Unionization, strikes, threatened strikes, and hospitals--the view from hospital management.

The history of union organizing efforts in the hospital field is discussed in this article, along with the factors judged necessary for successful union organizing. The role played by labor legislation in the unionization of hospital workers is shown, and the influences of the National Labor Relations Act, the Taft-Hartley amendments, and labor legislation at the local level are described. Management has largely resisted unionization because of the social nature of hospitals. Competitive market forces do not confront the not-for-profit hospitals, which are dependent upon third-party reimbursement. While strikes are an integral and essential part of collective bargaining in industry, they are, in fact, detrimental to hospitals because of these institutions' concern with human life. Despite laws and assurances from labor leaders that strikes will not occur, strikes have been used as a method for resolving disputes, through they are basically inconsistent with the economic characteristics and objectives of the hospital. The authors conclude that arbitration awards should be made by arbitrators appointed from outside of the local region of the hospital involved, ant that, because of the catastrophic effect of strikes upon patients as well as employees, arbitration awards should be required, should be binding upon both parties, and should be federally enforced.