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Legal Battle Begins over Unionization at Loma Linda University Health


On Monday, March 13, a pre-election hearing began with the National Labor Relations Board (NLRB) to determine whether medical residents at Loma Linda University Health (LLUH) will be allowed a formal vote to unionize. In February, organizers collected signatures from the required 30% of residents to file for an election with the NLRB, seeking to be represented by the Union of American Physicians & Dentists.

The NLRB is an independent federal agency responsible for enforcing labor law in the United States. Both the regional NLRB office overseeing the case and the national NLRB Board denied LLUH’s request to stop the pre-election hearing while it makes an argument that the government can’t interfere in its labor relations due to religious freedom.

On March 14, Loma Linda University Health also filed a lawsuit with the United States District Court for the District of Columbia seeking preliminary and permanent injunctions against the NLRB. “If the Church were to be ordered by the Board to recognize and bargain with the Union, it would be forced under the threat of civil sanction to act contrary to its long-standing and well-established religious teachings regarding labor organizations,” the complaint reads.

Testimony and legal filings have also addressed LLUH’s belief that residents should be classified as students rather than employees.

The hearing, held via Zoom, began on March 13, presided over by Kristen Scott, a hearing officer from NLRB Region 31, which covers a portion of Southern California.

Many medical residents have been following the testimony.

“We’re all talking about how we feel about this,” said Darya Tajfiroozeh, a second-year pediatrics resident. She has been listening to as much of the proceedings as she can amid her busy clinical schedule and hearing from other residents about the parts she can’t attend. “Them calling us students is making us feel even more under-appreciated and devalued,” she said.

The legal team for Loma Linda University Health called multiple witnesses to address the religious nature of the medical programs and the institution’s official ties to the General Conference of the Seventh-day Adventist Church. David Trim, director of the Office of Archives, Statistics, and Research for the GC, testified about how Loma Linda University medical entities are GC institutions.

As the hearing stretched into day two, Bill Knott, former Adventist Review editor and current associate director for the GC Public Affairs and Religious Liberty Department, testified about Adventist views on labor unions. Writings by Ellen White and the current GC Working Policy were admitted as exhibits.

“The statements of the church are of two kinds,” Knott said. “It indicates that church members should not participate in labor unions, but that church institutions must not. That distinction is clear.”

Historic stances by the Adventist Church, supported by writings from Ellen White, have been generally anti-labor union, though recent statements have not always been as unequivocal as hearing testimony may have indicated.

“The counsel of Ellen G White on employer-employee relations is rooted in historical situations of her time and a prophetic insight concerning social and economic conditions in the future,” a 2003 official guideline from the General Conference says. “She gave stern warnings about the trade union practices of her day. She was fiercely protective against incursions on the conscience of individuals or the intrusion of barriers to Church mission. Some would assert that the situation is considerably different today. To the extent that things are different one needs careful discernment in identifying and applying principles upon which her counsel rested.”

Much of Tuesday and Wednesday’s testimony involved Daniel W. Giang, associate dean for graduate medical education at Loma Linda University and president of the Loma Linda University Health Education Consortium (the nonprofit organization established in 2012 to contain LLUH’s medical residency and fellowship training). Giang gave hours of detailed explanations about how medical residencies work, how residency programs are financed, and how LLUH incorporates spiritual care into its operations. Earlier, Randy Roberts, in his dual roles as pastor of the Loma Linda University Church and vice president for spiritual life and mission at LLUH, was sworn in to testify about the prominent role of spirituality in resident training and physician care.

Throughout, Loma Linda University Health’s legal team has emphasized that they view medical residents to be primarily students. “The representations that have been made by the union and the union counsel . . . are completely inaccurate as to how these [programs] are funded, and it goes directly to whether or not these are students first or employees,” said attorney Christian Rowley, a partner at Seyfarth Shaw LLP. “And they are students.”

Despite the forceful pronouncements, proving that residents are students-first looks to be an uphill battle. Multiple NLRB decisions and court rulings have defined medical residents—who have already completed undergraduate degrees and four years of medical school—as employees. In a landmark 1999 case, the NLRB ruled that residents should be considered employees for the purposes of labor rules. The issue has also gone as far as the US Supreme Court, which gave a unanimous ruling in the 2011 case Mayo Foundation v. United States that residents should be classified as employees for employment taxes and social security.

LLUH’s religious freedom arguments seek another path for stopping the unionization effort, and the US District Court case makes an appeal under the Religious Freedom Restoration Act.

While LLUH asserts that negotiating with a union would violate core Adventist religious beliefs, Darya Tajfiroozeh insists that she and her fellow residents respect the religious mission.

“We are not looking to take away any religious practices from Loma Linda,” she said. “We just want a more fair contract and better compensation. It has nothing to do with Loma Linda’s religion.”

According to LLUH’s legal team, the NLRB hearing will likely stretch into a second week as they continue to call witnesses. The separate court case also awaits a decision. If the courts decide to take up the religious freedom claims, there could be profound implications for faith-based health care institutions across the country.


Alex Aamodt is managing digital editor and the Roy Branson Investigative Reporter for Spectrum. You can contact him here.

Title image: Carl Canwell / Adventist Media Exchange (CC BY 4.0)

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