AMA NOT WAFFLING ON PATIENT PROTECTIONS
Far from waffling on patient protection legislation, as your March 9 article ("Protecting its interests," p. 2) suggests, the American Medical Association is working with members of Congress from both sides of the aisle to develop the best possible legislation assuring patient protections.
The Patient Access to Responsible Care Act, introduced by Rep. Charles Norwood (R-Ga.), does not constitute a litmus test of support for patient protections. It is one of many legislative proposals, some yet to be introduced, designed to assure fair and appropriate treatment for patients. The AMA's support for such proposals began with its endorsement of legislation introduced by Sens. Conrad Burns (R-Mont.) and Paul Wellstone (D-Minn.) four years ago. More recent support was demonstrated by the AMA's participation in President Clinton's Advisory Commission on Consumer Protection and Quality in the Health Care Industry and its endorsement of the commission's patient bill of rights. Meanwhile, the AMA strongly supports Norwood's separate bill that removes health plan exemptions under the Employee Retirement Income Security Act, allowing patients to hold health plans accountable for medical-care decisions.
The legislative struggle for patient rights is far from over. We anticipate bipartisan legislation that will include basic protections, such as reasonable access to emergency rooms, privacy of patient records, access to specialists, and a guaranteed right of appeal for denial of care.
Thomas Reardon, M.D.
American Medical Association
MORE THAN `A FEW' INTERNS JOINING UNIONS
In what was otherwise a balanced report on the positions taken by various physician organizations in the case of collective bargaining rights for interns and residents now before the National Labor Relations Board, your story "AMA dodges union case" (Feb. 23, p. 30) missed the mark in discussing the growing union movement among interns and residents.
The reporter wrote: "Nationwide, only a few residents and interns bargain collectively at public institutions or through voluntary arrangements with teaching institutions." She further estimates there are 110,000 physicians in training.
The Committee of Interns and Residents SEIU now represents more than 9,000 interns and residents nationwide. Other unions represent another 2,200. That places the percentage of unionization among physicians in training at just over 10%. That's quite a bit more than the "few" referred to in the article and stands just two to three percentage points below the rate of unionization in the work force nationally.
And the rate of unionization among interns and residents is growing. The CIR has grown 40% in just the past two years. We are receiving calls from interns and residents all over the nation who are watching the CIR-initiated case now before the NLRB very closely.
Regardless of whether the NLRB rules in our favor in the Boston Medical Center case your article addressed, we believe the momentum behind house staff organizing will continue to grow. In a hospital industry driven more and more by profit, interns and residents are increasingly turning to the CIR as they attempt to preserve and protect the "nonmarket" values that constitute the vital core of the healing profession.
Angela Moore, M.D.
Committee of Interns and Residents
SEATTLE HAS SEEN CLOSURES
I enjoyed the recent article regarding the state of healthcare competition in the Seattle market ("Seattle's choosy consumers," Feb. 23, p. 92), but I must take exception to the statement by Randy Revelle of the Washington State Hospital Association that there have been no significant hospital closures in the past 10 years.
From 1989 to 1990, West Seattle Hospital, Cabrini Hospital, Northgate Hospital and Snoqualmie Valley Hospital all ceased operations. Meanwhile, the majority of the other hospitals in the city reduced the number of operational beds, with a few exceptions.
I'm not certain how Mr. Revelle defines significant, but I think it's noteworthy to include these closures in the mix.
Jeff Lyle, Superintendent
King County Public
Hospital District No. 4