The physicians, at Allina Health in Minnesota and Wisconsin, appear to be the largest group of unionized doctors in the private sector.In the latest sign of growing frustration among professionals, doctors employed by a large nonprofit health care system in Minnesota and Wisconsin have voted to unionize.The doctors, roughly 400 primary and urgent-care providers across more than 50 clinics operated by Allina Health, appear to be the largest group of unionized private-sector physicians in the United States. More than 150 nurse practitioners and physician assistants at the clinics were also eligible to vote and will be members of the union, which will be represented by a local of the Service Employees International Union.The result was 325 to 200, with 24 other ballots challenged, according to a tally sheet from the National Labor Relations Board, which conducted the vote. Allina Health did not immediately comment.The doctors complained that chronic understaffing was leading to burnout and compromising patient safety.“In between patients, your doctor is dealing with prescription refills, phone calls and messages from patients, lab results,” said Dr. Cora Walsh, a family physician involved in the organizing campaign.“At an adequately staffed clinic, you have enough support help take some of that workload,” Dr. Walsh added. “When staff levels fall, that work doesn’t go away.”Dr. Walsh estimated that she and her colleagues often spend an hour or two each night handling “inbox load” and worried that the shortages were increasing backlogs and the risk of mistakes.The union vote follows recent walkouts by pharmacists in the Kansas City area and elsewhere over similar concerns.A variety of professionals, including architects and tech workers, have sought to form unions in recent years, while others, like nurses and teachers, have waged strikes and aggressive contract bargaining campaigns.Some argue that employers have exploited their sense of mission to pay them less than their skills warrant, or to work them around the clock. Others contend that new business models or budget pressures are compromising their independence and interfering with their professional judgment.Increasingly, doctors appear to be expressing both concerns.“We feel like we’re not able to advocate for our patients,” said Dr. Matt Hoffman, another doctor involved in the organizing at Allina. Dr. Hoffman, referring to managers, added that “we’re not able to tell them what we need day to day.”Consolidation in the health care industry over the past two decades appears to underlie much of the frustration among doctors, many of whom now work for large health care systems.“When a physician ran his or her own practice, they made the decisions about the people and technology they surrounded themselves with,” Dr. Robert Wachter, chair of the department of medicine at the University of California, San Francisco, said in an email. “Now, these decisions are made by administrators.”Doctors at Allina say that staffing was a concern before the pandemic, that Covid-19 pushed them to the brink and that staffing has never fully recovered to its prepandemic levels.Relatively low pay for clinical assistants and lab personnel appears to have contributed to the staffing issues, as these workers left for other fields in a tight job market. In some cases, doctors and other clinicians within the Allina system have quit or scaled back their hours, citing so-called moral injury — a sense that they couldn’t perform their jobs in accordance with their values.“We were promised that when we get through the acute phase of the pandemic, staffing would get better,” Dr. Walsh said. “But staffing never improved.”Allina, which takes in billions in revenue but has faced financial pressures and recently eliminated hundreds of positions, did not respond to questions about the doctors’ concerns.Joe Crane, the national organizing director for the Doctors Council of the S.E.I.U., which represents attending physicians, said that before the pandemic, he would receive about 50 inquiries a year from doctors interested in learning more about forming a union. He said he received more than 150 inquiries during the first month of the pandemic. (Mr. Crane was with another physicians’ union at the time.)Mr. Crane, citing the siloed nature of the medical profession, said that unionization among attending physicians had nonetheless proceeded slowly, but that the victory at Allina could create momentum.In March, more than 100 doctors voted to unionize at another Allina facility, a hospital with two locations. Dr. Alia Sharif, a physician involved in that union campaign, said doctors were under pressure there not to exceed length-of-stay guidelines for patients, even though many suffer from complex conditions that require more sustained care.Allina is appealing the outcome of that vote to the National Labor Relations Board in Washington; a board official rejected an earlier appeal.Even as rates of unionization have languished among attending physicians, they have increased substantially among medical residents. A sister union within the S.E.I.U., the Committee of Interns and Residents, has added thousands of members over the past few years.Dr. Wachter said this could herald an increase in unionization among doctors outside training programs. “When these physicians finish training and enter practice, they are more comfortable with a world in which unionization doesn’t automatically conflict with their notions of being a professional,” he wrote.

