Court Ruling Forces AMA to Halt Organizing Effort

By Karen Pallarito, Reuters, Friday 8 June 2001, 1:22 PM ET

NEW YORK (Reuters Health)—In a blow to physician unionizing, the American Medical Association’s (AMA) labor union said it has decided to table efforts to organize doctors at private healthcare facilities.

The move follows a US Supreme Court ruling last week concerning whether a nurse or other healthcare worker is a supervisor, and therefore barred from joining a union.

Physicians for Responsible Negotiation (PRN), created by the AMA in 1999 to represent physicians in collective negotiations with their employers, currently represents four units in four states with roughly 250 physicians.

PRN said it would continue to represent those doctors. But as far as new organizing activity is concerned, we’re putting that on hold for the time being, Dr. Susan Hershberg Adelman, president of PRN, told Reuters Health.

Healthcare unions blasted the high court ruling, saying it undermines efforts to ensure basic workplace protections for doctors and nurses who represent patients’ interests.

By limiting the number of nurses who may be part of a collective bargaining unit, this Supreme Court decision amounts to a potential gag order on nurses who want to protect patients from harmful management practices that routinely lead registered nurses to organize, said American Nurses Association (ANA) President Mary Foley.

ANA’s labor arm, United American Nurses, is a national federation of state nurses’ associations that represent about 100,000 nurses nationwide.

Despite PRN’s decision, other healthcare unions contacted by Reuters Health said they do not intend to abandon future organizing activity at private facilities but expressed deep concern about the ruling’s impact.

It obviously will have a chilling effect on some organizing, said Daniel Kaufman, a spokesman for the American Federation of State, County and Municipal Employees (AFSCME), which represents more than 50,000 registered and licensed practical nurses nationally.

Although AFSCME will continue organizing healthcare professionals, the ruling puts a damper on efforts to recruit nurses by lessening the attractiveness of the profession, Kaufman told Reuters Health.

Ruling 5-4, the high court rejected the National Labor Relations Board’s (NLRB) test for determining when nurses or other healthcare workers are supervisors. The majority found that the NLRB erred in ruling that six registered nurses on staff at Kentucky River Community Care Inc. were not supervisors because they did not exercise independent judgment in giving patient care directions to other staff.

The court also unanimously agreed that the employer has the burden of proving that a nurse is a supervisor.

AMA Trustee Dr. Donald J. Palmisano, a New Orleans-based surgeon, said the decision would certainly make it more difficult, if not impossible, for most physicians in the private sector to use collective bargaining to deal with patient care and workplace concerns.

What we’re concerned about is if a physician is in there and directs a nurse to take a patient to the x-ray department...that the individual becomes a supervisor, Palmisano told Reuters Health. So in effect it would be very difficult for a physician not to be considered a supervisor.

The AMA remains committed to leveling the playing field for employed and self-employed physicians and will continue to press for state laws that permit collective bargaining, he said. It also plans to seek an amendment to the federal antitrust laws to allow healthcare professionals to jointly negotiate with health plans.

Palmisano said the issue would also be a topic of discussion at the AMA’s upcoming House of Delegates meeting.

PRN, meanwhile, will keep close tabs on how the NLRB interprets the Supreme Court decision, according to Adelman. And since the ruling does not apply to healthcare professionals who work for state, county or federal employers, it is beginning to do market research in that area.

Clearly, at this point the opportunity for assisting employed physicians is now greatest in the public sector, she said.