Daily CSR

Approximately 250 nurse practitioners and physician assistants working at clinics affiliated with Fred Hutchinson Cancer Center (FHCC), the University of Washington (UW), and Seattle Children’s Hospital (SCH) have submitted petitions to form a union with the Union of American Physicians and Dentists (UAPD).

Fred Hutchinson Cancer Center is internationally recognized for cancer treatment and research, serving patients throughout Washington, Alaska, Montana, and Idaho. The advanced practice providers involved say their move toward unionization stems from a collective effort to safeguard high-quality patient care across the Puget Sound region.

According to clinicians, recent organizational changes have led to heavier patient volumes and less time per appointment, making it more difficult to provide the level of care cancer patients require. They also contend that frontline providers have had limited input in decisions related to the organization’s growth and expansion. Involving clinicians in planning for new centers, they argue, would help ensure sustainable staffing and stronger collaboration among care teams.

“We are unionizing so that we can continue to provide excellent care to our oncology patients while improving transparency and fairness within FHCC, UW, and SCH,” said Sam Doyle, ARNP, who has worked at UW for 17 years. “We believe unionization offers a democratic and collaborative path toward these goals, and we hope our employers will negotiate with us in good faith.”

The unionization effort is being reviewed by two agencies because of the clinicians’ mixed public-private employment structure: the National Labor Relations Board (NLRB) for private-sector employees and the Washington Public Employment Relations Commission (PERC) for public-sector employees. Under Washington’s HB 1744 (2021–22), workers performing the same duties in the same setting can receive different benefits and protections depending on whether they are classified as public or private employees.

Providers say these inconsistencies have contributed to staff turnover and declining morale, issues they believe directly affect continuity of care and long-term patient-provider relationships in oncology.

“For clinicians across three healthcare systems to unite in this way highlights both the seriousness of the problems they’re facing and their commitment to protecting patient care,” said Dr. Stuart Bussey, president of UAPD. “These providers have decades of experience treating some of the region’s most vulnerable patients, and their decision to organize underscores the importance of giving frontline clinicians a meaningful voice in healthcare decisions.”

The NLRB has scheduled union elections for FHCC-employed clinicians on July 8 and July 9, 2026. UW-employed clinicians are still awaiting certification through PERC. If the bargaining units are certified, the clinicians will begin contract negotiations with the healthcare institutions over issues such as staffing levels, workplace conditions, pay equity, and clinical independence.