The health of about 80,000 patients could be at stake, and it is spilling over to California voters. Doctors for a National Health Program (NHP) and the American Medical Association (AMA) have just announced their intention to strike, possibly closing their Washington state headquarters.
Most employers in California will build a network of doctors, and nurses will also hold a one-day strike. The California Nurses Association, the largest union of registered nurses in the United States, will hold a strike day on September 20.
The American Medical Association, the largest physicians "union in the United States, has joined and created independent practice organizations (IPAs) for its members.
The number of doctors represented by the Union of American Doctors and Dentists has risen from 2,700 in 2005 to about 4,000 today. Norman Corcoran is a physician representing 50,000 physicians who are members of the California Medical Association, the leading group that advocates for the medical profession at the state Capitol.
Doctors differ from typical union members in that they include self-employed contractors and doctors - training staff. While some are partners in for-profit doctors "groups, many employees are members of various unions and guilds, depending on their service role. Some medical groups tend to be part - owned, while some universities and - outside - state doctors own a share. There are efforts to create a California Union of American Physicians and Dentists (UACD) based in California.
But the movement could still face hurdles because California still prohibits doctors from working directly in corporations. Various legal entities work for Kaiser Permanente, which operates more than 1,000 hospitals, clinics and outpatient clinics. In addition, the remaining Kaiser Precinct regions in California, such as San Francisco, Oakland, San Jose, Los Angeles and San Diego, all operate their own hospitals. Another 23 would create satellite dialysis, which includes 48 facilities across the Bay Area.
Most doctors prefer to practice in larger cities and are not inclined to move far from their training place or to train. The doctors who get into trouble are doctors from the Bay Area and other parts of California, such as Los Angeles, San Francisco and Oakland.
Dr. Y and others were reluctant to join the union because they wondered what collective action individual doctors might demand and how it might affect their patients "careers. They were convinced that they could find a way to ensure that patients would not suffer if a strike were necessary.
A provision of Prop 23 would allow dialysis clinics to apply for exemptions in the event of a justified shortage of physicians in an area and to employ nurses instead. The initiative would require that the doctor is always in the clinic, although the Ministry of Health could grant an exception to clinics if a doctor or assistant is in the clinic if there is a shortage of doctors. If approved, the doctors selected by the employer will be sent on their way. In San Diego County, this model was used as a model for indirect employment of doctors.
The CMA has been approached by the government - employed doctors for some sort of collective bargaining agreement. Collective bargaining for UC student service physicians who voted to join the Union of American Physicians and Dentists in November 2013 is going well. Dr. Lee practices as a general practitioner serving both adults and children, and the association of physicians and physicians at LSCHC influences policy. This is in stark contrast to the practice of many other trained physicians in San Diego County, such as the University of California Medical Center (UCMC).
The UAPD is a sister company of AFSCME and is the largest union of licensed doctors in the country with more than 2,000 registered nurses and 1,500 doctors. The UC San Diego facility typically has five full-time doctors and others working part-time. In 2017, Kaiser Permanente was the second largest provider of managed care services in California and operated in more than 100 hospitals, clinics and other healthcare facilities. In Los Angeles, there is now a primary care organization that serves underinsured and uninsured Medi-Cal patients.
Excluding general practitioners and federal doctors, 43.3 percent of physicians were employed in 1997, compared with 32.9 percent in 1983. Moreover, 57 percent of California doctors are in group practices, increasing their likelihood of holding a stake. Most California physicians are already members of other physicians - led organizations that make democratic decisions and take collective action, "said Dr. Robert D. Schumacher, president of the UAPD and professor of medicine at the University of San Diego.