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PubMed1993

The effect of the federal Family and Medical Leave Act upon employee benefits.

FMLA will substantially influence the administration of employee benefits. The plan sponsor, trustees, plan administrator and collective bargaining parties must make a number of policy decisions. These include employer reporting and contribution procedures, settlement of eligibility questions, delinquency procedures, coordination with COBRA, substitution of vacation and sick leave rights and procedures, restrictions on participants working during leave, procedures for the non-forfeiture of accrued benefits and restoration of benefits. After the policy decisions are made and the procedures are established, the proper notices and caveats must be communicated to plan participants, and the plan must update the SPD. Each of the policy decisions, administrative procedures and participant communications must be carefully thought out before implementation. Plan sponsors, trustees and plan administrators should seek the help, advice and assistance of the plan's professional advisers.

Employment↗
PubMed1991

Study shows ways to win, avoid union elections.

Because of an April Supreme Court ruling authorizing the National Labor Relations Board to establish eight collective bargaining units in hospitals, administrators should be concerned with consequences of unionization within their hospitals. A three-year study of union activity at hospitals across the nation indicated a typical pattern of union organization and isolated approaches a hospital should avoid to lessen the likelihood of employee dissatisfaction. Most important, administrators should establish a two-way communication system in which employees feel free to air grievances.

Communication↗
PubMed1995

Labor looks to lead counter-revolution.

The withdrawal of the California Nurses Association from the American Nurses Association on Oct. 1 exposed the tensions in nursing. Should nurse organizations be primarily professional associations or collective-bargaining units? How should they address their employers and the public? Having reached different conclusions, the CNA and the ANA will go their separate ways.

American Nurses' Association↗
PubMedDate not supplied

A guide to the EEOC's final regulations on the Americans with Disabilities Act.

The Equal Employment Opportunity Commission (EEOC) recently issued its final regulations on the Americans with Disabilities Act (ADA). Although the regulations offer some guidance for employers on how to comply with the Act, they fail to provide specific answers to the many complicated compliance questions that will surely arise. Further, the regulations are almost totally silent on certain critical issues related to insurance, workers' compensation, and potential conflicts between ADA obligations and terms of collective bargaining agreements. The EEOC has essentially left the resolution of many important ADA questions to case-by-case determination and the litigation process.

Architectural Accessibility↗
PubMed1982

Employer remedies for work stoppages that violate no-strike provisions.

An employer faced with a work stoppage that violates a contractual no-strike provision has several alternatives: the employer can seek an injunction against the strike, discipline employees involved in the strike, or attempt to recover damages for violations of the collective bargaining agreement. Each of these remedies, however, presents practical problems in terms of employer-employee relations as well as legal questions regarding the extent of relief available. In the following article, the author examines the remedies available to an employer when employees engage in activity that violates a no-strike provision. He also examines the impact of recent cases on an employer's ability to enforce a no-strike pledge.

Personnel Management↗
PubMed1982

Achieving equal pay for comparable worth through arbitration.

Traditional "women's jobs" often pay relatively low wages because of the effects of institutionalized stereotypes concerning women and their role in the work place. One way of dealing with sex discrimination that results in job segregation is to narrow the existing wage differential between "men's jobs" and "women's jobs." Where the jobs are dissimilar on their face, this narrowing of pay differences involves implementing the concept of "equal pay for jobs of comparable worth." Some time in the future, far-reaching, perhaps even industrywide, reductions in male-female pay differentials may be achieved by pursuing legal remedies based on equal pay for comparable worth. However, as the author demonstrates, immediate, albeit more limited, relief for sex-based pay inequities found in specific work places can be obtained by implementing equal pay for jobs of comparable worth through the collective bargaining and arbitration processes.

Female↗
PubMed1983

Protected activities of nonunion employees.

