Physicians and Joint Negotiations

1 May 2001 | Volume 134 Issue 9 Part 1 | Pages 787-792

This position paper of the American College of Physicians–American Society of Internal Medicine addresses public policy issues related to physicians' joining to negotiate issues affecting patient care and the working environment in which patient services are provided. It seeks to identify an appropriate way for physicians to negotiate jointly with health care plans while maintaining professionalism and keeping the interests of patients paramount. It proposes that physicians in nonintegrated private practices should be able to meet and communicate among themselves for the purpose of negotiating primarily with health care plans about specific issues that affect quality and access. However, the College opposes strikes or any joint action by physicians that would deny or limit services to patients or result in price-fixing or other anticompetitive behavior.

The College states that employed physicians should continue to have negotiating rights. It maintains, despite a recent decision by the National Labor Relations Board, that collective bargaining is not appropriate for resident physicians. Physicians in residency training are protected by accreditation requirements for programs of graduate medical education, and educational content should not be subject to negotiations. [Post-publication correction: The College states that employed physicians should continue to have negotiating rights. It maintains, despite a recent decision by the National Labor Relations Board, that physicians in residency training are protected by accreditation requirements for programs of graduate medical education, and educational content should not be subject to negotiations.] The College also calls for determination of negotiating units for physicians but recommends that nonphysician providers not be included in the same units as physicians. Membership in an organization that negotiates for physicians should be voluntary, and conflict-resolution mechanisms must be available for resolving impasses.

Author and Article Information

*This paper, written by Jack Ginsburg, MPE, was developed for the Health and Public Policy Committee and the Ethics and Human Rights Committee. Members of the Health and Public Policy Committee were Paul F. Speckart, MD (Chair); Lynne M. Kirk, MD (Vice Chair); David Blumenthal, MD; Jeffrey P. Harris, MD; Carlos R. Hamilton, MD; Mary T. Herald, MD; Martin E. Hickey, MD; Gregory A. Hood, MD; John A. Seibel, MD; Wayne J. Riley, MD, MPH; Philip T. Rodilosso, MD; Lee A. Toman, MD; Laurence D. Wellikson, MD; and Winthrop F. Whitcomb, MD. Members of the Ethics and Human Rights Committee were Risa Lavizzo-Mourey, MD, MBA (Chair); S.Y. Tan, MD (Vice Chair); David A. Fleming, MD; Susan Dorr Goold, MD; Vincent Herrin, MD; Joanne Lynn, MD; Bernard M. Rosof, MD; Daniel P. Sulmasy, OFM, MD, PhD; James A. Tulsky, MD; and Lee J. Dunn Jr., JD, LLM. Approved by the Board of Regents on 17 July 1999.

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Corresponding Author: Jack Ginsburg, Policy Analysis and Research, American College of Physicians–American Society of Internal Medicine, 2011 Pennsylvania Avenue NW, Washington, DC 20006.