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

Purpose. A resolution in support of physicians' unionization was recently a pproved by the American Medical Association's House of Delegates. This stud y investigated the factors associated with young physicians' approval of un ionization. Method. A survey was mailed to all 1987-1992 Jefferson Medical College grad uates (n = 1,272); 835 (66%) responded. Results. Of the respondents, 43% supported unionization, 31% did not suppor t unionization, and 26% expressed no opinion. Surgeons, medical subspeciali sts, pediatricians, and hospital,based specialists were more likely to supp ort unionization than were family physicians. Significant predictors of sup port for unionization were negative views of the changes in the health care system, negative perceptions of the quality of care provided by managed ca re, the belief that physicians' independence had been impaired by changes i n the health care system, and the belief that physicians' personal satisfac tion should take precedence over societal needs in determining the future o f health care. Support for unionization correlated with physicians' percept ions that mental health patients should be referred to psychiatrists, physi cian-assisted suicide should be legalized, and the involvement of nurse pra ctitioners in diagnosis and treatment could compromise the quality of care. Conclusions. Young physicians' support for unionization is a function of fr ustration with market,driven policies that compromise the quality of care a nd negatively affect physicians' autonomy and personal satisfaction.