Class 9 – UNIONS
Some doctors, including residents and interns, are looking for solutions in dealing with managed care issues and other issues such as benefits, salaries, working conditions at the place they work at and are considering unions
Some doctors, including residents and interns, are looking for solutions in dealing with managed care issues as well as other issues such as benefits, salaries, working conditions at the place they work at. In most cases, unions have been considered or applicable to situations involving employer and employee relationships. For example, doctors employed by a hospital. The American Medical Association indicates that of the600,000 doctors now treating patients in the U.S., about one in seven practicing physician is employed.
There was a long held status of residents at hospitals being considered students and not employees and therefore ineligible to bargain collectively. In Chicago, nearly 180 residents at Lutheran General Hospital in Park Ridge, Illinois may hold an election on whether to form a union. The residents are the first in the country to petition for an election since the National Labor Relations Board (NLRB) ruling in November 1999 that changed the status of residents. The November 1999 ruling allowed residents at the nation’s 5,000 private hospitals to organize.
The NLRB settled a 2-year old dispute brought by 430 medical professionals at Boston Medical Center ruling that interns and residents who work in private hospitals are employees and and have the option to join unions. This vote overturned the 1976 decision holding that residents, interns and fellows at Cedars-Sinai Hospital in Los Angeles were students.
Residents at Lutheran General said they are upset that they had to pay health insurance premiums this year, costs that previously were paid by the hospital. They also want better parking spaces, which were moved across the street from the hospital without input from the doctors. The residents claimed they had a “house staff organization” but that it was not effective.
The American Medical Association’s (AMA) Physicians for Responsible Negotiation (PRN) said they would represent Lutheran General residents. The PRN was created by the AMA in 1999 to help doctors with working conditions and negotiate with insurance companies.
Further, more than 800 residents at Northwestern Memorial Hospital in Chicago and five affiliated health facilities recently created a house staff. Residents at Northwestern Memorial Hospital concerned about low pay, inadequate health insurance, disorganized and unresponsive administration formed McGaw House Officers Alliance. This alliance was formed to improve working conditions and voice concerns about patient care issues.
Prior to the group’s formation residents starting salaries was allegedly well below the national average. According to an article by Sarah A. Klein, “Hospital Seeking a Union Antidote,” sub-caption “As Residents Organize, Northwestern Fights Back,” in Crain’s Chicago Business (October 30, 2000), since the Alliance’s formation, the medical center offered residents a 5.1% raise, expanded health coverage, and increased number of parking spots for residents working downtown.
One union in New York (Doctors Council) estimates that more than 40,000 or 13% of about 300,000 employed physicians eligible to join unions, not counting interns and residents have joined unions.
The major unions for doctors include the following, according to an article by Elizabeth Thompson, “Organized Doctors,“ Modern Healthcare (February 28, 2000):
(1) National Doctors Alliance Doctors Council with more than 16,000 members with 1,500 growth in past year;
(2) Committee of Interns and Residents with more than 10,000 members with 1,000 growth in past year;
(3) Union of American Physicians and Dentists with 6,000 members and 6,000 growth in past year;
(4) Federation of Physicians and Dentists with 8,500 members and 672 growth in past year.
(5) United Salaried Physicians and Dentists with 1,500 members and 500 growth in past year;
(6) Physicians for Responsible Negotiation with membership data unavailable and the first 36 eligible physicians to vote to form a collective bargaining unit in Detroit on March, 2000.
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