July 1999 AAOS Report

AMA House of Delegates approves formation of union

The House of Delegates of the American Medical Association (AMA), meeting June 20-24 in Chicago, directed the formation of an affiliated national negotiating organization. The organization, which has yet to be named or developed, will provide representation to employed physicians who work for HMOs, hospitals, universities, medical schools or other employers. It also will help residents, where permitted, in some states. These groups comprise about 17 percent of all physicians practicing in the U.S. as well as 17 percent of U.S. orthopaedic surgeons. The majority of physicians, those who are "self-employed" or who own and operate their own group practices, will not be able to participate in the AMA's national negotiating organization because they are prohibited legally from engaging in collective bargaining.

According to the AMA, the national negotiating organization will be a professional organization focusing on patient advocacy and responsive to the needs of local physicians and their patients. It will assist employed physicians in creating local collective bargaining units to jointly negotiate contracts with their employers. Physicians represented by the AMA's national negotiating organization will not strike or otherwise withhold patient care. This feature distinguishes it from traditional labor unions.

In related news, the AMA has pledged to continue working with the American Association of Orthopaedic Surgeons (Association) and other physician organizations for passage of the Quality Health Care Coalition Act of 1999 (H.R. 1304). This legislation would give self-employed physicians an exemption from federal antitrust law so they also could engage in collective bargaining with managed care plans. The Association will continue to diligently support the passage of the H.R. 1304. At the same time, the Association will monitor closely the AMA's efforts to develop its national negotiating organization for employed physicians. While the Association currently does not have plans to participate in the AMA's effort or to develop its own national negotiating organization, it will continue to provide current information about physician group negotiating to members as it becomes available.

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