If any group of workers might have expected their pay to rise last year, it would arguably have been pharmacists. With many drugstores dispensing coronavirus tests and vaccines while filling hundreds of prescriptions each day, working as a pharmacist became a sleep-deprived, lunch-skipping frenzy — one in which ornery customers did not hesitate to vent their frustrations over the inevitable backups and bottlenecks.“I was stressed all day long about giving immunizations,” said Amanda Poole, who left her job as a pharmacist at a CVS in Tuscaloosa, Ala., in June. “I’d look at patients and say to them, ‘I’d love to fill your prescriptions today, but there’s no way I can.’”Yet pay for pharmacists, who typically spend six or seven years after high school working toward their professional degree, fell nearly 5 percent last year after adjusting for inflation. Dr. Poole said her pay, about $65 per hour, did not increase in more than four years — first at an independent pharmacy, then at CVS.For many Americans, one of the pandemic’s few bright spots has been wage growth, with pay rising rapidly for those near the bottom and those at the top. But a broad swath of workers in between has lagged behind.In the two years after February 2020, income for those between the middle and the top tenth of earners grew less than half as quickly as income for those in the top 1 percent, according to data collected by a team of economists at the University of California, Berkeley.The gap is part of a long-term trend made worse by a slowdown in pay gains for middle- and upper-middle-income workers in the 2000s. “If you’re going to a hedge fund or investment bank or a tech company, you’ve done enormously well,” said Lawrence Katz, a labor economist at Harvard. Typical college graduates, he said, “have not done that great.”The stagnation appears to have moved up the income ladder in the last few years, even touching those in the top 10 percent.In some cases, the explanation may be a temporary factor, like inflation. But pharmacists illustrate how slow wage growth can point to a longer-term shift that renders once sought-after jobs less rewarding financially and emotionally.Growing Chains, Falling WagesIn 2018, Suzanne Wommack moved from western Missouri, where she had worked for several years as a pharmacist at a Hy-Vee supermarket, to the eastern part of the state, where she and her husband had relatives. The job she landed as a Walgreens pharmacy manager in Hannibal, roughly an hour-and-a-half outside St. Louis, paid her about $62 per hour — nearly $6 below her previous hourly wage, though regional pay differences helped to explain the drop.More striking was how few pharmacists Walgreens appeared to employ. At Hy-Vee, Dr. Wommack worked with one or two other pharmacists for most of the day. At Walgreens, the volume of business was similar, she said, but she was almost always the only pharmacist on duty during her shift, which often ran from 8 a.m. until the pharmacy closed at 8 p.m.Inflation F.A.Q.Card 1 of 5Inflation F.A.Q.What is inflation?

Some see an undue rush by employers to get workplaces back to normal, whether by dropping precautions or imposing new rules.When Kelly Harris, a personal grocery shopper in Steubenville, Ohio, was vaccinated in March against Covid-19, it was a huge relief. “I felt the weight of the world off my shoulders,” she said.Her sense of relief has turned to dread. After most supermarkets eased masking requirements in May, mask wearing plummeted in her area. She worried about bringing the virus home to her school-age children.Then, as the Delta variant proliferated in recent weeks, her anxiety levels spiked again. “I try to stay away from everybody and use self-checkout,” she said. “It has me pretty stressed out.”Judging from the policies of the stores Ms. Harris frequents, many employers appear to regard the recent increase in Covid infections as a mere blip on the long-awaited road to normal.Some companies have intensified their efforts to return to a pandemic before-times, easing safety protocols while expecting employees to return to previous routines.But for many workers, the perception is quite different: a sense of rising vulnerability and frustration even for the vaccinated, who find themselves inundated with stories of breakthrough infections and long Covid.The gulf between employers’ actions and workers’ concerns appears to foreshadow a period of rising tensions between the two, and unions appear to be positioning themselves for it. Some unions are calling on companies to do more to keep members safe, while others are questioning new vaccination requirements. The two positions may seem at odds, but they send a common message: Not so fast.“I think we’re rushing to return to normal,” said Marc Perrone, the president of the United Food and Commercial Workers, which has over one million members in industries like groceries and meatpacking.Many workers complain about a mismatch between plans their employers appear to have made before the rise of the variant and the reality of the past few weeks.For much of the pandemic, Amazon has offered free on-site Covid testing for employees. It incorporated a variety of design features into warehouses to promote social distancing. But a worker at an Amazon warehouse in Oregon, who did not want to be named for fear of retribution, said there had been a gradual reduction in safety features, like the removal of physical barriers to enforce social distancing.Kelly Nantel, an Amazon spokeswoman, said that the company had removed barriers in some parts of warehouses where workers don’t spend much time in proximity, but that it had kept up distancing measures in other areas, like break rooms.“We’re continuously evaluating the temporary measures we implemented in response to Covid-19 and making adjustments in alignment with public health authority guidance,” Ms. Nantel said. She added that the company would “begin ramping down our U.S. testing operations by July 30, 2021.”At REI, the outdoor equipment and apparel retailer, four workers in different parts of the country, who asked not to be named for fear of workplace repercussions, complained that the company had recently enacted a potentially more punitive attendance policy it had planned to put in place just before the pandemic. Under the policy, part-time workers who use more than their allotted sick days are subject to discipline up to termination if the absences are unexcused. The workers also said they were concerned that many stores — after restricting capacity until this spring — had become more and more crowded.Halley Knigge, a spokeswoman for REI, said that under its new policies the company allowed part-time workers to accrue sick leave for the first time and that the disciplinary policy was not substantively new but merely reworded. The stores, she added, continue to restrict occupancy to no more than 50 percent capacity, as they have since June 2020.Workers elsewhere in the retail industry also complained about the growing crowds and difficulty of distancing inside stores like supermarkets. Karyn Johnson-Dorsey, a personal shopper from Riverside, Calif., who finds work on Instacart but also has her own roster of clients, said it had been increasingly difficult to maintain a safe distance from unmasked customers since the state eased masking and capacity restrictions in mid-June.