Alameda Health System: Organizing Gets the Goods 


After taking action again and again, and with 98.4% of voting members authorizing a strike, resident physicians at Alameda Health System won a groundbreaking deal in May. Their new contract includes total compensation increases of more than 20% over three years, the right to honor their coworkers’ picket lines, and an amazing $60-an-hour call pay benefit (for being called in unexpectedly). 

We spoke with CIR RVP and AHS Bargaining Committee Member Dr. DaShawn Hickman about the campaign and why solidarity with other unions is so key for physicians. 

Tell me a little about AHS and what you all were fighting for with your campaign. 

Highland Hospital is the safety net hospital for Alameda County. We’re seeing most of the under or uninsured patients. During our campaign we were fighting for better working conditions that include pay, given that we live in the San Francisco Bay Area, where the cost of living has just been ballooning and our pay has not. 

Parental benefits were a priority, and we were able to increase parental leave from 6 to 8 weeks and establish a commitment from AHS to negotiate on family building benefits as well. Residents feel that they have had to put their lives on hold, meaning not starting families, not being able to go to family events, not living, for 3-5 years, which just isn’t fair. So we are really fighting to make it more of a life again. 

One of the other things we were pushing for was an increase in our diversity fund–we have one, which helps us to recruit and retain minorities in medicine. This is really important because there are studies that show that when you have doctors who look like you, it benefits patient care, and the patient population we serve is mostly Black and Latino. And us being able to provide a better salary will also help us recruit more diverse residents. It’s a question we get all the time when people are interviewing–applicants ask us if we can afford to live here. 

We’ve also seen residents who have had to work more than initially expected. They thought they had a weekend off and were pulled into work due to other residents calling out sick. So we now have language that will help residents get extra pay when they’re not on jeopardy or back up, but they’re still called in, which was a really big win I think. For two reasons: one, residents will feel more appreciated, but also because it will hopefully incentivize the hospital to staff better. 

What do you think made the campaign successful? What worked well? 

Being able to be in pretty frequent communication with our unit was important. We had representation from almost all of our specialties in the union on the bargaining committee, and we were able to always bring updates back to all of our members. Keeping them abreast of what was happening kept the momentum going, because we were in negotiations for a really long time. AHS did some kind of outrageous things that motivated our residents, including starting to bargain with us without the authority to bargain, having regressive bargaining. We were always announcing to everyone that we were having the bargaining meetings, so any time we ran into people in the hall we gave updates. 

When it came time to do the strike authorization vote, we had one-on-ones with our whole bargaining unit about the strike, the importance of it, the implications, we had a strike school. That really turned out most of our membership when it came time for the strike authorization vote. 

At the end of your campaign, AHS residents actually used pay as a bargaining chip to secure solidarity strike language. Why was that so important to you all? 

It was important because we know that strength comes in numbers, and being able to collaborate with other union folk at AHS was going to be really important. Near the end of our contract they really started showing up for us–the nurses’ union, other staff unions. They made calls to Board of Trustees members on our behalf. They came to our bargaining meetings to show strength. We really felt they were supporting us, and we wanted to make sure that we could support them too, which we felt like we couldn’t do without the ability to solidarity strike. 

What kind of impact do you think your wins will have on patient care at AHS? 

Hopefully our residents, when they don’t have to worry about things outside of the hospital, like getting food, taking care of their children, are happier, more able to focus. They have more to give to their patients, which I think is big. 

When patients are in the hospital they’re sick, they’re scared, they can be frustrated, and they let us know that. When you’re all of those things too as the physician, it can make the interactions harder. So all of those things will give us more bandwidth and energy to take care of our patients. 

Our diversity fund will be big as well in helping us recruit and retain residents of color to take care of our patient population, and make sure our patients feel more comfortable, have better health outcomes. 

How do you think residents and fellows fit into the larger labor movement? Why is it important for CIR to support other unions? 

Overall we are seeing companies make a ton of profit at the expense of workers and our labor. Especially at a time when the cost of living is really rising. Most workers are realizing that they’re being taken advantage of, especially with social media, which lets us communicate that this is happening, it’s not ok. Around the country people are standing up for workers’ rights. 

Physicians have not traditionally been unionized in the numbers of workers in other industries, and most people probably think that it’s because residents have these wonderful lives and are not being taken advantage of like other workers, when that’s not true. Seeing physicians standing up for themselves connects us to this larger fight and allows us to stand with other workers, other unions–which is really how we’ll all be able to win.