This case offers a “bottom up” view of the health care industry through the voices of workers essential to the industry’s operations, including unskilled and semi-skilled titles. Allied health care workers are often invisible members of the health care workforce, revealing the industry’s own internal hierarchies of class, race, gender and status. This case illuminates their struggles, successes and challenges to end structural inequality in the workplace as they fight to transform low-wage, exploitative jobs into dignified, fairly compensated careers. Non-clinical members of the team are essential to improving patient care and obtaining structural change. Their knowledge and insight as partners are central to new innovations in care delivery. The case concludes with four ways to forge effective ties with worker and labor organizations to deepen structural competency within health care organizations.