Understanding and Estimating U.S. Physicians Preferences for Unionization

We will recruit licensed, practicing U.S. physicians via email and compensate them for participating in an online survey. After screening for eligibility, non-unionized physicians will be randomly assigned to a control group or to one of two treatment groups that view a brief video highlighting either the compensation benefits or patient-care benefits of physician unionization. The sample will be regionally representative and balanced across primary care physicians and specialists, with a separate sample of Emergency Medicine physicians. The survey is designed to measure physicians’ preferences and beliefs regarding collective action and their motivations for practicing medicine, as well as their use of AI and experience with COVID.

Non-unionized physicians will be randomly assigned to one of three groups: a control group or one of two treatment groups. Physicians in the treatment groups will watch a two-minute video describing either the compensation benefits or the patient-care benefits of physician unionization.

After the intervention, the survey will measure beliefs about unionization, preferences toward unionization, and real-stakes behavior. Aggregate results will be shared with relevant professional organizations after the study concludes. A follow-up survey will be run around two weeks after the intervention to assess whether and to what extent views (e.g., beliefs and preferences) have been shifted.

Our analysis accommodates heterogeneity using observed covariates. Belief outcomes are measured using index scores that combine related survey items, with weights based on a validation survey. The beliefs can serve as the first-stage in a 2sls framework to estimate the causal effect of beliefs on choices.

2026-01-05

2026-06-01

Primary outcomes include physicians’ beliefs about the effects of unionization, measured before and after the intervention using 0–10 agreement scales. [Survey items assess whether unionization would increase pay, reduce excessive work hours, improve autonomy over patient care, improve staffing and benefits, improve patient outcomes, and reduce burnout.]

We also measure overall support for physician unionization and willingness to take actions in support of it.

Non-unionized physicians will be randomly assigned to one of three groups: a control group or one of two treatment groups. Physicians in the treatment groups will watch a two-minute video describing either the compensation benefits or the patient-care benefits of physician unionization.

Not available

Randomization will be done by a computer, with each of the three outcomes assigned to the physicians with equal probability

Individual physician

No

N/A

We assume a 1.5% response rate based on the piloting and with 70,000 physicians’ contact information which would yield approximately 1,050 responses

We are randomizing into equal sizes, so that will be 350 observations in each treatment group and in the control group