Strikes

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I saw recently that a big health care system's mental health workers are going to go on strike
I thought the reasoning behind physicians not being able to unionize was because the country felt medical care was too basic of a right that physicians should not be allowed to set prices and/or go on strike.
Yet these non professionals, log on strike and it's okay? Aren't they supposedly medical professionals? If so why can they unionize and strike to raise their pay, and if not, why are they being allowed to enter the medical field?

 

[Psai]

Everyone should be allowed to unionize and strike

 

[Goro]

Doctors already have a union. I'ts called the AMA. "Association" sounds more polite than "union".

 

[chipwhitley]

Doctors already have a union. I'ts called the AMA. "Association" sounds more polite than "union".

Except that most doctors don't belong to it.

 

[Goro]

Just like most Americans don't belong to a union!

Except that most doctors don't belong to it.

 

[SKaminski]

So, there's a lot of people NOT answering the question here.

In the past, physicians have NOT be allowed to strike because every physician owned their own practice. By coming together and collectively bargaining, while still owning their businesses, they were practicing "collusion"/price fixing. Essentially, its the same as if all the gas stations in your area got together and agreed to all sell gas bars at $7/gal. If gas is a necessity, and if they've fixed the price, you have no choice but to buy it. See physicians use to own their own businesses, this was price fixing.

It makes sense for collusion to be illegal as it pertains to gas companies. The consumer has no bargaining rights. Unfortunately, with large insurance companies who base their premiums off of medicares premiums, these independent physicians lost THEIR bargaining rights, kinda ironic, huh?

Anyways, the reason you are seeing these strikes now is due to the fact that these practitioners don't own their own practice. They work for a hospital. Since they are employees, and not owners, they can strike all they want.

 

[DrBowtie]

Doctors already have a union. I'ts called the AMA. "Association" sounds more polite than "union".

No. Just no.

 

[Straight_Four_Porsche]

Imo, residents need stronger collective bargaining networks. No reason hospitals should be able work them into the ground while the government pays their salary.

 

[Merely]

So doctors can strike now if they all work for a hospital? I thought striking was still illegal for physicians

 

[cbrons]

Doctors already have a union. I'ts called the AMA. "Association" sounds more polite than "union".

vast majority arent ama members. Ama is a lobbying group and a corrupt one at that sadly

 

[charmiedermie]

Doctors already have a union. I'ts called the AMA. "Association" sounds more polite than "union".

The AMA is not a union, it is a special interest group. No different than an oil company lobbyist group. They don't fight for collective bargaining and don't threaten to strike like the way unions can. If the AMA were a union, it would be the worst one ever, since each specialty is fighting to come out on top over the others.

 

[charmiedermie]

Except that most doctors don't belong to it.

Only the uninformed think the AMA is a union in the traditional sense. I do think doctors would be better off if we did unionize. I'd be fine with that.

 

[DrHalsey]

AMA is not a union it is a corrupt, greedy and politically motivated organization that exploits those seeking to become doctors.

 

[Goro]

Union is a very polite term for "special interest group". Most Americans aren't union members anymore either.

vast majority arent ama members. Ama is a lobbying group and a corrupt one at that sadly

The AMA is not a union, it is a special interest group. No different than an oil company lobbyist group. They don't fight for collective bargaining and don't threaten to strike like the way unions can. If the AMA were a union, it would be the worst one ever, since each specialty is fighting to come out on top over the others.

 

[Baller MD]

Doctors already have a union. I'ts called the AMA. "Association" sounds more polite than "union".

It is nowhere close to a union...

 

[SKaminski]

So, now that we've established that the AMA is not a union, do we think a union is necessary, and how would we go about creating one?

Would each specialty have its own union? Can a singular union represent the needs of each specialty?

 

[TooMuchResearch]

So, now that we've established that the AMA is not a union, do we think a union is necessary, and how would we go about creating one?

Would each specialty have its own union? Can a singular union represent the needs of each specialty?

First question: No.

