DOCTORS AND UNIONS

Abstract

This is a study of the unionization of physicians. This article will examine the factors that have affected the medical profession encouraging doctors to do something that was unheard of fifty years ago—to unionize. This article describes the societal changes that have encouraged doctor unionization, analyzes the legal overlay, examines the extent of doctor unionization, and makes a number of projections about the future. A half century ago doctors had nearly total control over the management of their profession. They typically worked in solo private practice. This involved either maintaining a separate office and staff or associating with a medical building for purposes of convenience and referral. Doctors had relationships with hospitals, to whom they sent patients. They also worked with private insurance companies for administration of patient claims. But doctors were essentially independent operators, working as general practitioners and, less often, as specialists. There was little regulation by government. The financial rewards and respect for the medical profession were at the highest levels. These were justified, as one practitioner put it, by the “. . . long years of training, hours of service, risk of exposure to disease, shortened earning life-span, attenuated freedom and family life, and devotion to professional self-advancement. . .” [1]. This situation no longer exists.