Staff at Unity Health Care, the largest network of community health clinics in D.C., have been fighting for over a year to unionize across positions and improve what they say are poor working conditions that make it hard to adequately care for patients.
Unity’s physicians and advanced practice providers unionized in 2023, and have been negotiating to reach a contract with Unity for nine months and counting. Now, Unity is seeing almost wall-to-wall union efforts across its staff. In recent months, two more groups within Unity have pushed to unionize — the nurses and the non-nursing support staff.
The non-nursing support staff, including patient registration clerks, or PRCs, voted to unionize with the National Union of Hospital and Health Care Employees (NUHHCE) on Sept. 18 with 123 votes in favor of the union. The non-nursing support staff are now beginning their negotiation process, Tracy said.
The nursing staff at Unity moved to unionize late last year, Tracy said, but have not yet officially voted to be represented by the Service Employees International Union (SEIU). The total tally of votes will take place at the end of January.
Employees hope the coordinated move for almost complete union coverage at Unity will show collective strength in negotiations for better working conditions. “We want more. Hopefully, across the board, we have greater bargaining power,” Jimmy Tracy, who has been a nurse practitioner for 12 years and is a peer representative at Unity, said.
Unity Health Care was founded in 1985 as the Health Care for the Homeless Project. It is a federally qualified health center in D.C. serving residents in underserved communities through 20 locations, including homeless shelters, schools, and the D.C. Jail. For uninsured and underinsured District residents, these clinics are often the first and only option.
But staff at Unity say an unreasonably high workload means patients receive subpar care and health care providers quickly burn out, leading to turnover. In August, the Union of American Physicians and Dentists, which represents the Unity’s physicians’s union, wrote in a press release that 30 primary care providers had resigned, leaving just 40 providers for over 85,000 patients.
Unionization efforts began when about 85% of Unity’s physicians voted to unionize in November 2023, citing safety and workload concerns. That union has been negotiating to reach a contract with Unity for nine months. In August, the union voted overwhelmingly to authorize a strike if conditions do not improve.
Since then, physicians at Unity have continued meeting for bargaining sessions twice per month. with the first negotiation of 2025 held on Jan. 9. Tracy said no significant progress has been made in terms of contract negotiations.
“We are absolutely preparing ourselves to do collective action and having a strike is certainly on the table,” Tracy said.
Unity providers are bargaining for better working conditions for physicians, dentists, nurse practitioners, and physician assistants at the community clinics and D.C. Jail. In particular, the providers are asking for better scheduling and safety measures for staff who work at the jail.
Currently, physicians at Unity are expected to see up to 24 patients a day, which Tracy says is an overwhelming amount, partially due to recent layoffs and departures from Unity. The physicians’ union is requesting Unity reduce expected patient visits to at least 20 to reduce burnout and increase quality care.
The push for more drastic collective bargaining tactics comes as physicians continue to leave Unity. These departures threaten the availability of care. The Stanton Road clinic, located in Ward 8, was closed indefinitely in November due to a lack of staff.
“I can think off the top of my head of four people who are leaving,” said Tracy. “It’s just a shame the way people are leaving. They’re not even getting appropriate [exit] interviews.”
As negotiations are ongoing, staff say upper management at Unity has not met with physicians since the beginning of the bargaining process. Last month, nearly all the community providers signed a petition asking for Dr. Jessica Boyd, the president and CEO, to attend the bargaining sessions, but did not receive a response. Unity did not respond to a request for comment by publication.
The next bargaining session will be held at the end of this month.
