I. INTRODUCTION

Today, only about 5 percent of the nation's physicians are union members, but the storm of change looms large on the horizon. While a full listing of present organizing efforts would continue ad infinitum, the following are representative of present efforts across the nation:

• The Service Employees International Union ("SEIU"), has recently announced that it intends to "spend over a million dollars a year at a minimum" in a campaign to organize salaried physicians.

• Under affiliation with the SEIU, a new union, known as the National Doctors Alliance, announced its formation in March 1999 and already claims 15,000 members.

• In May, 1999, 794 physicians in Los Angeles County, California voted to join the Union of American Physicians and Dentists ("UAPD").

• Perhaps the most visible organizing effort being undertaken is by the American Medical Association, whose members have traditionally fiercely opposed union organization for physicians, but whose House of Delegates defied the recommendation of the organization's leadership and voted in June 1999 to form a physician's union.

While union representation of physicians has, in the past, been essentially limited to physicians employed by clinics, hospitals and government, physician dissatisfaction over managed care insurance providers' influence and "control" over their practices appears to be driving this new interest and surge in union activities among medical practitioners and their advocates. According to Dr. Robert Weinmann, president of the UAPD, new union membership is coming from "doctors who resent cost controls." While "[d]octors in every state are looking at unions," Weinmann says, "where they have acted is . . . where for-profit HMOs have interfered with first their practices and next with their incomes."

There are, however, significant legal obstacles in the path of physicians seeking to unionize, particularly in the case of independent contracting physicians seeking to bargain collectively with third-party payers such as managed care insurance providers. This article will explore and explain those obstacles, as well as how some of them have been overcome by physicians seeking to unionize.

To obtain the full text of this article, please contact Thomas J. Bender, Jr. at bendertj@bipc.com or William E. Buelow, III at buelowwe@bipc.com.