Radiologists should consider unionizing to counter specialty’s corporate takeover, expert says

There’s been an uptick in corporate acquisitions of radiology practices in recent years, which has some early career physicians fearful about the specialty’s future. Perhaps, rads should consider unionizing to counter their income, productivity and autonomy concerns?

An expert recently made the case for such change in a new commentary, published in this month’s Journal of the American College of Radiology. Taking this step would come with numerous obstacles, but it’s certainly worth weighing, argued professor and neuroradiologist Arvind Vijayasarathi, MD, MBA, MPH. 

“As the radiology practice landscape changes, radiologists of all career stages, but particularly early career radiologists and radiologists in training, have much to consider,” he wrote March 2. “One potential response to the current wave of corporatization is organization of radiologists into a union that can participate in collective bargaining negotiations with the large national entities.”

Nurses, radiology technologists and other support staff have already formed unions within healthcare. As have some physicians in the U.S., though these examples are much scarcer. Radiologists have never really needed to go this route, due to the fact that many private physicians were also practice owners, the author wrote.

With the old guard transitioning out and new docs stepping in, many do not want their practice as part of a corporation, a new survey found earlier this month. Unionizing could be “particularly palatable” to younger rads, allowing them to negotiate directly to ensure “fair compensation, reasonable productivity goals, continued investment into state-of-the-art imaging technology and preservation of some amount of local practice autonomy,” Vijayasarathi noted.

Radiologists could also gain considerable leverage in negotiations by possibly pursuing a strike, an action that has worked for imaging technologists in the past.

“With specific regards to outpatient radiology practice, the largest segment of imaging performed in the United States, brief organized labor stoppages, when necessary to bring about meaningful positive change, could be orchestrated in a way that is safe and compassionate toward the patients that radiologists serve,” he wrote.

However, there are certainly numerous challenges to reaching this destination. Among them, as high-income earners, rads may experience “public backlash” for taking such actions. Patients could blame physicians rather than their corporate leaders for delays in care, and radiologists would have to worry about the threat of replacement by lower-cost international teleradiology providers. Aligning with unions that have political ties also may be unacceptable to some in today’s “era of increasingly polarized partisan politics.”

“These issues and other potential obstacles are not easily overcome and would require serious deliberation, as well as time, effort and resources on behalf of radiologists aiming to organize,” Vijayasarathi wrote. “Although there are many potential concerns and obstacles related to unionizing, the process of organization, potential risks and benefits, and general sentiment toward unionizing merit further investigation at this critical juncture,” he concluded later.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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