Adventist Voices: Unionization and Loma Linda University Health

Alex Aamodt shares insights from his week of watching the National Labor Relations Board hearing on the unionization efforts at Loma Linda University Health. He talks about the role played by representatives from the General Conference (David Trim and Bill Knott) who were sworn in to explain institutional structure and Adventist policy on unions rooted in Ellen White's writings. Drawing on the proceedings and his legal and historical research, Aamodt also details key definitions (students or employees), explains the difference between LLUH and LLUHEC, and provides perspectives from both sides: the physician residents/fellows and the arguments made by the lawyers representing LLUH. 

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It’s been too many years for me to compare today’s salaries to what residents made in 1990, but I am able to compare hours and call schedules. I’m a little surprised that given the legislation on residency hours we are still talking about 80 & 100+ hour weeks, and 24 hour call.

I’m particularly distressed that we are pulling up what’s rather a shaming approach to dealing with this— the bell-ringing of spiritual community and the expectation of painful sacrifice seems counterproductive and ill-advised.

Doesn’t the Biblical counsel discuss fairness to workers, and passages like I Timothy 5 advise say the worker is worthy of an honest wage? Yet church employees have often been shortchanged and then scolded that they aren’t willing to sacrifice in their service of God. Odd request when God doesn’t seem to ask this.

Physicians at this level of training are certainly well into their twenties and thirties and many supporting families. It also true that transportation and housing are a mind-blowing expense in that region’s cost of living. This doesn’t even include the fact that some of the significant loans they’ve needed to attend med school are needing paid already.

I’m sure it’s distressing to have this dragged out into a public legal forum. I would have thought we knew this was a possibility after seeing the Merikay Silver lawsuit. The best way to maintain autonomy might have been to be so exemplary in policy and treatment of their residents all along that they were a model to which other programs could be measured.

The emphasis on Loma Linda as a distinct spiritual community is also interesting. I found it to be a nurturing and positive place during my years in that community. I think perhaps this hearing will reveal what has changed since then, the motives and realities of the workers/residents, and what needs addressing and changing in this situation. I hope the leadership will be paying close attention. Community is in fact an important construct. If there was genuine community before this, wouldn’t the residents already have better hours and appropriate pay? All questions worth asking. I hope it isn’t too late.


My mother worked as a nurse for 20+ years at the Loma Linda Medical Center.

She has a lot of stories of the hospital mismanagement including various sorts of employee abuse, from officially asking nurses to clock out before they’re done charting - and then continue working - to actually not paying them for the time they were clocked in and working.

At one point the labor board came in and reviewed their payroll history and compelled the hospital to pay back wages for time recorded in their own time-clock system which went unpaid. As a result, she received a check for something like $45,000 in back wages.

Her assessment is that the hospital is not run in a professional way and that upper management not at all in control. Lower level managers run little fiefdoms, regularly making up their own rules which just happen to violate one or more labor laws - and no one really notices.

She recalls a recurring theme over the years: At one point there will be a nursing shortage and so everyone gets a bunch of overtime (sometimes almost forced overtime) and then six months later when they’ve blown their budget all of a sudden there’s a strict policy of no more overtime. At which point the hospital is either run short staffed (to the point of violating the law) or the hospital hires a bunch of contract nurses, which end up costing more than the overtime. And, at the same time, some nurses now denied any overtime but who grew to depend on it start working shifts at the local County hospital, realize how much more they are paid there and how much easier the job is, and then quit Loma Linda.


It’s sad that LLU, whose motto is to make people whole, got so behind the humanity-curve that 250 residents voted for a union to get more humane working conditions and salaries. If LLU’s core values (compassion, excellence, humility, integrity, justice, teamwork, wholeness) were in the driver’s seat, would some residents be working up to 120 hours/week or working for 15 days straight? At its best LLU, where I spent 40 years teachings ethics to med students and others, is fulfilling its mission to continue the healing and teaching ministry of Jesus. At other times it’s the attorneys and accountants and religious bureaucrats who seem in charge. Thank you, Spectrum editors, for candid reporting on this flagship Adventist institution and its dealing with its valued residents.

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