Many doctors who work for managed care, HMOs or hospitals feel that their ability to care for their patients is compromised, Dr. Nancy Dickey, president of the American Medical Association, told CBS News Face the Nation Sunday. And that's one reason that the AMA is supporting the option of unionization for doctors who are not self-employed.
Doctors' chief concern, said Dr. Dickey, has been about "having the ability to write the prescriptions for the drugs we think our patients need, not ones that are on a limited list based on how cheap they are; the ability to send our patients to the best possible facility or the best possible specialistÂ…instead of the ones who have signed on to take the cheapest rate for their surgeries."
Only doctors who work for someone else are legally allowed to unionize. The vast majority of doctors are still self-employed.
Dr. Dickey reassured Americans that while the AMA is pursuing negotiation tactics, patients don't need to worry that doctors may go on strike.
"Patients can rest assured that we're going to take care of them," she said. "But in order to improve the care of them, we are going to negotiate and use any other tool -- except one that might hurt patient care -- to try to improve the care that they can get through managed care and through employed physicians.
"The decision to form a union is partly because the National Labor Relations board says by law, if you have a recognized group, then the employer has to sit down with the employee and negotiate in good faith. Today. we often...can't get anyone to sit down at the table with us."
She added that working with the NLRB protects doctors.
"If a doctor were to go to the press or was to be critical of the employer in the treatment of patients, he or she may find themselves out on the street," Dr. Dickey explained. "But the protections of the NLRB mean that a union could go to the public and tell them what the problems were with a particular employer, and they would be protected against retaliation."
The American Medical Association voted last Wednesday to support a national labor organization for doctors, with the 494-member House of Delegates approving the committee recommendation.
California doctor Charles Goodman battled HMOs for ten years over fees and the freedom to treat his patients. He joined the Union of American Physicians and Dentists, which now negotiates on his behalf.
"It got to the point where on a daily basis I was receiving constant denials from insurance companies for treatment that I felt was necessary," said Dr. Goodman.
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