When Doctors Join Unions

Rating:
Summary: Uninspired treatment of a timely topic.
Review: A reasonable history of the UAPD prior to 1985. Author chose to ignore the Agency Shop agreements with the State of California and other Public jurisdictions as the primary reasons for UAPD's continued existence. Doctors working for those entities must pay agency fees or dues in order to work.

More recently, author did not delve into findings of US Dept of Labor that UAPD was not a Union for purposes of collective bargaining in private sector. In fact, UAPD severed its private sector bargaining units in order to avoid scrutiny of procedures for electing its officers. Findings of DOL suggest violations of NLRA, Taft-Hartley and Landrum-Griffin.

Author also did not choose to include decertification of UAPD as bargaining agent for doctors employed by Contra Costa County in 1995.

The one interesting innovation of UAPD, the UAPD IPA, was remarked upon only in casual passing and not provided any in-depth treatment.

Generally, book seems to be a subject author tired of during research and only published because the amount of time spent in research would otherwise have been wasted.

Rating:
Summary: Why patients need unionized doctors
Review: When Doctors Join Unions, Grace Budrys, Cornell University Press, 177 pages, c. 1997, describes the inexorable forces driving doctors into classical unions as opposed to more traditional medical associations and societies.

Insightfully, Budrys shows that traditional private practice doctors, independent contractors, are joining with their salaried colleagues to sign up with unions even though only the salaried doctors are entitled to classical collective bargaining at this time. The motivation for both groups of doctors is similar. In private practice for-profit HMOs and managed care programs often delay or deny diagnostic studies and treatments prescribed by treating doctors. The doctors, untrained in negotiations, then find they have to challenge their own administrations to provide care. In government programs at the state, county, and federal levels, including Medicare and Medicaid, doctors find that burgeoning rules and regulations also prevent them from doing what patients need. This obstructionism unifies doctors, cuts across financial and remuneration incentives, and drives them toward unionization, especially towards the Union of American Physicians and Dentists (UAPD), affiliated with the American Federation of State, County and Municipal Employees (AFSCME), the largest union in the AFL-CIO. Budrys states that the UAPD is "a harbinger signaling the emergence of new forms of collective representation" and concludes her book with these words about the UAPD: "I find it hard to imagine another organization that is in a better position to do so."