The vast majority of American workers are nonunion and therefore unprotected by many of the mechanisms established through collective bargaining. They are protected to some degree, however, by a number of statutes and evolving legal doctrines that limit the employer's right to hire, fire, or otherwise discipline its nonunion people. The most elemental of these limitations is embodies in the National Labor Relations Act: section 7 protects the concerted activities of nonunion employees, section 8(a)(1) makes it an unfair labor practice for an employer to interfere with the section 7 rights of its employees; and section 10(c) grants the National Labor Relations Board broad remedial powers to correct violations, including the power to reinstate workers with or without back pay. The following article will examine this basic protection of nonunion employees and will point out those areas in which the Board has attempted to expand the scope of section 7's protection.

Employee Grievances↗
PubMed1985

Wrongful discharge of the at-will hospital pharmacy employee.

The vast majority of hospital pharmacy employees are not covered by a contract or a collective bargaining agreement and are therefore subject to the employment at-will doctrine. In recent years, there has been considerable erosion of this doctrine with increased protection of the at-will employee from wrongful discharge. This paper reviews both the statutory and judicial limits on the right to discharge an employee at-will, and discusses the implications for pharmacy management and staff. Although the laws relating to wrongful discharge will vary from state to state, the changing theories governing this process are of significant importance to all concerned.

Employment↗
PubMed1985

Retiree health and welfare benefits: controversy over their duration.

As the cost of providing health-care benefits skyrockets, employers have begun to reduce or even to terminate health-care and life insurance benefits for retirees, often with little awareness of the possible repercussions. Retiree groups and unions have countered these actions with claims based on such theories as the "status benefits" argument--that retirement benefits should be viewed as earned compensation for years of service--or the "vested rights" view--that retirement rights may not be altered without the pensioner's consent. Crucial to these conflicts are the terms of the collective bargaining agreement. Case law indicates that employers can never feel themselves fully protected even if the agreement contains provisions explicitly stating the benefits' scope and duration. The authors demonstrate this point in their review of recent retiree benefits cases. They then explore in detail the problem of contract and document ambiguity, and offer guidelines for ascertaining intent. They conclude with a discussion of strategies for litigating retiree benefits cases.

Insurance, Health↗
PubMedDate not supplied

Due process key element of physician grievance.

The concept of grievance procedures, when applied to physicians, has a foreign ring to it. We ordinarily associate grievance procedures with unions and labor relations activities unrelated to professional conduct and behavior. As described in the preceding article, grievance procedures usually are extremely limited, having been created to resolve very specific violations of collective bargaining agreements in a unionized company or of conflict resolution policies in a nonunion environment. In health care organizations, "due process provisions" are designed to resolve specific conflicts in the relationship between the medical staff and individual medical practitioners.

Conflict, Psychological↗
PubMed1999

[Duration of maternity leave and sick leave during pregnancy].

The aim of the project was to describe the reasons for sick leave during pregnancy. This article presents data on a subgroup of women on sick leave. The purpose of this reanalysis was to examine whether women with short maternity leave had longer sick leave during pregnancy. Pregnant women in a Danish County applying for sick leave in a year were consecutively included in the study. Data were obtained by questionnaires during 1991-1992. Women with rights to a longer maternity leave, obtained through collective bargaining, were mainly employed in occupational groups related to the public sector and were on sick leave significantly longer, than women with short maternity leave, obtained only through legislation. The diagnoses differed among the two groups. Data suggest unequal possibilities for obtaining pregnancy related sick leave, as women with longer predelivery leave and a more secure employment situation had significantly longer sick leave than other women.

Denmark↗
PubMed1999

Physician organizing: a convergence of interests.

Economic forces and professional ideals are colliding to create further unrest in the health care industry in the form of organizing physicians into unions. Whereas self-employed or independent contractor physicians are barred from joining together to bargain collectively with third-party payers and HMOs, employed physicians may be able to avoid antitrust problems because they are eligible for protection under the National Labor Relations Act. Consequently, as the number of employed physicians has grown and the frustrations they encounter increase, unions (generally suffering a decrease in membership and political influence) are finding a receptive audience for their message of solidarity. However, will organizing into unions solve or aggravate the physicians' problems?

Antitrust Laws↗
PubMed1999

Physician unionization: a threat to integration?

