Inter professional medical union

[Future_Bone_Docta]

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A New Doctors’ Union in the South Is a Model for Health Care Organizing

Doctors’ unions are rare in the US, and unions comprised of both physicians and other medical providers are even rarer. But in North Carolina, a group of medical providers has successfully organized an interprofessional union.

jacobin.com

Just thought I would share.

 

[VA Hopeful Dr]

Doctors already have a union. It's called the American Medical association. Association is a much fancier word for saying Union.

You either have no idea what unions are or have no idea what the AMA does.

 

[voxveritatisetlucis]

So joining hands with people who want to take their jobs. Interesting choice

 

[Future_Bone_Docta]

So joining hands with people who want to take their jobs. Interesting choice

I prefer looking through rose colored glasses and telling myself "oh well maybe these are midlevels who love the idea of physician lead care"'

However.....

Regional director Lisa Henderson ruled that even though physicians have more education and job training than NPs and PAs, the job responsibilities among the various providers were so similar that the workers were eligible to form a bargaining unit together. Moreover, Piedmont physicians and advanced practice providers failed to meet the job criteria of a supervisor, wrote Henderson, since they do not assign work to their medical assistants.

I don't like the sound of this.

 

[voxveritatisetlucis]

I prefer looking through rose colored glasses and telling myself "oh well maybe these are midlevels who love the idea of physician lead care"'

However.....

Regional director Lisa Henderson ruled that even though physicians have more education and job training than NPs and PAs, the job responsibilities among the various providers were so similar that the workers were eligible to form a bargaining unit together. Moreover, Piedmont physicians and advanced practice providers failed to meet the job criteria of a supervisor, wrote Henderson, since they do not assign work to their medical assistants.

I don't like the sound of this.

Why would any doctor join this?

 

[Future_Bone_Docta]

Why would any doctor join this?

$$$ and less hours.

I feel like seasoned attendings know they are sitting pretty and don't have to worry about the mid-level thing. They will be out of medicine before the... feces... hits the fan.

 

[srirachamayonnaise]

Oh, I know that the AMA is useless now, but there was a time that they had considerable teeth. Hence my use of an old Alan King joke

Union implies collective bargaining power in employment contract. AMA is never a union. I don’t know what you mean by saying they used to have teeth.. you mean as a lobbyist? Any physician and medical student can be a member of AMA and it’s more of a club than anything else… not sure you understand what AMA does… for the same reason, there are many other medical associations. Association is not a fancier word for unions. They mean different things legally speaking….

 

[srirachamayonnaise]

Believe It or Not, history did not begin with you Sdners.

Go back about 60 70 years ago, and the AMA actually did have some significant political power. They sure as hell fought their damnedest against Medicare and medicaid.

They are lobbyists… not unions… that’s my point. Doctors are not unionized just because there’s AMA. I don’t know why I argue with you about something so simple. Anyway, I don’t suppose you are a physician to understand this point

 

[voxveritatisetlucis]

They are lobbyists… not unions… that’s my point. Doctors are not unionized just because there’s AMA. I don’t know why I argue with you about something so simple. Anyway, I don’t suppose you are a physician to understand this point

Isn’t there some antitrust thing about doctors unionizing, at least across hospital systems

 

[VA Hopeful Dr]

Believe It or Not, history did not begin with you Sdners.

Go back about 60 70 years ago, and the AMA actually did have some significant political power. They sure as hell fought their damnedest against Medicare and medicaid.

Political power =\= union. Otherwise the AHA would be a union (it isn't), nor is PhRMA.

The AMA doesn't do any collective bargaining, can't organize strikes, doesn't offer us legal help with contracts/work disputes.

 

[operaman]

This is actually a brilliant idea and gives the union much more power. Having been a union member in my past life that covered a number of different artists, we definitely had issues where CBAs were negotiated that benefitted one type of artist at the expense of others. If the sheer number of midlevels exceeds that of docs, it could mean that the unique interests of docs eventually get overshadowed. But for now it seems to have potential.

The possible strike power of a group like this is remarkable. Providers are the only revenue generating elements in any hospital system, so even just cutting out elective procedures for a week could seriously impact the hospital’s bottom line. It wouldn’t take much a strike to do serious financial damage to the institution.

 

[VA Hopeful Dr]

$$$ and less hours.

I feel like seasoned attendings know they are sitting pretty and don't have to worry about the mid-level thing. They will be out of medicine before the... feces... hits the fan.

