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ACP-ASIM Supports Joint Negotiations for Physicians

April 30, 2001

Physicians at Disadvantage Protecting Patient Needs

(Washington, DC) Imbalances in negotiating power between doctors in independent practice and insurers justifies exempting physicians from some federal antitrust laws and must be addressed legislatively according to a position paper by the American College of Physicians - American Society of Internal Medicine(ACP-ASIM.) The paper was contained in the May 1 issue of Annals of Internal Medicine, published by ACP-ASIM.

"The quality of, and access to, medical care for many patients is determined by the policies of large managed care entities," stated William Hall, president of the ACP-ASIM. "These include limits on medical treatment, access to procedures, practice guidelines and performance targets, all of which are part of an insurers contract. Yet independent physicians who come together to discuss the effects of these policies can be found guilty of criminal antitrust violations."

Nearly one-third of the nation's physicians are in independent practices that are currently prohibited from joint negotiations with health plans. "Employed physicians and residents have the right to negotiate with insurers over policies that may harm patients and infringe on a doctors medical decision making," said Jack Ginsburg, ACP-ASIM's director of health policy analysis and research. "We are seeking to extend that right to independent doctors, who historically have less leverage in the negotiating process."

The policy distinguishes between joint negotiations and collective bargaining, since the latter implies an adversarial relationship. The College also encourages joint negotiations through the use of professional associations of physicians that also include patient representatives in advisory roles. "Physicians are bound by responsibilities and ethical constraints that may be at odds with the tactics used by some traditional labor unions" according to Mr. Ginsburg. "Preservation of the physician-patient relationship should not be jeopardized at any time by joint negotiations."

While the ACP-ASIM policy recognizes the need for balanced negotiations between health plans and physicians, it opposes any action that would disrupt patient care including strikes, slowdowns or boycotts. It also prohibits price fixing or other anti-competitive behaviors.

ACP-ASIM also recognized that membership in any organization that negotiates for physicians should be voluntary and that physicians should not be penalized based on their membership in such organizations.

ACP-ASIM is the nation's largest medical specialty organization and the second largest physician group. Membership comprises more than 115,000 internal medicine physicians and medical students. Internists are the major providers of medical care to adults in America.


Jack Pope, Washington Office, (202) 261-4556

Page updated: 11-04-03

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