Physicians, primarily those salaried by hospitals and health systems, are increasingly turning to labor unions to help them in their frustration over what they see as eroding clinical autonomy as well as diminishing compensation. Significantly, non-salaried physicians are also looking to the concept of collective bargaining as a tool in their negotiations with health insurers. The pro-labor doctors may get some of what they're looking for in the coming months and years, with a combination of economic and political forces driving the nascent trend forward regionally and nationwide. But victory won't come without a struggle and some major legal and regulatory hassles. And what will physician unionization mean for integrated health systems and other large healthcare organizations? Plenty, say industry observers and those in the trenches.

American Medical Association↗
PubMed2000

Physician unions--an ethical and legal issue in health care delivery.

The controversial issue of physicians' unions has been revived in the past few years by the economic juggernaut of managed care. The uproar of legal and ethical dilemmas surrounding the creation of physician unions centers around self-employed physicians, their formal employment relationship to HMOs under the National Labor Relations Act, and the ramifications of exempting physicians from current antitrust laws. Will physician collective bargaining increase competition and equalize the power between physicians and HMOs so that the quality of patient care improves? This report discusses relevant laws and the history of physicians' unionization, reviews contemporary thought and present policies on physician unionization, and comments on alternatives and new policies that could be created in order to resolve this dilemma.

Delivery of Health Care↗
PubMedDate not supplied

Case study: unionization of a newly acquired satellite practice.

In March 1997, a 24-physician primary care medical group in upstate New York acquired an occupational medicine practice. Shortly after the merger, motivated primarily by job security concerns, the employees of the occupational medicine group voted to unionize for the purpose of collective bargaining. The author--the practice manager for the merged medical group--describes the events that ensued as practice management and union employees struggled toward an agreement.

Decision Making, Organizational↗
PubMed2001

Legal considerations of sleep deprivation among resident physicians.

Medical training in the United States often takes the form of a grueling endurance test in which patients are often those most at risk. This Article discusses sleep deprivation among resident physicians in the United States with an eye towards resolving the problem through legal channels. It analyzes the effects of sleep deprivation on resident physicians, with subsequent discussion of the implications for patient care and medical training. Next, it makes comparisons to medical training in other developed nations, as well as regulations that exist in the airline and trucking industries, where public safety is a principal concern. Furthermore, this Article discusses proposals to mend the dilemmas created by sleep-deprived resident physicians through statutory and regulatory reform, deterrence by way of tort law, and unionization or collective bargaining.

Automobile Driving↗
PubMed2000

Physician responses to the marketplace: group practices and hospital alliances.

Congress is now debating legislation that would give independent physicians the right to bargain collectively with managed care organizations. Proponents argue that this legislation is needed to counterbalance the market power of managed care organizations; opponents argue that physicians can already gain leverage and negotiating strength by forming group practices or through joint ventures with hospitals. This debate has brought attention to the competitive nature of the health care marketplace, and physician responses to managed care. This Issue Brief examines how physicians are reorganizing their practices to meet the demands of the competitive marketplace.

Delivery of Health Care, Integrated↗
PubMed1955

Organization of health care in small plants in the USA.

In the USA, the concept of an occupational health programme has grown steadily, and now embraces the total health of the worker. Elements of basic in-plant health programmes have been identified and patterns developed for successful operation.Today, health services in small plants still fall far short of optimal requirements. No more than 5% of workers in small plants enjoy the benefit of occupational health services. The main reason for the arrested development of these programmes is the lack of organizational and administrative techniques for providing health services in small plants. Recently, however, several projects have demonstrated that these difficulties can be overcome, and the future development of such programmes in small plants thus looks hopeful.Other recent developments hold promise of strengthening the health services available to workers. Union health centres, now being established in increasing numbers, offer the workers varying services, ranging from diagnostic and preventive procedures to complete medical care. Further benefits to both the worker and his family are being provided under collective bargaining agreements by voluntary health-insurance schemes.In addition to making services available to large numbers of workers previously not covered, the development of both union health centres and the prepaid health-insurance schemes offer future possibilities for integration of these programmes into the preventive and diagnostic services offered in the plant.Finally, governmental occupational health agencies, in addition to their industrial hygiene activities, are taking an increasing interest in the establishment and development of in-plant health programmes.

Health Promotion↗