County Doctors Vote Decisively to Leave Union

Doctors who work for Los Angeles County have voted to part ways with the union that had represented them since 1999, ending an unusual alliance between 800 medical professionals and organized labor.

The physicians voted 331 to 229 to leave the Union of American Physicians and Dentists, according to ballots cast in the last few weeks and tallied Thursday.

Many doctors complained that they were uncomfortable with the hardball negotiating tactics of labor unions and dissatisfied with the results.

Some noted that since unionizing they had lost a popular benefits package that helped make up for the lower salaries many doctors earn at county hospitals compared to the private sector.

Others said the union’s tactics exacerbated tensions with management amid a crisis in the Department of Health Services in which hundreds of physicians face layoffs or transfers.

And some thought union membership was incompatible with their professional roles as patient advocates.

“The role of a union in medical practice -- it just wasn’t appealing to me,” said Dr. Laron McPhaul, a pathologist at Harbor-UCLA Medical Center near Torrance.

Union officials said the doctors’ decision could come back to haunt them as the health department struggles to cut costs.

“I’m surprised by the size of the margin” of victory, said Joe Bader, regional administrator in Los Angeles for the union.

He said the union had made gains for the doctors by boosting their salaries and improving work conditions. He said it is likely that the union will seek another vote by the doctors.

An increasing number of employees in the medical profession are represented by unions, but that trend has been slow to spread to doctors. The pro-union vote by Los Angeles County physicians in 1999 -- itself largely in response to cutbacks in the health department -- was seen by many observers as a milestone for labor.

At the time, because of the size of the county’s physician work force, labor experts said the vote would inspire similar efforts nationwide, where only 6% of doctors were then unionized.

But doctors in Los Angeles County ultimately faced the same dilemma confronted by physicians who organize everywhere.

“What is the big weapon that a union has? One of its most valuable tools is the threat of strike, and I just don’t know as medical professionals how doctors feel about using that weapon,” said Glenn Alan Melnick, a health economics professor at USC and an economist at Rand Corp.

A strike is “counter to their professional oath, in a sense,” he added. “That may be the reason it has never taken off in the U.S. Doctors aren’t comfortable with the ultimate trump card.”

Dr. Glenn Mathisen, an infectious-disease specialist at Olive View-UCLA Medical Center in Sylmar, agreed: “I don’t feel we can [strike] -- it’s not ethical or moral. We’re professionals. We can speak for ourselves.”

In 2000, some Los Angeles County doctors participated in a one-day walkout to support a rolling strike among other county workers, but many physicians remained at work in hospitals because they did not want to leave patients unattended.

Physicians opposed to the union say they had long been dissatisfied with its work on their behalf. Some said it took them two years just to get a vote to decertify because the union kept throwing up legal roadblocks to an election.

The most divisive issue was a benefits package known as megaflex, which gave doctors extra dollars to purchase insurance and other benefits, in some cases increasing their compensation by 19%. County officials ended megaflex in 2001 after the pro-union vote, substituting a package that doctors said was less generous.

Union officials said megaflex was stripped to punish doctors for joining the union. But many doctors blamed the union for the loss, which they said drove talented physicians from the county system.

The benefits package is important because doctors at county hospitals typically earn less than their counterparts in private practice. The megaflex package provided additional financial security.

Bader said the county’s decision to take away megaflex was illegal because it defied a state law barring employers from rescinding benefits after employees join a union. The union has since sued the county over the matter, but the case may not be resolved until late summer.

If the court rules in the union’s favor, Bader said, the union may then ask the judge to recertify the union or ask for another election.

Donna Singh, the county’s chief of employee relations, said Thursday that there appear to be no immediate plans to restore megaflex in the wake of the doctors’ vote. The decision ultimately rests with the Board of Supervisors, she said.

Meanwhile, the county has begun laying off doctors or transferring them in recent weeks. As many as 200 may lose their jobs by the end of this month.

Losing the union is “a temporary setback,” said Dr. Louis C. Simpson Jr, a psychiatrist at Martin Luther King Jr./Drew Medical Center in Willowbrook and a union supporter. “Many doctors have been laid off and have called us and said they wanted us” to fight for their jobs.

He said many doctors cast their ballots before word of the layoffs spread.