs. Overall, industry had no modification effect in both exposures. Sensitivity analysis using GHQ-36 as a continuous outcome demonstrated no real change in the patterns of the results. INTERPRETATION: The mental health of workers in unionised workplaces appears to have worsened less than the mental health of those in non-unionised workplaces; however, there is insufficient evidence of effect differential by type of industrial sector. Designing policies that encourage and facilitate trade union presence in workplaces should be promoted, as they are likely to mitigate adverse mental health effects in times of extreme uncertainty. FUNDING: Medical Research Council, Chief Scientist Office, Belgian National Scientific Fund.

Labor Unions and Staff Turnover in US Nursing Homes.

This cross-sectional study examines the association between labor unions and health care staff turnover in the US using data from 2021.

Labor Unionization Among Physicians in Training.

This study examines the number of unique unions and characteristics of unionization elections among physicians in training in the US.

The Effect Of Labor Unions On Nursing Home Compliance With OSHA's Workplace Injury And Illness Reporting Requirement.

All US nursing homes are required to report workplace injury and illness data to the Occupational Safety And Health Administration (OSHA). Nevertheless, the compliance rate for US nursing homes during the period 2016-21 was only 40 percent. We examined whether unionization increases the probability that nursing homes will comply with that requirement. Using a difference-in-differences design and proprietary data on union status from the Service Employees International Union for all forty-eight continental US states from the period 2016-21, we found that two years after unionization, nursing homes were 31.1 percentage points more likely than nonunion nursing homes to report workplace injury and illness data to OSHA. Data on injuries occurring in specific workplaces play a central role in injury prevention. Further unionization could help improve workplace safety in nursing homes, a sector with one of the highest occupational injury and illness rates in the US.

Exploration roles and responsibilities of trade unions in preventing and responding to emergencies against epidemics: The case of COVID-19.

BACKGROUND AND AIM: The coronavirus disease 209 (COVID-19) pandemic has been affecting various strata of society including different guilds. Each of these segments has its role to play in controlling epidemics. Accordingly, this study aimed to explore trade unions' roles and responsibilities in the prevention and emergency response to epidemic, including the COVID-19 pandemic. MATERIALS AND METHODS: The present qualitative research was conducted using directed content analysis. Participants were selected by a purposeful sampling method. Data were collected through semistructured interviews and field notes and validated through Lincoln and Guba's (1985) evaluative criteria. Data were analyzed by MAXQDA software. RESULTS: Data analysis, constant comparison, and class integration provided a total of seven main themes, which were extracted into four domains of Plan, Implementation, Review, and Action. The main themes were categorized into the dimensions of each domain, so that the Plan domain included three dimensions of union/guild contexts, leadership and staff participation, and planning. The Implementation domain included two dimensions of support and operations. The Assessment domain had a performance evaluation dimension, and the Action domain was made up of an improvement dimension. CONCLUSION: Relying on their organizational and social capacities, trade unions can facilitate the leadership and participation of employees and communities for appropriate policies and making resilient decisions to control epidemics and other roles and responsibilities related to health.