 

[charmiedermie]

Union is a very polite term for "special interest group". Most Americans aren't union members anymore either.

No it isn't. The AMA was very much against residents unionizing in the first place and stopped the federal anti-competition lawsuit against the Match. They are the exact opposite of a union.

 

[SKaminski]

First question: No.

And what makes you say that?

 

[Mjolner]

No it isn't. The AMA was very much against residents unionizing in the first place and stopped the federal anti-competition lawsuit against the Match. They are the exact opposite of a union.

Ok. As a guy who actually was involved in the unions I feel like I should weigh in here.

1) while the AMA is NOT a real Union like what you see portrayed on tv and in literature and in the news, but all the REAL unions are dying and won't be a thing if it keeps going this way so we're using a flexible definition anyway. I mean pro athlete player's unions aren't really collectively bargaining. SAG DEFINITELY isn't trying to level the pay across the world of acting. If they can be called a Union, I am not sure you can't call the AMA one. To be more thorough:

2) they lobby in our name, which unions do. (Union like)

3) they take dues to do so. (Union like)

4) I didn't remember getting my steward's contact information when I signed up (yes I was dumb and excited to be a Med student) and got my AMA card and I am PRETTY certain if poop hits the fan I won't be looking to them to get me out of it. (NOT Union like)

5) they try to stop competition from other unions. When they didn't want doctors to unionize (form a rival Union) they fought it. This happens all the time in "real" unions. The best, current example I can think of is in St. Louis (I THINK). The IBEW (electricians) are local 1. The carpenters are local 73. The carpenters started local 57 as their own version of electricians. You better believe the electricians fought it. Also, if you're looking to start a busy trauma practice, try and set up shop near job sites with both locals 1 and 57 at the same place. There are bound to be lots of "accidents" involving death (hard to fix) and almost death (easier to fix) which will keep you afloat until those loans are paid off. (Union like)

In the absence of something more tangible I'm gonna call them our version of a union. However, now that we're employees at many places we CAN organize (labor talk for make a union) and take control. But we won't. How would you handle hearing about a school bus crash and letting them die because you can not cross a picket line? Also, to the public we're rich. Like FABULOUSLY rich. They won't be on our side of we strike because we work too hard/much/"for too little"/"we're angry at Midlevels" whatever. And to win a strike you need two things. One, a monopoly of the labor force and two, public opinion. We don't have either. They'd start pumping out Midlevels to fill in the non life threatening gigs and the first child to die because a surgeon was on strike and congress will act (if nothing else they could have the DEA yank our DEA licenses, assuming the state doesn't have all of our medical licenses yanked.

Tl;dr AMA is kinda almost a union, but definitely the closest we'll get for many reasons.

 

[Mjolner]

AMA is not a union it is a corrupt, greedy and politically motivated organization that exploits those seeking to become doctors.

You obviously have not spent much time around union leadership if you think that precludes them from being a Union.

 

[charmiedermie]

Would each specialty have its own union? Can a singular union represent the needs of each specialty?

Hell yes and absolutely not, respectively.

 

[Mjolner]

Can a singular union represent the needs of each specialty?

It would have to for it to work.

Would each specialty have its own union?

Almost certainly, and they'd act against each other's interests and hospitals and insurance agency's and management teams and the nurses would all put us against each other until things were a thousand times worse.

 

[charmiedermie]

Almost certainly, and they'd act against each other's interests and hospitals and insurance agency's and management teams and the nurses would all put us against each other until things were a thousand times worse.

It's not the job of one physician specialty to defend the worth of another physician specialty to the federal government.

 

[Mjolner]

It's not the job of one physician specialty to defend the worth of another physician specialty to the federal government.

Wow. Everyman for himself, eh? You can stop being a gunner when Med school's over buddy.

The most effective strikes are when every union respects the strike. If the pipefitters strike but everyone else goes to the job site and works, it's minimally effective. If when the pipefitters strike and everyone at the job site says, "hey, if they're crapping on them, they'll crap on us too, I'm striking with them!" The union gets what they need.

