Doctors have a unique opportunity to organize in order to bring a more worker-centered approach to their practice. While they cannot unionize like many other workers – only about 5% of doctors belong to a traditional union – they have the ability to join together to form regional or national umbrella organizations that provide their members with the tools to better manage their careers, health insurance and work conditions.
An example of the kind of doctor organization that could emerge is a coalition of independent physicians that would promote policies that benefit patients and help them to negotiate more favorable terms in their contracts with health systems or other employers. This type of organization would not compete with a patient’s primary physician, but rather would serve as an advocacy group for the needs of patients and their families.
Other examples of doctor organization are the regional and national medical associations that are part of the World Organization of Family Doctors (WONCA). The WONCA is an independent confederation of free professional associations. It was created in 1947 to ensure that physicians remain independent and are able to pursue the highest standards of medicine and science, and to protect their interests at all times. Its Declarations, Resolutions and Statements provide medical guidance to national and international authorities and also support the work of National Medical Associations.
WONCA meetings are held three yearly and between these the organization has numerous working parties, special interest groups and young doctor movements that progress specific areas of research and activity. A number of these have produced important publications.
The AAMC leads and serves the academic medicine community to improve people’s health worldwide. Its mission includes transforming medical education, supporting the health care system, fostering medical research and contributing to community collaborations.
A key challenge that the AAMC faces is the fact that it is not representative of the whole of academic medicine. For this reason, the AAMC has been developing a strategic plan that takes a clear-eyed perspective of the environment, sets priorities, establishes agreement around intended outcomes and charts an effective course for the future.
In conclusion, it is a fact that doctors, like workers in most other industries, feel smothered by the ever-growing and unwieldy bureaucracies of corporate America. This is a fundamental problem that cannot be resolved system-by-system or facility-by-facility. Neither can it be addressed by individual, short-term, stop-gap measures. Workers need to have a real voice in their workplaces and it is time for doctors to reclaim this power. A reformed collective bargaining that is inclusive of all the issues and dynamics that have driven workers to call for action must be developed and quickly put into place. This means a shift from wage and hour bargaining to an agenda that encompasses the major drivers of healthcare outcomes – quality, patient experience, affordability and safety. Without such a change, the growing wave of worker militancy will be doomed to failure.