PHYSICIAN UNIONIZATION: Labor Board Denies NJ Doctors
In a setback to doctors' efforts to unionize, a regional director of the National Labor Relations Board turned away a request by more than 500 New Jersey doctors that they be allowed to form a union. Dismissing a petition "filed by Local 56 of the United Food and Commercial Workers," Dorothy Moore-Duncan said that the physicians are independent contractors of AmeriHealth HMO Inc., not employees, the Philadelphia Inquirer reports (Rouse, 5/25). The doctors had argued that since AmeriHealth "controlled many of the details of their work, such as the maximum wait for patients, the size of their waiting room and whether patients should undergo surgery," they should be considered employees of the HMO. However, Moore-Duncan said that the doctors are not employees since they run their own businesses, contract with other HMOs and receive only about 4% of their practice business from AmeriHealth. She wrote that the doctors "lack the close economic relations and integration with AmeriHealth that would support a finding of employee status."
The "case was widely viewed as an important test case," the New York Times reports, although some said the New Jersey doctors particular arrangement "represented an unfavorable set of circumstances for a test case" because of the lack of integration with AmeriHealth and the relatively small amount the HMO contributes to the doctors' caseloads (Greenhouse, 5/26). Robert O'Brien, attorney for the union, said the group has until June 7 to petition the labor board's main office in Washington (Inquirer, 5/26). "We believe that our efforts along with the other unions have brought this to a head," said Anthony Cinaglia, president of the local union. While the union has not yet decided whether to appeal the decision, it "may turn it efforts toward federal legislation that would give physicians the right to organize." But even if the doctors' unionization efforts are successful, said Princeton University health economist Uwe Reinhardt, it may not allow them to wrest back much control from the HMOs. "They think they can as a union sit there and shove a unionized fee scale down the throat of the insurer," Reinhardt said, noting that insurers would then in turn band together for more clout. "You just simply can't create a physician monopoly," he noted (Burney, AP/Bergen Record, 5/25).