Doctors, Unite!

Jay Harness, 31, a fourth-year resident in general surgery at the University of Michigan Medical Center, is better educated but not so well paid as most of the men who work in nearby automobile factories. But Harness does have at least one thing in common with the auto workers. He too is a union member who believes that only by organizing can he and his fellow physicians guard against being exploited by their employers. President of the U. of M. Interns and Residents Association, Harness battled for two years before forcing the hospital to recognize his organization as a bargaining unit last February. Now that he has succeeded, he plans to use his newly gained power not only to win better wages but to influence hospital policy as well.

Jail Clinic. Prounion physicians like Harness believe that organizing is an idea whose tune has come. Though unions still represent only a small fraction of the country's more than 300,000 practicing physicians, their strength is increasing inexorably. The A.M. A., which is frankly alarmed by the trend, estimates that anywhere from 25,000 to 30,000 doctors now pay dues to unions of various types. Most of them belong to the American Federation of Physicians and Dentists, which was founded last January with 7,500 members and now has a national membership of 55,000.

Some of the doctors' unions, like other labor organizations, were formed mainly to get more money for their members. Interns at New York's Albert Einstein College of Medicine banded together to form the Interns and Residents Committee unit to demand--and get --better salaries back in 1967. Organizations in Chicago and other cities have also played a major role in raising the incomes of interns from as little as $5,000-6,000 a year to more than $13,000 at some hospitals. Other organizations take an altruistic stance. Harness's union, which staffs a clinic in a county jail, is also seeking to improve patient care.

Many medical unionists are less interested in salaries than in preventing what they see as a gradual encroachment by the Government and the insurance industry on the practice of medicine. Some object to the paper work involved in handling health-insurance claims. "We were founded when it became apparent that the Government as well as others, like insurance companies, were attempting to lodge themselves between the doctor and the patient," says Dr. Harold Yount, 51, a West Palm Beach, Fla., pediatrician who formed the American Physicians Guild in 1965. Others oppose the Government's Phase II regulations that set doctors' fees and regulated their profits.

"Lay persons are dictating to us how much and what kind of care we can deliver to our patients," says Dr. Sanford Marcus, 52, a surgeon who heads the San Francisco-based, 2,300-member Union of American Physicians. "What we are negotiating for is the right to maintain the autonomy of the physician." The U.A.P. has already fought for and won the right to exclude non-doctors from several hospital committees on medical practice.

Thus far, the doctors' unions have been able to accomplish their aims without taking to the picket lines. Indeed, doctors generally find the idea of a strike unthinkable. "When someone's sick, you have to treat him," says Dr. Kenneth G. Burton, a general practitioner who heads the two-year-old American Physicians Union, which is headquartered in San Antonio. But it is not inconceivable that U.S. physicians may some day take part in a walkout. Says Yount: "The ultimate weapon of any organization is the threat of withdrawal of services."

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