Since you're apparently not getting it, for example, if derm struck and no other specialties struck with them all those freshly minted derm NPs and I suppose PCPs would fill the gap. Not as well, but most people wouldn't notice, and you'd lose a lot of bargaining power. Now if when derm struck, and all the physicians walked out, the nurses and Midlevels would be hopelessness overwhelmed and that would make your bargaining power greater.

However the derm folks would have to rub elbows with the PCP folks. It'll be ok tho, I hear you know how to clear up any rashes you might get from contact with the little people.

 

[charmiedermie]

Wow. Everyman for himself, eh? You can stop being a gunner when Med school's over buddy.

The most effective strikes are when every union respects the strike. If the pipefitters strike but everyone else goes to the job site and works, it's minimally effective. If when the pipefitters strike and everyone at the job site says, "hey, if they're crapping on them, they'll crap on us too, I'm striking with them!" The union gets what they need.

Since you're apparently not getting it, for example, if derm struck and no other specialties struck with them all those freshly minted derm NPs and I suppose PCPs would fill the gap. Not as well, but most people wouldn't notice, and you'd lose a lot of bargaining power. Now if when derm struck, and all the physicians walked out, the nurses and Midlevels would be hopelessness overwhelmed and that would make your bargaining power greater.

However the derm folks would have to rub elbows with the PCP folks. It'll be ok tho, I hear you know how to clear up any rashes you might get from contact with the little people.

Are you done mansplaining now? No, more like every specialty for themselves and proving their worth to the govt. that pays for their services, which only they know best. Has nothing to do with being a gunner. I don't expect some surgeon to put down the scalpel just because a Pediatrician or Psychiatrist is getting hit with government cuts or is getting layoffs, and I definitely would not expect Pediatrics or Psychiatry to come to the aid of Surgeons ever. If your specialty is as important as you say it is then prove it and let the public decide. If you can't prove that or can't prove you'd at least have better outcomes than a midlevel, that isn't the problem of another specialty. The public hates protectionism.

 

[Mjolner]

Are you done mansplaining now? No, more like every specialty for themselves and proving their worth to the govt. that pays for their services, which only they know best. Has nothing to do with being a gunner. I don't expect some surgeon to put down the scalpel just because a Pediatrician or Psychiatrist is getting hit with government cuts or is getting layoffs, and I definitely would not expect Pediatrics or Psychiatry to come to the aid of Surgeons ever. If your specialty is as important as you say it is then prove it and let the public decide. If you can't prove that or can't prove you'd at least have better outcomes than a midlevel, that isn't the problem of another specialty. The public hates protectionism.

Well, see. That's not how unions are most effective.

Your statement of "let the public decide" sounds great and all, but what about derm guys? How're they going to REALLY convince people they are as important as say transplant surgeons? People see transplant surgeons as saving lives. They see dermatologists as lotion peddlers and Botox dispensers. Right or wrong, fair or not. We hold up derm high because it's ultra competitive and let's be honest, those guys worked HARD to get there, but the general public doesn't know that.

I'm betting the general public would rate our specialties by importance VERY differently than we do.

 

[charmiedermie]

Well, see. That's not how unions are most effective.

Your statement of "let the public decide" sounds great and all, but what about derm guys? How're they going to REALLY convince people they are as important as say transplant surgeons? People see transplant surgeons as saving lives. They see dermatologists as lotion peddlers and Botox dispensers. Right or wrong, fair or not. We hold up derm high because it's ultra competitive and let's be honest, those guys worked HARD to get there, but the general public doesn't know that.

I'm betting the general public would rate our specialties by importance VERY differently than we do.

I'm referring to HHS, CMS, and Congress where physicians can and have testified. Your analogy doesn't work as most of the population is not getting transplants. Unions are effective when all members have the same interest. That happens when they are all of 1 specialty.

American doctors will never strike, at least not in anything resembling large numbers. It's not our culture and not how we're trained. We are very different from our (shift-working, self-centered, lazy) British NHS cousins.

