'A shocking result.' Fred Hutch clinicians' union vote ends in tie

The Fred Hutch Cancer Center in Seattle.

KUOW Photo/Monica Nickelsburg

A two-day vote by nurse practitioners and physician assistants at Seattle’s Fred Hutch Cancer Center about whether to unionize has resulted in a tie. The unionization effort has been driven by concerns about patient care and working conditions, clinicians say.

Sam Doyle, an oncological advanced registered nurse practitioner at Fred Hutch who led the effort to join the Union of American Physicians and Dentists, called it “a shocking result.”

In order to hold a second vote, the union must successfully appeal to the National Labor Relations Board.

Clinicians at Fred Hutch say they want a greater voice in decisions affecting their workplace.

Workers say changes following the merger of Seattle Cancer Care Alliance and Fred Hutch Cancer Center increased workloads, contributed to staff turnover, and made it harder for clinicians to provide the level of care they believe patients deserve. They argue retaining experienced providers and ensuring clinicians have adequate time for patients are key to maintaining quality care.

Changes after the merger

“We didn’t need a union before because people were, overall, quite happy with things,” said Doyle. “When the merger happened, our management structure, vibe, and day-to-day really changed at that point.”

The new workplace requirements, according to Doyle, trickle down to patients. She’s heard from colleagues that patients experience a decline in care in several ways: longer wait times for testing, longer waits to receive a call or message about results, and changes in care teams and more reliance on floating or temporary staff members. There’s also the reality of burned out health care workers not bringing their best selves to help people dealing with the toughest battle of their lives: cancer.

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Doyle said the changes have contributed to providers quitting, which she believes ultimately affect patients.

“We’ve lost a lot of [nurse practitioners and physicians assistants.],” she said. “Someone just resigned. The overall stress level is just untenable and people cannot keep up with the new demands of this project they feel has been thrust upon them.”

Seeking a seat at the table

Doyle said those concerns led her to help organize the union effort.

“It won’t be a perfect solution, but it is the only legally binding solution to get us a legal seat at the table,” she said.

The organizing campaign took about 15 months to reach this week's vote. Doyle said she felt Fred Hutch showed little opposition to the effort until organizers formally filed for an election .

“Once we filed the petition, they were like, ‘Let's go. It's on,’” Doyle said.

Fred Hutch pushes back

Ahead of this week’s vote, Fred Hutch launched an information campaign through a website called Get the Facts Fred Hutch . The site includes videos from executives and advanced practice providers, information about union dues and election procedures, and outlines management's opposition to unionization. The website states that Fred Hutch believes employees and patients are best served by “working together directly and not through a union.”

In a video message posted on the website, Dr. Tom Lynch, Fred Hutch’s president and director, addressed concerns raised by advanced practice providers.

“I know we have got to do better and I am sorry for the fact that we have not done a better job of having the [advanced practice provider] voice heard,” Lynch said. “You deserve a seat at the table. We’re going to work as hard as we can to find the best ways to make that work.”

Criticism about the campaign

Doyle shared a voicemail recording and screenshots of a text message sent by Lynch to a Fred Hutch employee with KUOW.

“I'm just calling to remind you to vote this week in the election — the union election,” Lynch states in the voicemail. “Your vote matters. I very much hope that it’s a no vote.”

Fred Hutch President

KUOW called the number associated with the voicemail and text message and reached Lynch. He confirmed he did contact employees to discuss the union vote.

In a statement to KUOW, Christina VerHeul, Fred Hutch’s associate vice president of communications, said the organization had created opportunities for providers to ask questions and engage in dialogue, including group meetings, one-on-one conversations, phone calls, and text messages.

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LaborLab, a workers' rights watchdog that tracks employer anti-union campaigns, estimates Fred Hutch spent between $380,000 and $513,000, or about $3,000 per worker, on its Get the Facts Fred Hutch website and related outreach efforts.

Prominent labor attorney Matt Bruenig launched a competing website, Real Facts for Fred Hutch . The website argues in favor of union representation. Bruenig said he created the site in response to what he viewed as a union-avoidance campaign by Fred Hutch and argued the employer's website closely resembles anti-union websites used in other health care union elections.

The Union of American Physicians and Dentists plans to file a complaint with the National Labor Relations Board to address what they say are “unfair labor practices related to the conduct of the company during the election process.”

The union alleges Fred Hutch threatened, surveilled and bribed employees, among other tactics intended to influence the vote. The National Labor Relations Board will then investigate those charges and a hearing could be called. If the union wins, the most likely outcome would be another election.

Fred Hutch Cancer Center released the following statement in regards to the tie vote and claims by the Union of American Physicians and Dentists of “unfair labor practices:"

In an election overseen by the National Labor Relations Board (NLRB), Fred Hutch-employed Advanced Practice Providers (APPs) voted to determine whether to be represented by the Union of American Physicians and Dentists (UAPD). The ballot count indicates a tie vote, which means UAPD did not achieve the simple majority decision legally required for union representation. As part of its process, NLRB is reviewing the details of the election before issuing the official certification. Fred Hutch APPs are highly skilled professionals who play an essential role in the care we provide. We are grateful for their engagement, their insightful questions leading up to the election, and for making their voices heard. Our unified mission to provide exceptional cancer care to our patients and pursue scientific breakthroughs remains strong, and we are grateful for the opportunity to continue working together with our APPs and all employees to make Fred Hutch a great place to work.

Correction, 7/10/26 at 3:53 pm: A previous version of this story incorrectly stated that Fred Hutch clinicians who voted on unionization are also employed by the University of Washington, and incorrectly stated Christina VerHeul's title.

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