One year after the American Medical Association’s historic vote to form a national labor organization, a group of Michigan doctors is becoming the first to actively negotiate a contract, the doctors are telling AMA members at this week’s annual meeting in Chicago.
Nearly 40 doctors employed by Wellness Plan, a Detroit-based health maintenance organization, are negotiating a three-year contract with the help of Chicago-based Physicians for Responsible Negotiation (PRN), the national labor organization spun off at the direction of AMA leaders last year.
The labor organization was created last June to give doctors more muscle with managed health-care systems that doctors say take decisions out of the hands of medical professionals and put them into those of insurance companies. The union was launched as PRN about six months ago but has only recently begun grass-roots organizing.
The Wellness Plan doctors, who say they have been working without a contract since June 1998, are seeking a three-year deal with the HMO that provides insurance for 50,000 Medicaid patients in Michigan. Among their demands, the doctors say they want seats on the health plan’s operations committee and want to be involved in how patients are assigned to them from Wellness’ four inner city clinics.
“They are looking for a mechanism so they can tell the managed-care plan what they need,” said Dr. Susan Hershberg Adelman, an AMA board member and PRN’s president.
The doctors at Wellness say they believe they will have a new contract by this fall and won’t have to strike to get what they want.
Unlike traditional unions, PRN forbids strikes by its member doctors.
For its part, Wellness has said its employed doctors have been involved in operations through a task force that evaluates the HMO and its clinics.
The Wellness doctors, however, say they believe they have come this far and will be successful in their first negotiations because PRN has clout from its affiliation with the AMA, the nation’s largest doctor group.
“PRN and AMA and no strikes seem to sit well with doctors,” said Dr. Prashant Dixit, a Detroit pediatrician and one of the doctors employed by Wellness Plan.
Because the doctors are employees, they are among the more than 100,000 physicians in the U.S. who are able to bargain collectively and are thus critical to PRN’s success. Meanwhile, the majority of the nation’s more than 700,000 physicians are self-employed and are barred by federal antitrust law from bargaining collectively.
Looking for money: Despite the progress of the PRN’s first negotiating effort in Detroit, the union’s leadership is still seeking financial backing for organizing drives.
PRN has a $1.2 million loan from the AMA that has been used to help the Detroit group and hire staff. Two weeks ago, Dr. Robert Bernat, a physician and a lawyer, joined PRN as its first executive director.
PRN also has some 500 sustaining members, doctors who contribute $50 a year or residents who pay $25 a year to support the organization. Once doctors become actively involved in an organizing situation, physicians pay $50 a month and residents and medical students pay $25 a month.
PRN may eventually ask for more support from the AMA because its loan expires Dec. 31.
But Adelman believes PRN’s bargaining units will become self-sustaining as doctors flock to PRN. She said a second “major” organizing effort may be announced later this week.
“We need to get through the hump of the first year,” Adelman said. “After that [PRN local bargaining units] could be making money.”
Lobbyists to gear up: Now that Gov. George Ryan has signed sweeping changes to the state’s health-planning process, health-care providers will bring fewer projects before a state regulatory board.
Ryan last week signed a bill to curtail the Illinois Health Facilities Planning Board after the House and Senate voted last month to curb the regulator’s authority to control health expansions and major medical equipment purchases.
The measure frees hospitals and other medical facilities from seeking regulatory approval before proceeding on non-clinical projects like parking garages. The bill also raises the threshold for seeking approval of clinical projects to $6 million from $2.7 million and cuts down on some lobbyist communications with board members and planning staff after projects are submitted.
Industry sources say several lobbyists wanted the governor to seek a watered-down version of the bill, especially where the legislation bans “ex parte communications” with board members once capital projects have been submitted.
But Ryan signed the bill, which was approved last month in the House and Senate by veto-proof majorities.
We’ll now be watching for the lobbyists to look to preserve their revenue streams by pushing for a new health-planning law, especially since the measure signed by Ryan sets a sunset date for the board of July 1, 2003. Supporters say that deadline is intended to force parties to discuss ways to improve the planning process in the interim.
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E-mail Bruce Japsen at Bjapsen@tribune.com
