Physicians aren't invited to the hospital industry's pity party because they're having one of their own.
But unlike hospitals, physicians lay most of the blame for their alleged practice and financial woes at the feet of the managed-care industry, which doctors say exerts too much control over the delivery of patient care.
But once again, the numbers tell a different story, as highlighted by the information contained in this chapter on physicians.
* Physicians' average net income hit a record high of $199,600 in 1997, according to the latest available data from the American Medical Association. That's a 50% jump from 1987, when physicians' average net income was $132,300, according to the AMA.
* Physicians aren't putting in any more work hours for their money. In 1998, they spent an average 56.6 hours per week on professional activities, including patient care. That's the lowest weekly work average since at least 1989, AMA data reveal.
* Most physicians are self-employed, meaning they, not health insurance executives, set their own work hours. According to the AMA, 62.3% of all practicing physicians were self-employed last year.
* Physicians still derive nearly half of their practice revenues from nonmanaged-care sources. Some 46.7% of physicians' practice revenues came from nonmanaged-care payers last year, according to AMA data.
For these reasons and more, many observers think the move by the AMA's membership to form a new national labor union for doctors is misguided.
Over the opposition of the AMA's senior management and board, the group's 494-member House of Delegates passed a resolution in June instructing the association to form a physicians' union.
Ostensibly, the union will give member physicians the collective-bargaining clout they want to battle managed-care plans. But unless federal law is changed, the union will do little toward that end.
Only employed physicians can join the union, and only employed physicians can collectively bargain without fear of violating federal antitrust laws. The laws bar independent competitors from collectively setting prices for services.
The AMA estimates that only about 15% of the nation's post-resident practicing physicians, or about 108,000, are eligible for collective bargaining. And they would bargain with their employers, which are primarily hospitals and group practices, not managed-care plans.
Consequently, the AMA is pushing federal legislation that would effectively immunize independently competing physicians from antitrust laws, giving them the legal right to collectively bargain with payers.