“You have whole families who are picking out a pound of ground beef,” she said. “Children who are not vaccinated because of age are touching everything, not masked, either.”Amazon’s warehouse on Staten Island. Workers at Amazon have become concerned in recent weeks that the company is overly eager to wind down safety measures.Chang W. Lee/The New York TimesMs. Johnson-Dorsey, who had Covid last year and was vaccinated in March, said that what she was encountering in stores had become a major source of worry as the Delta variant spread. “I think it’s just showing that maybe we jumped too quickly to try and beat this imaginary deadline,” she said.On Tuesday, after the Centers for Disease Control and Prevention provided new guidance on masking, some employers said they would adjust their policies as warranted.“We’d always defer to state and local ordinances on capacity and masking mandates,” said a spokeswoman for Albertsons, which also owns Safeway and Jewel-Osco. “We don’t have a national mandate on capacity at this time.”Ms. Harris and Ms. Johnson-Dorsey, the personal shoppers, do not belong to a union, but Bob O’Toole, the president of the food workers local in Chicago, which represents more than 15,000 workers in the grocery, meatpacking and food-processing industries, said many of his members shared their sentiments.“The employees don’t feel as though the employers are doing anything to enhance safety after so many precautions were relaxed,” he wrote in a text message..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 auto;overflow:hidden;}.css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}Mr. Perrone, the international president for the food workers union, said in a statement on Tuesday that the new C.D.C. guidance wasn’t sufficient and urged a national mask mandate.Public-sector workers, too, have expressed safety concerns as officials move to get government services back to prepandemic norms. In Chicago, Mayor Lori Lightfoot recently brought back office-based city employees who had been working remotely during the pandemic.But one of the unions representing them, the Illinois council of the American Federation of State, County and Municipal Employees, has argued that more needs to be done to space workers apart and improve ventilation.“The workplaces where those people work could be sources of transmission because we live in a cubicle world where people are often very close together,” said Roberta Lynch, the union’s executive director in the state. “We want to ensure that people who have high-risk work locations are able to work safely.”A spokeswoman for the mayor did not respond to a request for comment.The Office and Professional Employees International Union, which represents nurses who are increasingly subject to vaccine requirements around the country, is unlikely to take a position on the mandates per se but will seek to have a voice in setting policy to guarantee that employees are treated fairly, said Sandy Pope, its bargaining director. For example, the union wants to ensure that no workers are disciplined or fired for refusing the vaccine if they have legitimate reasons for doing so.“We will demand to be consulted on these things,” Ms. Pope said. “I know a couple of members who have legitimate health issues that have prevented them from being vaccinated.”The union, which also represents clerical workers at insurance companies, credit unions and universities, has employee-management committees pushing to arrange adequate ventilation systems for workers, with mixed results, she said. She added that the union was preparing for a potential standoff in September, when many employers have said they will end hybrid work arrangements and require full-time attendance.“I think that’s going to be the big fight,” Ms. Pope said. “A number of employers had September as the target date.”The Culinary Workers Union, which represents casino workers in Las Vegas, has been calling for the return of a mask requirement for all customers indoors since Nevada relaxed the rule in May.John Locher/Associated PressBy contrast, the United Automobile Workers union said it was working with major automakers through a Covid task force to help make safety decisions. General Motors and Ford Motor both recently reinstituted masking for all employees at separate sites in Missouri, and Ford reinstituted masking at offices in Florida, after the companies assessed virus-related data in those regions. And a number of employers, including Amazon and the meat processor JBS, have had vaccination facilities for workers on site.Some unions may have been spared a fight by the C.D.C.’s move on Tuesday. In Las Vegas, the Culinary Workers Union, which represents casino workers, has been calling for the return of a mask requirement for all customers indoors since Nevada relaxed the requirement in May. The casinos had not heeded the call, but after the C.D.C. announcement, the state said it would reimpose an indoor mask mandate.In other cases, a reckoning still looms. The federal government’s mask mandate on airplanes is set to expire after Sept. 13, and unions representing airplane personnel are uneasy about the possibility that it will lapse, though Tuesday’s C.D.C. announcement suggests it may be more likely to be extended. The unions have applauded the airlines for moving to stop the spread of the coronavirus on airplanes by installing more sophisticated air filtration systems, but maintain that they are not sufficient.“Filtration is helpful for circulated air in the cabin,” said Sara Nelson, president of the Association of Flight Attendants. “But it doesn’t stop the general spread from one person to another sitting six inches apart.”

The Occupational Safety and Health Administration announced a rule on Thursday outlining steps that employers must take to protect workers from the risk of Covid-19, but it will apply only to the health care industry, not to other high-risk workplaces, as the Biden administration initially indicated.

After a shift by the C.D.C., employers withdrew mask policies that workers felt were protecting them from unvaccinated customers.The Kroger supermarket in Yorktown, Va., is in a county where mask wearing can be casual at best. Yet for months, the store urged patrons to cover their noses and mouths, and almost everyone complied.