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Less than three months after its house of delegates voted — against the wishes of the association's hierarchy — to create a national union for employed physicians, the Chicago-based American Medical Association (AMA) has released the name and constitution of the labor organization, as well as a partial list of members of the nascent union's governing body.
According to the constitution's preamble, the union, named Physicians for Responsible Negotiation (PRN), will "advocate on behalf of our members, with their employers and others, as the law allows, to create and maintain a health care system that guarantees our members a working atmosphere where they can devote the time and attention to their patients' needs." What the union will not do, however, under any circumstances, is strike or withhold essential medical services, a provision that sharply differentiates it from "almost all traditional unions," says Todd Vande Hay, the AMA's vice president of private sector advocacy and a member of PRN's governing committee.
"Most of the people who have been involved in organizing physicians up to this point have actively gone out and tried to convince physicians that [unionization] is an option that they should pursue," Vande Hay says. "PRN isn't going to be doing that. It's going to respond to physicians who have a desire to collectively bargain."
Currently, only two states, Washington and Texas, allow nonemployed physicians to bargain collectively, but that could change. A bill by Rep. Tom Campbell (R-CA) would amend federal antitrust laws to allow self-employed physicians to bargain collectively with managed care organizations. The bill currently has 150 co-sponsors. Vande Hay says that if the Campbell bill is passed, it could "dramatically expand the focus and potential of PRN activity."
In addition, residents may soon win the right to unionize, pending the outcome of a case in Boston in which residents argue that they are employees rather than students. "That's a huge group of people; it would also expand the PRN's focus," Vande Hay says. A ruling in that case could come by end of October.