I imagine that few physicians contemplated being part of organized labor when they enrolled in medical school but as more and more physicians make the leap from private practice to hospital employment, perhaps large-scale unionization of the physician workforce could become a reality. According to an article by David J. Leffell today on WSJ.com, the notion is perhaps not as far-fetched as we might have thought. Mr. Leffell notes that one of the side-effects of the shift by physicians to employee status will be the right to engage in collective bargaining. This presumably would also entail the right to strike – likely not the ideal model for the delivery of quality care. The implications of physician unionization are so monumental that one must wonder whether this possibility is an unintended consequence or an intended result.