Employed or Self-employed: Did You Make the Right Choice?

Leigh Page

Disclosures

October 12, 2016

In This Article

Could Unions Help Employed Physicians?

For reasons such as those that Dr Patrick voiced, "employed doctors need a union," Dr Proscia says. "A union can empower them to have a voice in their organization."

"One doctor speaking up against management is not going to be heard," he adds. "They're a cog in the proverbial wheel. But a whole group of doctors organized as a collective voice will be heard."

Dr Proscia says the Doctors Council has been getting an increasing number of calls from employed physicians all over the country. One of the few new doctors' unions to be formed in the past decade was founded in 2014 by two dozen hospitalists at PeaceHealth Sacred Heart Medical Center in Oregon.

Since its inception, however, the new Oregon union has been hung up in negotiations with management over such issues as their ability to use their professional judgment, according to a report[11] in the New York Times. The union says the administration has tried to centralize decisions that they used to make on their own, such as hiring new hospitalists and arranging daily schedules.

In June, the union announced[12] that both sides had reached a tentative agreement, but details weren't revealed because the contract still had to be voted on by the membership. "I believe that this contract gives our members a voice, not only as doctors, but [also] as advocates and decision-makers for our patients," union spokesperson David Schwartz, MD, stated in the announcement.

US physicians, however, remain deeply skeptical of unions. The AMA created a union in 1999, called Physicians for Responsible Negotiation (PRN). But the AMA did not allow it to strike, believing that strikes were antithetical to a physician's duty to care for patients.

The PRN model did not work. The AMA disbanded the union 5 years later, after spending at least $3.6 million on it and signing up only about 40 doctors.[13]

AMA policy,[14] updated after PRN's demise, specifically discourages physicians from joining unions. "Formal unionization of physicians, including physicians-in-training, may tie physicians' obligations to the interests of workers who may not share physicians' primary and overriding commitment to patients," the policy states.

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