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The AMA's Surprising Announcement

By Msgr. George G. Higgins

The Yardstick

August 2,1999

The AMA stresses that its purpose in encouraging doctors to organize is not primarily to promote their economic interests, but to give them a voice in improving patient care. Presumably they will do this by engaging in collective bargaining with HMOs and other heath care providers.  Nurses long have tried to do just that through their own union, but until recently few doctors supported their efforts. Doctors commonly argued that collective bargaining by nurses over patient care (or even over nurses' economic interests) was unprofessional, if not unethical.
 By and large the word "union" was a dirty word in the health care industry. The AMA's decision to encourage doctors to unionize will help to change all that.

 By stressing the right of doctors to participate in the management of the industry, the AMA has changed the climate of labor-management relations not only in the health-care field, but across the board.   In the private sector of the American economy, even the minority of employers who have willy-nilly learned to live with unions have, for the most part, adamantly argued that unions have no right to participate in management.
 The AMA's decision to encourage collective bargaining by doctors over management decisions involving patient care will not, of course, immediately change the situation in the private sector of the economy. But over the long haul it undoubtedly will help to convince the general public that unions, in addition to bargaining over wages, hours and working conditions, have a positive role to play in the economy.

 Catholic social teaching supports a move in this direction.
 In 1982 the Catholic Health Care Association of the United States published a collection of essays on labor-management relations in the health-care industry, edited by Cardinal Adam J. Maida of Detroit, who was then a Pittsburgh priest with degrees in civil and canon law.  Leonard J. Weber's essay on labor unions in this important volume makes for timely reading in light of the AMA's recent decision. Weber, summarizing the development of Catholic social teaching on labor's right to organize, points out that for most of this century the emphasis has been on the right of workers to organize for the purpose of protecting and advancing their economic interests.  But in recent decades, he says, "another dimension of the right to unionize has emerged in Catholic thought." This concerns "the need of individual workers to participate actively in the management of enterprises in which they are employed.''

 In effect, if not in so many words, what Weber says about the right of workers to participate in management is what the AMA said in announcing that it will foster the unionization of doctors. It is also what nurses and nonprofessional health-care workers have been saying as they've tried to organize against strong opposition from health-care administrators, including too many 
Catholic hospital administrators.

 In addition to bargaining over wages, hours and working conditions, they want to be heard through their unions on management issues, especially on issues involving patient care. Catholic social teaching, as Weber pointed out, supports this demand and now so does the AMA.