You so realize that many of the attendings here are pretty young, right? I'm still in my 30s so retirement is 20+ years away.

 

[voxveritatisetlucis]

This is actually a brilliant idea and gives the union much more power. Having been a union member in my past life that covered a number of different artists, we definitely had issues where CBAs were negotiated that benefitted one type of artist at the expense of others. If the sheer number of midlevels exceeds that of docs, it could mean that the unique interests of docs eventually get overshadowed. But for now it seems to have potential.

The possible strike power of a group like this is remarkable. Providers are the only revenue generating elements in any hospital system, so even just cutting out elective procedures for a week could seriously impact the hospital’s bottom line. It wouldn’t take much a strike to do serious financial damage to the institution.

Aren’t you an ENT though? Midlevels have 0% chance of taking your job and or lowering your salary. I’m curious if IM/FM/Psych etc. feel the same. Midlevels are a much larger threat in these type of fields.

In my opinion, any strike would probably lead to midlevels demanding the same or similar compensation as physicians.

 

[operaman]

Aren’t you an ENT though? Midlevels have 0% chance of taking your job and or lowering your salary. I’m curious if IM/FM/Psych etc. feel the same. Midlevels are a much larger threat in these type of fields.

In my opinion, any strike would probably lead to midlevels demanding the same or similar compensation as physicians.

My specialty doesn’t change the strategic advantage of such a union. Having 90% of the hospitals revenue generating personnel in the union offer some real power.

I doubt midlevels would try to use strike power to get equal salaries with physicians. First the physicians would be unlikely to support that CBA and the hospital surely can’t afford to increase comp that much. Usually unions will push for adequate col adjustments and increased pay and perks with seniority. In this case it sounds like the big push will be for adequate admin time and other support services to help relieve some of the paperwork burden we all face. If one group tried to use the union power against other union members, those members would just leave. NC is a right to work state so the union can’t compel employees to join.

 

[VA Hopeful Dr]

Aren’t you an ENT though? Midlevels have 0% chance of taking your job and or lowering your salary. I’m curious if IM/FM/Psych etc. feel the same. Midlevels are a much larger threat in these type of fields.

In my opinion, any strike would probably lead to midlevels demanding the same or similar compensation as physicians.

Most of the ones I know do.

 

[srirachamayonnaise]

Isn’t there some antitrust thing about doctors unionizing, at least across hospital systems

I suppose so, if the union covers a large swath of geographic regions. I never practiced antitrust law so my knowledge in that is limited to what I learned at law school…

 

[Kierkegaard's Bud]

Isn’t there some antitrust thing about doctors unionizing, at least across hospital systems

Funny you should bring this up...not actually well-known.

Antitrust Issues in Integrated Health Care Delivery Systems

Good afternoon. It is a pleasure to be here today to discuss the antitrust analysis of physician networks and other integrated delivery systems.

www.ftc.gov

 

[srirachamayonnaise]

Funny you should bring this up...not actually well-known.

Antitrust Issues in Integrated Health Care Delivery Systems

Good afternoon. It is a pleasure to be here today to discuss the antitrust analysis of physician networks and other integrated delivery systems.

www.ftc.gov

This only applies to physician owned joint ventures reaching agreement with other entities to collectively control pricing. That has nothing to do with unionizing physicians. The union would negotiate with employers of some sort to get a collective bargaining agreement executed between the employees in this case salaried physicians and employers such as a hospital corporation or private equity groups. This is not within the purview of anti-trust laws, but rather under the employment laws such as EEOC and etc.

 

[Future_Bone_Docta]

You so realize that many of the attendings here are pretty young, right? I'm still in my 30s so retirement is 20+ years away.

Yeah, sorry I wasn't trying to point fingers at specific people.

Did you say something that made it seem like I was calling you out?

 

[VA Hopeful Dr]

Yeah, sorry I wasn't trying to point fingers at specific people.

Did you say something that made it seem like I was calling you out?

Not at all, but plenty of us who are young woth most of.our careers ahead of us aren't all that worried about midlevels.

 

[annoyedpsychiatrist]

Im a psychiatrist and not worried about midlevels.

1. Most psychiatrists are older and there will be a large number of them retiring in the near future
2. Midlevels have been going into psych but there is still a huge shortage in MH
3. I still get 1,000 jobs sent to me a day
4. I dont think depression/anxiety/addiction is getting better anytime soon, probably worse if I had to guess
5. Some my patients explicity want a physician