PHYSICIANS FEDERATIONS: KAISER DOCTORS PLAN FORMATION

      "In a new offensive to land more national customers," Kaiser
 Permanente doctors are forming a national federation, SAN
 FRANCISCO CHRONICLE reports.  Doctors in Kaiser's 12 autonomous
 regional medical groups "have a tentative plan to join forces"
 this spring under the name "Perm Corp."  CHRONICLE reports that
 the federation will "give Kaiser doctors the ability to develop
 new business opportunities with health plans other than" Kaiser
 and allow for "direct provision of care."
      OPEN MARRIAGE?:  CHRONICLE reports that a "side effect" of
 the move could be "the erosion of Kaiser's long-standing
 tradition as a closed system in which Kaiser doctors treat only
 Kaiser patients at Kaiser facilities."  Francis Crosson,
 assistant executive director of the Permanente Medical Group in
 Northern California, said that "very limited" contracting with
 non-Kaiser doctors may occur in areas where Kaiser providers are
 not available.  "The health plan has been looking at how to form
 a broader geographic profile around the country.  One of the
 issues is how can the Permanente Medical Group act as a component
 partner when we are all divided up into 12 groups," Crosson
 continued.
      DETAILS:  The proposed federation might initially "focus on
 improving Kaiser's internal operations by standardizing medical
 care nationwide," CHRONICLE reports.  By allowing Kaiser
 physicians to "sell their managed care expertise to other HMOs or
 doctor groups," Kaiser physicians could expand to other care
 providers.  Also, the federation may attract new business in
 parts of the country where Kaiser lacks a strong presence.  The
 federation currently includes 9,329 physicians including 3,581 in
 Northern California (Hall, 9/27).
      ARIZONA:  In related news, a group of Tucson, AZ, physicians
 met with representatives of the National Labor Relations Board
 September 26 to discuss whether they are "entitled to join a
 union."  The physicians contend that "[a]llowing doctors to join
 unions would help ensure the quality of patient care, especially
 during an era dominated by" HMOs, AP/Tucson ARIZONA DAILY STAR
 reports.  The meeting followed a petition filed earlier this
 month by physicians from the Thomas-Davis Medical Center in
 Tucson and Green Valley, who want to join the Florida-based
 Federation of Physicians and Dentists.  Keith Shelman, one of the
 Thomas-Davis doctors, said, "The reason we are doing it is for
 patient care.  People are more important than money" (9/27).