In a groundbreaking development for the telehealth industry, telehealth clinician unionization is making headlines as clinicians at Bicycle Health—a prominent virtual treatment provider specializing in opioid use disorder (OUD)—have officially filed to unionize with the Union of American Physicians and Dentists (UAPD). This effort marks a significant milestone, as Bicycle clinicians could become some of the first workers at a digital behavioral health company to secure union representation.
About Bicycle Health: A Rising Star in Virtual OUD Treatment
Founded in Boston, Bicycle Health has quickly established itself as a key player in the virtual treatment space for opioid use disorder. The company offers a comprehensive range of services, including virtual therapy, medications for opioid use disorder (MOUD), personalized treatment plans, and peer support groups.
Bicycle’s rapid growth has been fueled by strong investor interest; the startup raised $50 million in a Series B funding round in 2022, pushing its total funding to $83 million. This capital infusion reflects the expanding demand for accessible, telehealth-driven OUD treatment options.
Why Unionize? Clinicians Speak Out
Despite Bicycle Health’s success and growth, clinicians say the company’s priorities have shifted noticeably—from focusing on employee well-being toward maximizing profit margins. This shift has motivated many frontline providers to seek a formal collective voice through telehealth clinician unionization.
Multiple anonymous clinicians shared with Addiction Treatment Business that the core of their unionization drive is a desire to “have a seat at the table.” They want a meaningful role in decision-making processes that directly affect their work conditions, patient care, and professional satisfaction.
Specifically, clinicians are advocating for:
- More control over their schedules to balance patient care with workload
- Benefits that recognize employee tenure and commitment
- Greater transparency and influence over company policies
A collective group of clinicians submitted a detailed letter of concern to Bicycle’s leadership, expressing frustration over several issues that have grown more acute over time. These concerns include:
- Insufficient time for follow-up appointments: Priority is increasingly given to onboarding new patients, leaving less time to adequately support existing ones
- Confusing billing practices: Changes in billing have resulted in higher patient bills, causing distress both for clinicians and those they serve
- Diminished channels for clinician feedback: Opportunities to provide input and influence company policies have been removed or curtailed
One source told Addiction Treatment Business, “If changes are not made, and we continue on the same trajectory, then patient care will suffer. Patients will suffer.” This sentiment highlights a crucial link between employee satisfaction and quality of care, a relationship often overlooked in rapid-growth tech-driven healthcare companies.
Bicycle Health’s Response: A Commitment to Collaboration
In response to these concerns, Bicycle Health emphasized its commitment to collaborative decision-making. The company stated that its medical team stakeholders are involved in every major organizational decision and that feedback from clinicians is carefully considered.
The company acknowledged recent changes to scheduling and billing practices but positioned these adjustments as necessary adaptations to evolving business needs, including expanded insurance contracts. They noted that a large number of providers are satisfied with the current scheduling system for new patients, and ongoing efforts are underway to improve billing communication with patients.
While these statements reflect an attempt to balance operational efficiency with provider satisfaction, the tension between frontline clinicians and leadership remains palpable.
Unionization Trends in Telehealth and Behavioral Health
Union membership rates in the U.S. have been declining for decades, with just 10% of wage and salary workers unionized in 2023—the lowest rate on record until recently, according to the U.S. Bureau of Labor Statistics. Despite this, the telehealth sector is emerging as a new frontier for telehealth clinician unionization efforts.
Stuart Bussey, president of the UAPD, explained the inevitability of unionization in telehealth: “With the rise of telehealth in 2020, we anticipated it was only a matter of time before providers would start to unionize. The tech industry prides itself on being innovative and disruptive, but it shouldn’t come at the cost of providers and their ability to provide quality patient care.”
This sentiment underscores a growing awareness that digital health innovations must go hand-in-hand with fair labor practices, especially in behavioral health fields where provider well-being directly affects patient outcomes.
Notably, clinicians at Resilience Lab, another venture-backed digital behavioral health company, voted to unionize in early 2023. Resilience Lab’s leadership acknowledged that they had underestimated workers’ frustrations and committed to better communication and responsiveness moving forward. Despite the unionization, the company continued to grow and expand its services—demonstrating that unionization and company success are not mutually exclusive.
What Does This Mean for Bicycle Health and Its Clinicians?
The upcoming union vote, scheduled for Monday, April 8, will be overseen by the National Labor Relations Board through a secret ballot. Should the vote pass, Bicycle clinicians would join a small but growing number of telehealth providers pushing for collective bargaining rights through telehealth clinician unionization.
While some experts believe that behavioral health clinicians hold considerable leverage due to a nationwide workforce shortage, clinicians at Bicycle Health express concerns that the company could swiftly replace employees if necessary. However, they caution that any rapid turnover could degrade the quality of care—something both clinicians and patients want to avoid.
One clinician shared a heartfelt message to employers: “Listen to the providers. We are the ones on the front lines every single day doing the work. We know what’s working, what’s not working, and we always have a suggestion.”
This advice strikes at the heart of the unionization debate: true progress in digital behavioral health requires meaningful dialogue and respect between leadership and those delivering care.
Looking Ahead: A New Era for Digital Behavioral Health Labor Relations
The Bicycle Health unionization effort signals a potential shift in how telehealth companies approach labor relations. As the industry grows and evolves, balancing innovation with employee rights will be essential.
The success or failure of this union vote could set a precedent for other digital health providers facing similar challenges—highlighting the importance of transparency, employee engagement, and patient-centered care in the evolving landscape of behavioral health treatment.
In this new era, telehealth clinician unionization may become a key factor shaping the future of virtual behavioral health care—ensuring that providers have a voice, patients receive quality care, and companies operate with fairness and accountability.
