Dr. Jacob Lentz, an emergency medicine physician at UCLA and organizer with UC Doctors United, joined the America's Work Force Union Podcast to discuss the effort to unionize nearly 10,000 attending physicians across the University of California system through CIR-SEIU and Doctors Council SEIU.
Lentz brought an unusual personal history to the conversation: he spent more than eight years writing for Jimmy Kimmel Live, is a current member of the Writers Guild of America West and has firsthand experience of two WGA strikes before he left entertainment for medicine. He graduated from medical school in 2015, completed his residency at UCLA and has worked as an attending physician in the UCLA emergency department for approximately 11 years. He is also a medical consultant for the HBO series The Pit.
Lentz said the organizing drive is not about wages — no one in the campaign has raised their own pay as a priority — but about securing the contractual authority to improve conditions that prevent physicians from delivering adequate patient care. This includes boarding, overcrowding, inadequate staffing and inadequate resources that he said are worse in the UCLA emergency department than anything depicted on television.
Jacob Lentz took an unusual path to working in a hospital emergency department. He studied economics in college, found his way into television writing and spent more than eight years on the staff of Jimmy Kimmel Live. He is still a member of the Writers Guild of America, where he went on strike twice. He saw firsthand what an effective, well-organized union can accomplish. But at some point, he decided he wanted to try medicine.
He took extension courses, completed the prerequisites, passed the MCAT and got into medical school. He graduated in 2015, completed his residency at UCLA and has been an attending physician in the UCLA emergency department for approximately 11 years. He is also a medical consultant for The Pit, the award-winning HBO series depicting an emergency department. When asked how realistic the show is, he said the conditions it portrays are accurate — and then noted that the actual UCLA emergency department is worse.
He is now one of the organizers behind UC Doctors United, the effort to unionize nearly 10,000 attending physicians across the University of California system through CIR-SEIU and Doctors Council SEIU.
Lentz described the UCLA emergency department as overwhelmed almost all the time. Boarding — the practice of holding admitted patients in the emergency department because no inpatient beds are available — is a constant. Wait times are long. Staffing is inadequate. Resources are inadequate. He said that over his 11 years in the department, conditions have only worsened, and the gap between what physicians want to do for patients and what the environment allows them to do has only widened.
This is why he got involved with UC Doctors United, he said. The physicians who took an oath to care for patients are operating in a system that structurally prevents them from fulfilling that solemn promise. And after a decade of raising these concerns through normal channels and watching management respond with sympathy but not change, he and his colleagues concluded that contractual authority is the only way to actually fix it.
He also stressed that the organizing drive is not about physician compensation. No one in the organizing committee has put their own wages on the table as a priority. What they are fighting for is the ability to influence the rules governing the delivery of patient care. They want safe staffing ratios, boarding protocols and resource allocation. The same concerns that have driven nurse organizing for decades are now driving physician organizing at the University of California.
Lentz pointed out that attending physicians are the only group of employees at UCLA Health who are not currently represented by a union. Nurses, support staff and residents are all covered. The attending physicians who direct patient care and carry final clinical responsibility are the one group operating without union protections.
The organizing process is now in the card collection phase. The campaign is gathering union authorization signatures from physicians across the UC system, with SEIU providing organizational support. Annual dues under the structure being discussed are capped at $1,180. Lentz said he expects the union will more than recover that in concrete benefits once a contract is in place.
What he described as most valuable about the organizing process so far is what happens when physicians from different departments sit in the same room. Emergency medicine, internal medicine, psychiatry, pediatrics, surgery — every department comes in thinking its problems are unique. They are not, he said. The same issues surface everywhere, expressed slightly differently. That recognition is a form of solidarity, and Lentz said it has reinforced everything he learned in the Writers Guild about why collective action works.
Lentz was candid about the biggest obstacle in the organizing drive, and it is not management opposition. It is the doctors themselves. He studied economics in college and for years accepted the argument that unions were economically counterproductive. It took working a union job — and striking twice — to understand that the argument was wrong.
A certain segment of American society has run a highly effective multi-decade campaign, convincing Americans that unions are the problem, he said. Doctors, who typically have no experience with union workplaces, have been especially susceptible to that message. Many struggle to think of themselves as workers, even though medicine is structurally one of the most apprenticeship-like fields in the economy.
The reframe that matters, Lentz said, is recognizing how management views physicians, regardless of how physicians view themselves. Management treats attending physicians as costs and revenue generators. That is not a criticism of any individual administrator. It is a description of how institutions operate. The sooner physicians understand that, he argued, the sooner they can act accordingly.
Lentz described Hollywood as a genuinely working-class union town. Almost everyone who works in the industry is a union member. Health insurance is negotiated through unions. Pensions are negotiated through unions. Wage floors are set by a union contract. And the industry is better for it, he said, because unions provide democratic input from the people doing the actual work and prevent the kind of shortsighted management overreach that damages long-term institutional performance.
What Lentz observed during two WGA strikes was that an effective, well-organized union does not just improve conditions for members. It creates a better-functioning institution, he said, adding that he carried that observation into medicine and into the UC Doctors United campaign.
He presented the idea to the writers of The Pit for an episode in which a physician launches a union organizing drive. He is not involved in the writing of the show and made clear he does not intend to be. But he said the subject would be highly relevant and would capture something real about this moment in American history.
Lentz said the labor history he has read while doing this organizing work is what gives him perspective when colleagues ask whether he is worried about retaliation. The people who built the labor movement gave up far more than a job, he said. Their houses were firebombed, their families were targeted and they were beaten for the act of saying that working conditions could be better. Compared to that history, the risk of getting fired — which would be illegal — does not register as much of a deterrent, he said.
His message to physicians begins with the reminder that we all entered medicine to care for patients. The conditions preventing us from doing that are not going to change just because we asked nicely. They are going to change because we organized and won the contractual authority to change them, Lentz said.
More information on UC Doctors United is available at ucdoctorsunited.org.
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