Correlates of young physicians' support for unionization to maintain professional influence.

Abstract

A resolution in support of physicians' unionization was recently approved by the American Medical Association's House of Delegates. This study investigated the factors associated with young physicians' approval of unionization. A survey was mailed to all 1987-1992 Jefferson Medical College graduates (n = 1,272); 835 (66%) responded. Of the respondents, 43% supported unionization, 31% did not support unionization, and 26% expressed no opinion. Surgeons, medical subspecialists, pediatricians, and hospital-based specialists were more likely to support unionization than were family physicians. Significant predictors of support for unionization were negative views of the changes in the health care system, negative perceptions of the quality of care provided by managed care, the belief that physicians' independence had been impaired by changes in the health care system, and the belief that physicians' personal satisfaction should take precedence over societal needs in determining the future of health care. Support for unionization correlated with physicians' perceptions that mental health patients should be referred to psychiatrists, physician-assisted suicide should be legalized, and the involvement of nurse practitioners in diagnosis and treatment could compromise the quality of care. Young physicians' support for unionization is a function of frustration with market-driven policies that compromise the quality of care and negatively affect physicians' autonomy and personal satisfaction.