ANALYSIS    AIR DATE: June 24, 1999

Background: Doctors Vote to Unionize

SUMMARY

The American Medical Association voted to form a labor union. The AMA argued the union will improve the working conditions for doctors and serve as an advocate for patients.Susan Detzer explains the vote.

Background: Doctors Vote to Unionize
The Henry J. Kaiser Family Foundation provided funding for this project

SPOKESPERSON: It is clearly adopted. (Applause)

SUSAN DENTZER: The American Medical Association was founded back in 1847 to raise the professional and ethical standards of the nation's physicians. But yesterday, the AMA took a step that could drastically change its character and give new meaning to the phrase long used to describe it, organized medicine.

SPOKESPERSON: We want the ability to negotiate here. That's the most important thing: Fair, unfettered, open communications. We want physician advocacy that keeps our patients at the forefront, where it must always stay.

SUSAN DENTZER: In a highly controversial move, the AMA's House of Delegates voted yesterday to form what was described as an affiliated national labor organization, also known as a union. Much like the umbrella national unions for autoworkers or pipe fitters, the new organization would help develop local collective bargaining units of doctors around the country. The ultimate aim is to give doctors more leverage in negotiating fees and other arrangements with HMOs and various health insurers. Recently many managed care organizations have been consolidating to beef up their ability to drive hard bargains with doctors. Dr. Nancy Dickey, the AMA's immediate past president, says unionizing is intended to do more than boost doctors' incomes.

DR. NANCY DICKEY: Now we have another tool to help define what's best for our patients.

SUSAN DENTZER: Under current federal law, the AMA's organizing efforts would be limited mainly to roughly 100,000 doctors who are employees of managed care companies, government hospitals, and the like. That's about one in seven of the nation's doctors. Roughly 40,000 of those physicians are already members of other unions such as the Service Employees International Union. But the AMA is also pushing for a broad change in federal law that would allow it to organize another 300,000 physicians who are self-employed. As health professionals, these doctors currently cannot band together to negotiate fees without violating federal antitrust law. With the support of the AMA, Republican Representative Tom Campbell of California backs such a change in the law.

REP. TOM CAMPBELL: The HMOs right now do not like the fact that I am proposing somebody can bargain with them. This will cut into the HMOs profits.

SUSAN DENTZER: Meanwhile, doctors express varying views about the wisdom of the AMA's move. And amid signs that the AMA's membership and board are also split, more fallout almost certainly lies ahead.

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