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What is preventing physicians from unionizing?

Home Practice Management What is preventing physicians from unionizing?

  • Avatar wcinewbie 
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    How about something as simple as these excessive non competes that most of us employed docs still have to agree to?

    #227009 Reply
    Avatar wcinewbie 
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    Nurses have gone on strike over poor nursing ratios. What about excessive patient volumes? Anesthesia being forced to supervise crna and em being forced to supervise nps administratively?

    #227010 Reply
    Zaphod Zaphod 
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    But couldn’t we strike on the nonessential things while still providing essential care? 

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    Striking on the nonessential things would be meaningless.

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    Would it?  I’m not sure how much these things affect you in ER medicine, but they are a total drain on the average doctor who provides chronic care.  It would not be meaningless to those doctors, but I see how it would be meaningless to those who don’t do those things much.  I respect your opinion, and I guess I’m making my own point about arguing about minutiae.  I do think that if we all refused to tolerate the parts of the system that frustrate us most that would lead to improvement.

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    Absolutely. This is why drs cant effectively strike. If you still take care of the pt you just show you have no actual hard line and are just whining. This kind of “striking” is how we ended up where we are. We complain put up a minor stink for a sec, someone says theyll address or look into it, we get back to work, and nothing changes or it just gets worse.

    Its just like trying to take MOC to the woodshed while validating and standing up for ABMS, not a strategy that will work.

    It just shows you are not coming from a strong vantage point. If we were to simply actually strike, we would learn how much power we actually had. Again, herding cats and all that.

    IntensiveCareBear IntensiveCareBear 
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    Status: Physician
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    Joined: 12/22/2018

    What is preventing physicians from unionizing?

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    Terrorism.

    Public opinion tends to look unfavorably on you when you bargain with human lives. Those be the facts. Watch interviews with Euro and India and other nations’ doctors on strike… they get crucified and villainized and guilt tripped back to the job site by the media and politicians and admins.

    …Unwillingness to strike.

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    Correct. For reasons mentioned above: nobody wants to be a terrorist.

    …plus everyone thinks they are the smartest person in the room.

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    Winner, winner. This ego thing is a key reason doc unions and large scale cooperation is rare… second only to the whole striking being terrorism thing.

    "Hmm, that sounds risky." - motto of the middle class

    #227018 Reply
    q-school q-school 
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    How about something as simple as these excessive non competes that most of us employed docs still have to agree to?

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    State laws vary widely and not an issue for some states.

    some specialties don’t rely on referrals and essentially these are moot.

    Some specialties rely on hospital to provide expensive technology-if you quit the hospital, you have to move anyways.

    Definition of what’s excessive will likely vary.

     

     

    #227023 Reply
    IntensiveCareBear IntensiveCareBear 
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    … But, really most docs wouldn’t be able to afford to go on strike.  If you’re living paycheck to paycheck, you wouldn’t be able to go a month or two without income.  Even a 2 week strike would result in 1 month of no pay.  Most docs wouldn’t be able to handle that. So, it’s out of the question for the masses…

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    Incorrect. You are only looking at one side of the coin. For hospital docs, esp mega-system, strike is viable (unless they’re check-to-check). People will drive a bit further for ER, MRIs, mammo, OB, etc… then when the strike blows over (or the striking doc groups are replaced?), the patients come back for convenience. The hospital name and location is the primary draw, not so much the docs.

    For private practice (aside from highly rural… only show in town), the docs and their reputation are the big draw factor. They’ve spent YEARS building up a patient base with marketing and referral base and good payer mix and quality team of employees and docs. The month of missed pay is nothing to them… but even if they pay their associates and employees during shutdown, the goodwill and community rep from even a short shutdown is VERY significant. It varies by specialty and location, but a lot of metros are dog-eat-dog, man. The loss of patient recursion and referral sources that would happen with just a couple weeks of closure and bad Google reviews is a killer to most private offices (since other offices or facilities would “take” majority of their business… and much of it won’t return).

    "Hmm, that sounds risky." - motto of the middle class

    #227024 Reply
    Avatar beagler 
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    Status: Physician
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    When I was in med school a group of surgeons at several hospitals in a neighboring state went on strike.  They all took simultaneous leave.  I think one guy stayed for true emergencies, all the elective cases got cancelled, some urgent cases got diverted to us.  It was something over malpractice premiums–they were pressuring the state legislature.  I don’t remember how long it lasted or if it worked.  But it was a relatively homogenous group over a very specific issue.  There are so many issues to tackle, and everyone has their own opinions about which are most important, even within one specialty, where would we start?

    I think from an administrator’s point of view, things like answering all portal questions regardless of medical utility, making sure patients feel satisfied, and making sure the insurance companies have all the info they need directly from us so nobody else needs to be paid to do the trivial data mining, are essential.  But they are not essential from our POV if we are thinking just about necessary medical care.  That’s why I’m saying we could refuse to do those things that waste our time while continuing to provide care.  Either they can pay someone else to do it or can agree with us that it doesn’t need to happen.  Right now when a doctor refuses to do those things they get labeled disruptive.  If we all did it what would happen?   Would the effect be meaningless?

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    Anne for President of AMA.

    Solo Internist, Midwest

    #228235 Reply
    q-school q-school 
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    When I was in med school a group of surgeons at several hospitals in a neighboring state went on strike.  They all took simultaneous leave.  I think one guy stayed for true emergencies, all the elective cases got cancelled, some urgent cases got diverted to us.  It was something over malpractice premiums–they were pressuring the state legislature.  I don’t remember how long it lasted or if it worked.  But it was a relatively homogenous group over a very specific issue.  There are so many issues to tackle, and everyone has their own opinions about which are most important, even within one specialty, where would we start?

