Unionization and Professionalization: Oppositional or Complementary Forces in Postwar US Health Fields?

Andrew Hogan, Creighton University

During the mid 1960s, the American health professions of occupational therapy (OT) and physical therapy (PT) faced an unavoidable dilemma about unionization. National leaders of these predominantly female fields viewed unionization as a major threat to their efforts to gain greater professional status. However, their hospital-based practitioners were increasingly being forced to join large, service worker labor unions. How could OT and PT achieve greater professional prestige, and come closer to the status of medicine, when their colleagues were appearing to undermine their fields’ reputations by unionizing? This presentation draws on archival, gray literature, and published sources to examine OT and PT leaders’ diverse responses to the quandary of collective bargaining. My case studies have direct relevance to the broader sociological literature on professionalization, as it relates to autonomy, gender, prestige, and labor market shelters. I show that the few male leaders in each field were among the earliest proponents of embracing unionization. This small cohort of men looked to the medical profession and recognized that it frequently benefited from collective tactics, even as the American Medical Association decried unionism. Ultimately, many OT and PT leaders chose to form their own collective bargaining units to avoid association with larger service worker unions. Soon, they also began successfully negotiating for better wages too. In the 2020s, US physicians have joined labor unions in greater numbers, a trend driven by the increased bureaucratization of medical care by large corporations. While sociologists have previously highlighted the role of professionalization in creating labor market shelters, my research demonstrates that health workers, past and present, have also embraced collective bargaining as a means of protecting their autonomy from large bureaucracies like service worker unions and healthcare corporations. My presentation gives increased attention to the synergistic interests and outcomes of unionization and professionalization in healthcare fields.

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 Presented in Session 106. Organizing Workers: Unions, Professionalization, and Labor Militancy in the United States