These Doctors Pay Their Dues-To a Union

By Lowes, Robert L. | Medical Economics, January 26, 1998 | Go to article overview

These Doctors Pay Their Dues-To a Union


Lowes, Robert L., Medical Economics


Are they extremists? Or simply desperate? In either case, a doctors' union illustrates the sour side of practice acquisitions.

In 1994, when Rockford Health System acquired the 80-doctor Rockford Clinic in the Illinois city that shares their name, buzzwords like "partnership" and "integration" created an all-toofamiliar drone.

Today, the descriptive phrases being bandied about include "growing pains" and another one that's both spiky and surreal, at least in medicine-"collective-bargaining unit."

That's what Rockford doctors formed last summer to regain some of the autonomy they lost when they became employees. "We're dealing with a system that's running the doctors and not the other way around," says internist Dennis Norem, a former board member of the old Rockford Clinic, who's helping spearhead this medical labor movement.

The collective-bargaining unit, dubbed the Rockford Physicians' Council, wants a voice in decisions that affect patient care-staffing cutbacks and how many patients a doctor should see each month, for example-as the health system tries to cut expenses and maximize revenue in financially trying times. The creation of the council, says Norem, already has pressured the health system to give more say-so to physicians. Administrators contend they were moving in that direction anyway.

Norem, a member of the council's steering committee, says his group isn't a traditional union. Ostensibly, the council isn't trying to negotiate higher pay for physicians-no Teamsters pounding the table for raises here. But pet issues like physician productivity do affect income. The doctors also vow never to jeopardize patient care by striking. Otherwise, it's a traditional labor-management tussle, with all the attendant acrimony. The Physicians' Council already has gone to the National Labor Relations Board, charging a subsidiary of the health system with trying to break the union. Some partnership.

What has emerged is a landmark coalition between the council organizers and the American Medical Association. The AMA is supplying the doctors with two labor attorneys through its new Division of Representation, created to protect doctors from business-suit bullies. Rockford-the hometown of the AMA's just-resigned executive vice president, P. John Sewardrepresents the association's first foray into nitty-gritty labor organizing. AMA officials suggest that more may follow, considering the phone calls they get from other employed physicians.

"They want to know how they can advocate for quality care without being fired," says general surgeon Donald J. Palmisano, an AMA trustee. Palmisano adds, however, that the AMA will assist only those physicians who've taken the Rockford pledge-no strikes, lest patients suffer.

A drop in hospital income sets off a crisis

The turmoil in Rockford was triggered by a financial crisis that illustrates the dangers of hitching your future to another organization's bottom line. Rockford Memorial Hospital, the core of the Rockford Health System, posted healthy earnings in the mid-1990s-$23 million in 1995, for example, according to Medicare cost reports. Earnings fell to $10 million in 1996, however.

More significantly, the hospital lost $2 million on patient services, which the year before had netted nearly $12 million. Tom DeFauw, the health system CEO, attributes the slump largely to shorter hospital stays. But discounting of hospital charges deepened, too.

Physicians protested when, in response to the downturn, the health system in late 1996 eliminated roughly 300 jobs, mostly in the hospital. The cuts made life more difficult for doctors and patients alike, says Norem. "There weren't enough people to draw blood, so you had lines snaking around hallway corners. Transcription of dictation and lab tests slowed down, and it was harder to retrieve patient charts. Sure, the budget had to be cut, but decisions were made by administrators with little input from physicians. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

These Doctors Pay Their Dues-To a Union
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.