Docs hold feverish debate on unionization

It was an unlikely setting for a shouting match. Tuesday evening, about 150 people -- many of them area medical students -- gathered in Stemmler Hall's Dunlop Auditorium for a heated debate on physician unionization. The fifth annual Thomas Langfitt Jr. Memorial Symposium brought four of the leading authorities on the controversial subject to Penn for a panel discussion and an open question-and-answer session. Arthur Caplan, the director of Penn's Center for Bioethics, served as the moderator. Much of the dialogue centered around the Campbell bill, a piece of legislation currently making its way through Congress that would give self-employed physicians the right to unionize. They are currently prevented from doing so by antitrust regulations. Doctors employed by hospitals can form unions, however. The experts who argued in favor of unions said they felt that the current system robbed them of critical decision-making power. Susan Adelman, the president of Physicians for Responsible Negotiations, began the forum by asserting that doctors were being taken advantage of by managed care organizations. "If [physicians] wish to be altruistic, they will be the altruistic recipients of crummy contracts," she said, referring to the terms many health maintenance organizations require doctors to comply with if they wish to treat their patients. Indeed, managed care often served as the focus of the evening's discussion. Panel member John Kelly, the director of Physician Relations for Aetna/U.S. Healthcare, wondered if unions for physicians would improve the quality of healthcare. "What impact would collective bargaining have? on patients?" he asked. However, Robert Weinmann, the president of the American Union of Physicians and Dentists, offered emphatic support for the Campbell bill "Health care dollars are being shuffled away from the doctors? to shareholders and executive pay packages," he said. Martin Gaynor, a professor at Carnegie Mellon University, upheld the opposing view. "We're in very turbulent times in the healthcare system," he said, adding that he felt collective bargaining for individual physicians was not the solution. The event frequently became contentious as audience members asked questions of the panel. Caplan, for instance, asked how doctors could force HMOs to bargain if they themselves were not permitted to strike -- a question that sparked further debate between the panel and the audience. After the talk, Peter Traber, the interim chief executive officer of Penn's Health System, said he believes that patient care should always be the No. 1 priority of hospitals. "I think that I would come down on the side of professionalism and the integrity of the patient-physician relationship," he said. And James Wall, a first-year Medical student at Penn, said he felt that, "As a physician, [collective bargaining] would improve the state of physicians, not necessarily? society."

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