    I think from an administrator’s point of view, things like answering all portal questions regardless of medical utility, making sure patients feel satisfied, and making sure the insurance companies have all the info they need directly from us so nobody else needs to be paid to do the trivial data mining, are essential.  But they are not essential from our POV if we are thinking just about necessary medical care.  That’s why I’m saying we could refuse to do those things that waste our time while continuing to provide care.  Either they can pay someone else to do it or can agree with us that it doesn’t need to happen.  Right now when a doctor refuses to do those things they get labeled disruptive.  If we all did it what would happen?   Would the effect be meaningless?

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    Anne for President of AMA.

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    Or even just

    Anne for President.

    oh captain, my captain.

    🙂

     

    #228237 Reply
    Avatar jacoavlu 
    Moderator
    Status: Physician, Small Business Owner
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    Joined: 03/01/2018

    I’ve been thinking much about the progressive abuse of physicians with us being turned into cogs in the wheel of the medical industrial complex.  Many of us have even been sidelined into being permanent employees with no job securities and insane non-competes.  Whenever extra work needs to be done (non stop paperwork, insurance authorizations, medical records, urgent patient visits, colleagues call out sick), we’re expected to step up and do it with no extra compensation.  Meanwhile, all the business and finance people are sitting on the sidelines skimming off all the money.

    What is preventing us from unionizing?  Clearly the abuse is reaching a breaking point with half the people on this forum trying to figure out how to become financially independent.

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    Doesn’t sound like you need a union. I assume you’re employed. How about you and your colleagues just agree to refuse scut work that is below your pay grade? Will they fire all of you? And don’t sign a contract with an insane non compete. Or one which requires you to cover a sick colleague without compensation. Just learn the power of No.

    The Finance Buff's solo 401k contribution spreadsheet: https://goo.gl/6cZKVA

    #228239 Reply
    Avatar Chessknt 
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    Status: Resident, Physician
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    The optics would be horrendous if money was mentioned. The public would see that we want to make 500k instead of 400k and we decided to let people die or not get care to accomplish this.

    They don’t understand or care about the siphoning by admin, intensity of the work or really anything we do. Any kind of union would be useless without the power to strike and striking with negative publicity wouldn’t last long so we would lose.

    It seems obvious to me why they don’t exist.

    #228251 Reply
    Liked by Anne, iradoc
    ENT Doc ENT Doc 
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    Status: Physician
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    Joined: 01/14/2017

    Best explanation I’ve seen on this matter:

    Can Doctors Form a Union?

    #228253 Reply
    Avatar AR 
    Participant
    Status: Physician
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    Joined: 03/10/2016
    Just read through some of the threads on here–we have a tendency to fight to the last word over minor variances in opinion.

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    That’s not unique to here.  It happens on forums everywhere routinely.  That’s just the way the internet is.

    #228259 Reply
    Avatar wcinewbie 
    Participant
    Status: Physician
    Posts: 59
    Joined: 09/30/2017

    I’ve been thinking much about the progressive abuse of physicians with us being turned into cogs in the wheel of the medical industrial complex.  Many of us have even been sidelined into being permanent employees with no job securities and insane non-competes.  Whenever extra work needs to be done (non stop paperwork, insurance authorizations, medical records, urgent patient visits, colleagues call out sick), we’re expected to step up and do it with no extra compensation.  Meanwhile, all the business and finance people are sitting on the sidelines skimming off all the money.

    What is preventing us from unionizing?  Clearly the abuse is reaching a breaking point with half the people on this forum trying to figure out how to become financially independent.

    Click to expand…

    Doesn’t sound like you need a union. I assume you’re employed. How about you and your colleagues just agree to refuse scut work that is below your pay grade? Will they fire all of you? And don’t sign a contract with an insane non compete. Or one which requires you to cover a sick colleague without compensation. Just learn the power of No.

    Click to expand…

    No doesn’t work well if some people say yes.

    #228278 Reply
    Lordosis Lordosis 
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    Status: Physician
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    Joined: 02/11/2019

    “Never let your sense of morals prevent you from doing what is right.”

    #228279 Reply
    Avatar jacoavlu 
    Moderator
    Status: Physician, Small Business Owner
    Posts: 2059
    Joined: 03/01/2018

    I’ve been thinking much about the progressive abuse of physicians with us being turned into cogs in the wheel of the medical industrial complex.  Many of us have even been sidelined into being permanent employees with no job securities and insane non-competes.  Whenever extra work needs to be done (non stop paperwork, insurance authorizations, medical records, urgent patient visits, colleagues call out sick), we’re expected to step up and do it with no extra compensation.  Meanwhile, all the business and finance people are sitting on the sidelines skimming off all the money.

    What is preventing us from unionizing?  Clearly the abuse is reaching a breaking point with half the people on this forum trying to figure out how to become financially independent.

    Click to expand…

    Doesn’t sound like you need a union. I assume you’re employed. How about you and your colleagues just agree to refuse scut work that is below your pay grade? Will they fire all of you? And don’t sign a contract with an insane non compete. Or one which requires you to cover a sick colleague without compensation. Just learn the power of No.

    Click to expand…

    No doesn’t work well if some people say yes.

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    Then that’s the answer to your question right there. If you and your small group of colleagues can’t be united on a few issues specific to things that affect you, how could you expect a larger group to get on the same page?

    The Finance Buff's solo 401k contribution spreadsheet: https://goo.gl/6cZKVA

    #228316 Reply
    Liked by Vagabond MD

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