BY TIM BONFIELD
The Cincinnati Enquirer
Several Cincinnati doctors cheered the news this week that a group of orthopedic specialists have launched a union, and they predicted many more doctors will follow if the union shows signs of success. "I think this may start a trend, actually," said Dr. Joe Hackworth, a cardiologist and past president of the Academy of Medicine of Cincinnati. "Quite a few specialists are applauding the efforts of the orthopods."
Earlier this week, more than 80 orthopedic specialists revealed they have joined the Federation of Physicians and Dentists based in Tallahassee, Fla., a union with more than 7,500 members in 14 states. The move is the latest action in a growing, national wave of union interest among physicians frustrated with increasingly powerful managed care health plans.
"Everyone is waiting" Since early 1997, union drives have started in many cities, including Dayton, Ohio; Toledo, Ohio; Baltimore; Boston; Rockford, Ill.; Santa Fe, N.M.; Trenton, N.J.; Hartford, Conn.; and several cities in Florida.
The American Medical Association estimates 14,000 to 20,000 of the nation's 740,000 practicing doctors have joined unions, a figure union representatives dispute as much too low.
It remains to be seen how the new Cincinnati union will affect medical care. The key tests will come this fall when doctors and health plans begin negotiating contracts for 1999. The new union says it represents more than 90 percent of local orthopedists. "Everyone is waiting to see if this is really effective," said Dr. Molly Katz, president of the Academy of Medicine of Cincinnati. "Hopefully, this will wake some third-party payers up and realize there is a limit to what doctors will take."
Tristate residents probably won't see slogan-chanting doctors walking picket lines. But if contract talks turn ugly, some doctors may attempt a work slowdown, such as delaying care for patients with non-emergency problems, Dr. Hackworth said.
Job actions by physicians are rare.
Unions representing medical residents have called several strikes against hospitals over the years. In 1975, thousands of California doctors stopped providing everything except emergency care in a fight about reforming civil lawsuits. In 1985, several thousand physicians in upstate New York stopped doing elective surgeries in a dispute over malpractice insurance.
In 1996, doctors in Puerto Rico staged an eight-day slowdown during which they provided only emergency care. This year, doctors in British Columbia and several other Canadian provinces have staged work stoppages over a proposed salary cap.
The U.S. government response to physician unions has been chilly at best.
The Department of Justice is investigating Federation of Physicians and Dentists activities in Dayton, Connecticut and Tampa, Fla. The Federal Trade Commission fined the Puerto Rico doctors $300,000 after declaring their actions an illegal boycott. In January, the National Labor Relations Board rejected an attempt by several hundred New Jersey doctors to form a bargaining unit.
