Staff members at One Medical, a membership-based primary care company, announced this past week their intention to unionize.   

According to Workers United, a Service Employees International Union affiliate, the bargaining unit will comprise about 500 staff members, including customer service agents, phlebotomists, administrative workers and assistants, front desk workers and members of the virtual team.  

"Each of us at One Medical pours our time, talent, and energy into providing the best possible healthcare for our patients. The workers on the front lines of delivering this care have been at the center of our organizing process," wrote members of the One Medical Workers Union Organizing Committee in an unsigned letter to One Medical leadership that was provided to Healthcare IT News.   

A Workers United representative said the committee has chosen to wait before surfacing publicly out of fear of retaliation.  

"The experience of our patients is paramount in this effort," the letter continued. "Our union will make it possible for us to continue providing the best primary care experience our country has to offer, and to take our organization to levels previously unseen."  

WHY IT MATTERS  

A spokesperson for Workers United said the decision to organize stemmed from workers' displeasure with wages, workflow and job demands. For instance, said the spokesperson, staff members say they are "often misled" during the hiring process about the workload, complexity and level of responsibility the job entails.  

"One Medical is clear with prospective employees about the expectations of their role," said One Medical in response to this allegation. "We understand that all jobs come with unexpected challenges, and One Medical is committed to enhancing the way we address feedback and concerns from our team members."   

"We encourage team members to go to their managers or other leaders with concerns, but also have a compliance hotline available for anyone who would like to raise concerns anonymously," the statement continued.  

The Workers United spokesperson said that employees also felt "severely underpaid" for the labor done, with salaries often below the living wage in their cities.

One Medical noted that all entry-level positions pay "well over minimum wage," with entry-level positions in San Francisco starting at 37% above minimum wage and structured annual compensation increases.  

Given San Francisco's recent minimum wage jump, that hourly rate would be $22.36. According to MIT's living wage calculator, the living wage in San Francisco County for a single adult with no children is $28. In the metropolitan area, which extends to Oakland and Hayward, it is $22.88.

The difference appears to vary from market to market.

Although One Medical does not list salaries for open roles on its website, a phlebotomist job opening posted on Indeed.com for Seattle reportedly pays $20 an hour – slightly over the living wage in Seattle and in King County for a single adult with no children, as calculated by MIT.  

An administrative assistant position in Bethesda, Maryland, also posted on Indeed.com claims to pay $18 an hour. According to MIT, the living wage for Montgomery County for a single adult with no children is $19.82.  

"One Medical is also diligent about conducting annual compensation assessments and is dedicated to maintaining wages that are considerate of cost of living expenses in the local market," said the company in a statement.  

Organizing staff members also cited the lack of hazard pay offered to frontline workers during COVID-19 as an issue.  

"One Medical, like many of its peers, did not provide hazard pay, but instead took a number of different measures to address our employees’ concerns and mitigate the risks associated with exposure to the virus," said the company.

Employees with in-person care roles were provided with personal protective equipment and training, said the organization. It also said it invested in safety protocols for locations and provided many individuals with accommodations, as well as giving all administrative staff a one-time bonus during the pandemic.   

In addition, organizers pointed to what they described as problems with One Medical's vaccine rollout. Forbes reported earlier this year that the company had not enforced state guidelines in its initial distribution of COVID-19 vaccines in California, resulting in stress for staff.  

"We have taken vaccine eligibility requirements seriously since day one of our vaccine rollout. To be sure, over time we identified areas where we could’ve done better to verify vaccine eligibility, and we changed our process for determining eligibility several times to address the changing environment for vaccine distribution and to respond to input from public health authorities," said One Medical in response to these claims.  

"One Medical values our culture of continuous improvement and has made strides to improve the way we address feedback and concerns from our team members," it added. "In addition to the ability for employees to communicate with leadership directly under an 'open door' policy, we also have an anonymous 24/7 hotline for employees to voice concerns to the compliance department."  

Organizing committee members say they believe the right to form a union is one that should be celebrated and encouraged.  

"Our goal is to have One Medical leadership recognize One Medical Workers Union. We want to build a relationship based on equality and mutual respect with the One Medical executive team. This equality will come from your recognition of our union and your commitment to bargaining in good faith," said the organizers in the letter sent to leadership.  

The company said that it will not recognize a union without an election conducted by the National Labor Relations Board.   

"One Medical will recognize a union if our employees vote for one after having the opportunity to go through the NLRB, secret-ballot process," it said in a statement provided to Healthcare IT News.    

"Our leadership remains dedicated to directly engaging with our team members and listening and learning from them, so we can continue to support them in delivering exceptional healthcare," it said.  

THE LARGER TREND  

The COVID-19 pandemic contributed to feelings of burnout for many workers in the healthcare industry. In some cases, employees were disappointed in their companies' responses.  

Last summer, Epic Systems sparked a backlash when it announced its intention to bring most of its 10,000 employees back to its Verona, Wisconsin, campus amidst the COVID-19 crisis.  

The move, which was ultimately paused until mid-2021, led some employees to consider potentially unionizing – but efforts in that arena have not made any public progress.  

Meanwhile, One Medical apologized this past week after accidentally exposing hundreds of customers' email addresses.

ON THE RECORD  

"Mutual respect will be the responsibility of all parties involved – to see all sides of each issue and make the decisions that are best for the company in its entirety," wrote organizing committee members in the letter to One Medical leadership. 

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.