The physician union movement, which has been gaining speed in recent months, has hit a road bump, in the form of antitrust probes in several states.
The Department of Justice is investigating whether the Tallahassee, Fla.-based Federation of Physicians and Dentists is organizing group boycotts and engaging in illegal collective bargaining on behalf of private practice physicians who are union members. The union's activities are under investigation in Connecticut, Delaware, Florida and Ohio.
Earlier this summer, FPD Executive Director Jack Seddon spent two days giving depositions to Justice Department officials in Tallahassee.
Antitrust laws prohibit private practice physicians from collectively bargaining, but more and more physicians -- frustrated by managed-care contracts and negotiations -- are turning to physician unions for assistance. The FPD, which has 8,000 members nationally, says it acts as a third-party messenger for private physicians and merely relays contract information from payer to provider.
"The misnomer here is that because we provide an economical service and review contracts for good and bad language and enforceability and patient advocacy . . . we're a union and we must be attempting to collectively bargain and we must be violating the law," Seddon says.
Justice Department officials had no comment, but Robert Leibenluft, assistant director for healthcare of the Federal Trade Commission's Bureau of Competition, says the law is quite clear on what third-party messengers can do for private practice physicians.
"Doctors cannot collectively agree or collectively negotiate unless it's pursuant to some legitimate joint venture," he says. "It's one thing to communicate to the payer that Doc X is willing to sign up at this rate, and Doc Y at this rate, but the negotiator can't communicate what one doctor is doing to the next."
The Oakland, Calif.-based Union of American Physicians and Dentists is not currently under investigation, but it was cleared of antitrust charges following an FTC probe in 1990. Executive Director Gary Robinson says publicity of that investigation put a damper on the union's recruiting efforts, and he expects the same thing to happen in Florida.
"These investigations are time-consuming and costly, and it really slowed our momentum," he says.
Seddon says despite the probes, his union continues to grow "because of managed care's philosophy, which is to control the practice of medicine." He expected the investigations, he says, because of complaints from the insurance industry. "God forbid anyone mess with the insurance industry."