Should Surgeons Unionize? What Would Hippocrates Say?

Am Surg

Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

Published: September 2025


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Article Abstract

This article explores the evolving landscape of surgical practice and the potential need for unionization among surgeons. Historically, surgeons were too consumed by their demanding workloads to consider collective bargaining. However, shifts in health care employment structures-where hospitals and health systems increasingly govern surgeons' work conditions-have led to discussions about unionization. Surgeons and labor lawyers argue that as surgeons lose autonomy and face worsening conditions of employment, unionization could provide a means to regain better conditions of employment affecting surgeons and patient outcomes. Though legal barriers exist under the National Labor Relations Act, precedent from resident physician unions suggests feasibility. The article conducts a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis of unionization, weighing its advantages (collective bargaining power, improved work-life balance) against potential drawbacks (loss of autonomy, legal complexity). The piece also refers to the Hippocratic Oath, emphasizing how unionization aligns with surgeons' commitment to patient care and professional dignity. The author presents a modified oath advocating fair working conditions and surgeon solidarity. The article concludes that modern surgical practice necessitates a reassessment of labor protections. The author suggests that if Hippocrates were alive today, he would support unionization to safeguard both surgeons' well-being and patient care.

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http://dx.doi.org/10.1177/00031348251376686DOI Listing

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