FP Report -- December 1998 Unions: a new look
The NLRB is looking at the case for unionization for residents in private hospitals.
In 1976, the National Labor Relations Board ruled that residents in private hospitals were more students than employees and therefore lacked protection under the National Labor Relations Act.
However, residents in public hospitals have been protected in collective bargaining by state laws for public employees.
With the current mix of unions and union wannabes (see story below), the NLRB is considering a request to overturn its 1976 ruling. The request, submitted by residents in the Committee of Interns and Residents at Boston Medical Center, a private facility, asks for residents in private hospitals to come under the protection of the National Labor Relations Act. The act prohibits unfair retaliation for collective bargaining activities including strikes. However, many residents say they would not engage in strikes.
Deb McPherson The NLRB chair resigned in August, no replacement has been nominated by the president and the Senate will need to confirm the nomination. A new chair may be needed to break a possible 2-2 tie on the NLRB concerning the request.
The bottom line: The NLRB ruling may not matter to many family practice residents.
"At our annual meeting of family practice residents and students, there has not been a lot of discussion about unionizing because we have more pressing issues: scope of practice, credentialing, hospitalist issues," said Deborah McPherson, M.D., of Omaha, Neb., resident member of the AAFP Board.
"We're not considered to be just cheap labor," she said. "We get decent benefits, our hours aren't horrendous -- they're hard, but realistic in terms of what we'll do in practice -- and overall we're treated very fairly."
As the NLRB considers whether HMO physicians may unionize, residents are paving the way.
For 41 years, residents in some public hospitals have been able to unionize. And during the past 25 years or so, residents in some private hospitals have formed union "look-alikes" with clout.
"The resident community may lead the way in physicians' collective bargaining," said Andrew Thomas, M.D., of Columbus, Ohio, residents' representative on the AMA Board of Trustees.
"Residents know if there aren't enough EKG machines or techs or nurses," said Thomas, a general internist who's taking an administrative fellowship. "They see problems before they ever reach the quality assurance chart."
One way to tackle problems in public institutions: Join a union.
Family practice resident Felix Aguilar, M.D., of Torrance, Calif., is a vice president of the residents' union in the Los Angeles area Committee of Interns and Residents. The national CIR has nearly 10,000 members, including about 1,800 in the Los Angeles area.
"Medicine is no longer the 'solo practitioner,'" said Aguilar. "Being in CIR prepares us to fight for physicians' and patients' interests. It prepares us for the new environment."
Los Angeles CIR leaders are trying to derail a plan to consolidate county hospital labs in a single location to cut costs. "That's a money-saving step," said Aguilar. "But if I'm on rotation in the ER, I might need a heart enzymes test immediately, to see if the patient had a myocardial infarction. If the lab's across town, I won't get results for hours."
Residents in some private hospitals have come one step short of unionizing.
For example, family practice co-chief resident Geoffrey Jones, M.D., of Ann Arbor, Mich., belongs to the University of Michigan Medical Center House Officers' Association.
"The association makes sure our training is humane," he said. The group negotiates residents' contracts, protects their four days off each month and has a direct link to medical center administrators to address residents' complaints.
About 900 residents belong to the association. "I've always considered it a union," Jones said.
FP Report is published by the AAFP News Department. Copyright © 1998 by American Academy of Family Physicians.
FP Report | Headlines |AAFP Home | Search
