Doctor Unions On The Horizon?

As more and more doctors become hospital employees it seems only inevitable that they will eventually unionize.    Let’s give a quick background.  Insurers take over healthcare.   Physicians are unable to stand up to them.    Docs then get wooed by the hospitals to marry them in order to fight back (the enemy of my enemy is my friend).  Docs become the bitches of the hospital administrators.  The ACA is passed and the rest of the private doctors get employed.    Lastly, in frustration, they unionize which only drives up healthcare even more, kind of like how Detroit priced itself out of competition with the rest of the automobile industry.   Most of this is described in a WSJ editorial by David Leffell.  Here are some highlights:

  • As the effects of the Affordable Care Act come into focus, it becomes clear that when the majority of physicians are no longer self-employed—and barring any legislation to the contrary—their new employed status will provide doctors with the right to collective bargaining.
  • Leaders of the organized-labor movement already view service workers with nonexportable jobs as the last best hope of labor unions whose membership is at an all-time low. The truth is that physicians are now becoming service workers. They are well-educated and expensive to train, and their decisions have substantial significance in the lives of others. But doctors essentially provide a service, one that cannot be outsourced to India or China.
  • For now, it’s enough to contemplate what will occur when the practice of medicine becomes detached from its past as a profession—when doctors may in time come to see themselves not solely as healers but as workers, units of labor, in a system that is committed to delivering care to the greatest number.
  • When doctors occupy a service niche like the chambermaid in Las Vegas or the school teacher in Chicago, the expectations and compensation of the physician-worker will be defined in ways that may make the benefits of collective bargaining appear very attractive.
  • As has happened in other countries that have charted the course we are now on, a new reason for lack of access may at times be: “Office closed, doctors on strike.”

I hate to say it but I definitely see this coming.  How sad for a once proud profession to become “units of labor”?

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  9 comments for “Doctor Unions On The Horizon?

  1. Scott
    February 7, 2013 at 3:37 pm

    10 years ago when I was in Air Force and arrived at a new base, I met with my new commander to lay out his vision and expectations. I was told that I was a “production unit”. That my job was to see the patients, move them through, and not make a lot of trouble. That attitude is pervasive in military medicine, a socialized system, and one of the main reasons I left the Air Force. As we move toward socialization of civilian medical care, we could look at the military to see what we’re in for, with underpaid, unhappy physicians, too many patients, and way too many administrators.

    • Doug Farrago
      February 7, 2013 at 9:00 pm

      RIGHT ON!

  2. GHD
    February 6, 2013 at 3:39 pm

    I have said this for years. We have become employees of the insurance companies. They tell us how to practice, they in essence tell us when to work, and obviously they tell us how much we will make. The only (IRS) condition that does not fit is that they do not provide us with tools to do our job. But that is not a necessity to be considered an employee. I tried unsuccessfully to get the AFL-CIO interested in this in 1990. I’ll bet now they wish they would have gotten us in their camp then.

  3. Bridget Reidy
    February 3, 2013 at 4:48 pm

    I have lost jobs because I believed the line above my signature “This patient is likely to die in six months” – and therefore this company should get over 500 a day to help them – should be thought to be true and that a sabotaging and error prone receptionist should have their mistakes documented if adminstration asks me to so HR can reassign to something she is capable of, even if she does have a special relationship with the boss. We can’t help our patients if we have no rights. Unionization is far overdue. Here in Canada my “union”, the Ontario Medical Association, (and I call it a union because everyone belongs and we can threaten a strike) got the Province to use evidence in it’s payment practices and cut too frequent paps and colonoscopies and PE’s, instead of across the board cuts. That’s what physicians should be doing.

  4. Dr Phil
    February 2, 2013 at 12:23 am

    A Union? I thought that is what the AMA was supposed to be? (Tongue firmly in cheek)

  5. Pat
    February 1, 2013 at 2:00 pm

    Once the public came to see health care as a “right”, this was inevitable. The more force applied by the public (Medicare/ Medicaid, EMTALA, EHR’s, et al et al), the less obligation felt by physicians. The rise of unions will be a way to reunite the public with the consequences of their choices.

  6. Ken
    February 1, 2013 at 10:54 am

    It will be interesting to see how overtime hours are worked out. It might make answering that goddamned phone at 2:00 less painful knowing I will be getting paid for it.

  7. Jason Valentine
    February 1, 2013 at 7:19 am

    Not units of labor, Relative Units of Labor. We’ll be RULs providing RVUs.

    • Doug Farrago
      February 1, 2013 at 10:42 am

      OMG, I love that!

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