Foot Doctors Taking Steps to Unionize

Saying they are losing power to managed-care groups, podiatrists from around the U.S. are forming the first national labor union for doctors.

“Big business has taken over the medical field,” Dr. John Mattiacci said. “In the past five years, we, the deliverers of health care, have watched our ability to control our professions usurped by managed-care organizations.”

Mattiacci is president of the new First National Guild for Health Care Providers of the Lower Extremities. The union will be headquartered in Harrisburg, Pa., be affiliated with the AFL-CIO and become part of the Office and Professional Employees International Union.

Leaders of the fledgling group said they expect more than 10,000 of the nation’s 14,000 podiatrists to join the union, which will negotiate contracts and lobby lawmakers.

In California, the issue of doctors forming unions is “discussed every year” among California Medical Assn. leaders, but the matter has gone nowhere, said Jack Lewin, executive director. “I understand and appreciate what the podiatrists are doing,” he said, “but the clear implication is that the podiatrists see themselves as workers and the HMOs as management. It’s an admission of defeat.”

Doctors should keep fighting, he said. “I think the physicians are the management in health care. And if there is any other source of management, it should be patients, not executives of HMOs,” Lewin said.

The podiatrists’ action is an example of the growing militancy of doctors seeking to maintain control of their professions as more patients join managed-care organizations.