They unionized in Oregon, http://forums.studentdoctor.net/threads/physicians-unionize-in-oregon.1103014. Surgeons aren't the unionizing type. I have yet to meet a surgeon who likes any type of union, and that's the problem.

 

[charmiedermie]

Unionizing is one thing, striking is another.

Agreed on surgeons. Wanna piss off a surgeon? Tell her/him they have to cancel their OR cases.

Yes, but if surgeons formed a union they would be the most powerful physician group ever. They'd be like the NRA lobby but in healthcare. If surgeons strike, the hospital collapses, so you can have your demands met readily to avoid that.

 

[Mjolner]

I'm referring to HHS, CMS, and Congress where physicians can and have testified. Your analogy doesn't work as most of the population is not getting transplants. Unions are effective when all members have the same interest. That happens when they are all of 1 specialty.

Fine. Trauma surgeons. People get hurt all the time. Or general surgeons. And it doesn't matter how often they need the doctor, the public sees certain specialties as more important and sorry Derm isn't one of them.

As to testifying in congress and winning public opinion?! Yeah you'll sway all 3 CSPAN viewers.

 

[charmiedermie]

Surgeons hate each other.

Yup! That's the one thing that realistically stops it in its tracks, which is why it wouldn't happen. Surgeons are rugged individualists who love competition and coming out on top. Which is weird since they tend to round as a team, but whatever. They aren't collectivist types like some other specialties.

 

[charmiedermie]

Fine. Trauma surgeons. People get hurt all the time. Or general surgeons. And it doesn't matter how often they need the doctor, the public sees certain specialties as more important and sorry Derm isn't one of them.

As to testifying in congress and winning public opinion?! Yeah you'll sway all 3 CSPAN viewers.

When did I ever say Derm was one of them? Stop putting words in my mouth to prove a point I didn't make. Congress and govt. agencies decide reimbursement, not the general public. Surgeons can prove they are worth the costs to the system. Good for them. No psychiatrist is going to ever strike on their behalf as chances are they don't like them anyways.

 

[Mjolner]

When did I ever say Derm was one of them? Stop putting words in my mouth to prove a point I didn't make. Congress and govt. agencies decide reimbursement, not the general public. Surgeons can prove they are worth the costs to the system. Good for them. No psychiatrist is going to ever strike on their behalf as chances are they don't like them anyways.

I am using it as an example like you keep using psychiatry. Am I not allowed to use examples, or is that solely your privilege?

 

[Commer_Knocker]

You guys may well be right in that a physician union, let alone a strike, would never go down.

I'll tell you what though, in an era where large hospitals are starting to resemble proift-hungry corporations more and more, this sure scares me.

 

[username456789]

Wow. Everyman for himself, eh? You can stop being a gunner when Med school's over buddy.

This is sort of the reality already. Do you know what the RUC is?

 

[username456789]

Are you done mansplaining now?

This is quite possibly the stupidest buzzword to come into use in the past year, and does not do the utterer any favors in their rhetoric.

 

[Mjolner]

This is sort of the reality already. Do you know what the RUC is?

Fair enough, but it Doesn't mean it is how it SHOULD be.

 

[username456789]

Fair enough, but it Doesn't mean it is how it SHOULD be.

Not disagreeing there.

 

[charmiedermie]

I am using it as an example like you keep using psychiatry. Am I not allowed to use examples, or is that solely your privilege?

You've called me a gunner, because I don't think 1 union is a good idea, and then said Derm won't benefit as if that is somehow supposed to change my mind all of a sudden. I already said all specialties need to prove their worth to the government. Psychiatrists would be stupid to put Surgeons' interests ahead of theirs. They both have different prerogatives.

This is quite possibly the stupidest buzzword to come into use in the past year, and does not do the utterer any favors in their rhetoric.

It may be a buzzword in the last year, but it is appropriate here if I'm going to be lectured here by someone, not you, on how wrong I am on a position that I didn't even hold or if I'm going to be called a gunner for it.