The American Medical Association's struggling labor union won a new lease on life last week.
Just two months after rejecting the union's request for a loan, the AMA's 20-member board of directors reversed course under pressure from the association's 550-member House of Delegates, which voted at its annual meeting in Chicago last week to continue financial support.
The union, called Physicians for Responsible Negotiation, faced almost certain shutdown after the board rejected its plea for $1.6 million in April. At the time, the board said no evidence showed that the union would become self-supporting.
The union has organized just 38 physicians since its formation in late 1999, subsisting mainly on $3 million in AMA funding.
The board is expected to consider a revised loan request of $811,000 at its next meeting in September, after the union presents a new business plan. The union said the money will fund scaled-back operations through 2003.
A previous business plan called for PRN to spend about $1.1 million against revenue of $65,000, officials said. The union collects $50 monthly dues from about 25 bargaining-unit members and 250 "sustaining members," as well as $250 per year from each of 13 medical associations.
Union President Mark Fox, M.D., an AMA delegate from New York, said no one should expect the organization "to be making money two years out."
He added, "I think the board would be hard-pressed to reject our request. The board needs to weigh the value of this organization to physicians versus the pure economics."
Despite the delegates' directive, the board still could decide to reject the loan request.
"We're supportive of keeping PRN viable," AMA board Chairman J. Edward Hill, M.D., a family practitioner from Tupelo, Miss., said last week. But, he said, "After they present a plan, we plan to do what we do with any formal request-we'll go through the process. The House (of Delegates) made it clear they expect us to be fiscally responsible."
Supporters said the union must be kept alive long enough to gauge the impact of National Labor Relations Board decisions involving pending organizing efforts.
In other action last week, delegates approved limits on resident work hours that resemble guidelines announced June 11 by the Accreditation Council for Graduate Medical Education. The AMA's policy calls for the same 80-hour workweek as the private, not-for-profit accreditation council, which oversees 7,800 resident programs. AMA officials said they will encourage the council to "vigorously enforce" its accreditation standards. Previous AMA guidelines varied by specialty.