The American Medical Association's governing body yesterday voted to form a national union to help give doctors more leverage in the cost-cutting managed care insurance market.
At the AMA's annual meeting in Chicago, its 494-member House of Delegates approved creation of a national organization that would support formation of local bargaining units for doctors employed by health maintenance organizations and other companies.
Many doctors in managed care settings believe their employers are depriving them of both autonomy and income, and they want some negotiating clout, AMA officials said.
The contracts they work under "often don't let doctors practice the best medicine. . . . it's a David-Goliath situation in terms of those contracts," Dr. Nancy W. Dickey, AMA president, told reporters in a conference call after the vote.
Dr. Randolph Smoak, chairman of the AMA's Board of Trustees, was more blunt. Too often, he said, doctors in such settings are "seen as ditch-diggers. . . . They are not treated as professionals" by their employers.
As a result of yesterday's vote, he said, "We're developing an organization that will have negotiating capability but will not strike. We, as physicians,
are held to a higher standard than any other workers, since we're dealing with patients' lives. . . . We would not harm a patient, regardless of how we might feel about an issue."
At this time, only 1 in 7 of the nation's approximately 684,000 physicians would be eligible to join local bargaining units, said Dr. Smoak.
Self-employed doctors would not be involved unless Congress passes a measure pending in the House Judiciary Committee to give such doctors collective-bargaining rights.
Because of federal antitrust law, it is currently illegal for independent physicians to join together in collective-bargaining units.
The AMA supports a bill, sponsored by Rep. Tom Campbell, California Republican, that would treat independent health care professionals negotiating with health maintenance organizations and other managed care plans, like labor bargaining units and protect them from certain antitrust laws. …