AMA calls for doctors' unions

WITH ITS VOTE IN JUNE TO FORM doctors' unions, the American Medical Association (AMA) entered the world of collective bargaining. The move comes as the AMA, which represents over a third of the nation's six hundred thousand practicing physicians, seeks new ways to deal with its membership's problems, such as constraints on patient care imposed by certain health plans.

Patrick B. Shaw, director of the AAUP's Department of Organizing and Services, says the emergence of the medical association as a protagonist in union activities resembles the AAUP's shift into collective bargaining nearly thirty years ago. The AMA's momentous step, Shaw notes, shows the "resolve of another group of professionals to accept collective bargaining -.is a powerful means to protect professional judgment and discretion." With the rise of health plans that restrict enrollees' access to physicians, many AMA members previously indisposed to taking collective action joined in the effort to approve doctors' unions.

As might be expected when a professional group forms a union, the AMA vote has triggered some internal backlash. Organization spokespeople acknowledge a handful of negative calls to headquarters that may lead to canceled memberships. But with its September announcement of a new national negotiating committee, Physicians for Responsible Negotiation, which forswears strikes and bears a nonconfrontational name, the AMA is looking to assuage fears that unions of doctors will somehow frustrate consumers or hold up contract settlements with demands for higher physician pay.

As a group of highly skilled workers, doctors seeking to unionize face barriers in antitrust laws, which protect consumers against monopolies of professional services. (The effect of these laws, in limiting physician unions to doctors in nonmanagerial positions, resembles the effect on private-college faculty of the Supreme Court's 1980 decision in the case of Yeshiva University. In that decision, the Court ruled that professors are managers and therefore ineligible to form unions under the National Labor Relations Act, under which collective bargaining occurs at private colleges.)

To avoid antitrust barriers, the AMA, in its initial efforts is focusing on the 17 percent of physicians who are nonmanagerial employees rather than those who are in private practice or who occupy executive or supervisory positions.

According to Shaw, "The AMA and its members, both for and against doctors' unions, might learn a great deal from the AAUP about how a professional association can accommodate the prospect of being involved in collective bargaining."