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PubMed1998

Health care insolvency and bankruptcy.

Bankruptcy is an event that is often considered a business' worst nightmare. Debt, lawyers, and the U.S. government can lead to the eventual destruction of a business. This article shows how declaring bankruptcy can be a helpful instrument in continuing a successful venture in the health care marketplace.

Bankruptcy↗
PubMed1992

Union organizing drives dealt a blow by Supreme Court.

The Lechmere case is important because it reaffirms that employers' property rights take precedence over the rights of nonemployees to engage in union organizing on employers' property. This is particularly important for hospitals and health care institutions because of their heightened exposure to union organizing activity after American Hospital Association v. National Labor Relations Board, discussed above. Providers should, however, remember two points. First, the principal focus of Lechmere was on union organizing by nonemployees; nothing in Lechmere limited the basic right of employees to form and join labor unions as guaranteed by Section 7 of the NLRA. Additionally, Lechmere notwithstanding, providers must be careful not to discriminate in their approach to union organizing activities--even by nonemployees. Thus, if a provider allows nonemployee groups other than unions to enter upon its property for purposes of soliciting employees and/or distributing literature, any attempt to bar nonemployee union organizers from the property would probably be deemed discriminatory and could indeed be an unfair labor practice. (In Lechmere, the employer consistently enforced a ban against all such nonemployee groups.)

Collective Bargaining↗
PubMedDate not supplied

Serf or citizen: physician status and organizational structure.

For more than a decade, dynamic changes in the health care industry have created new organizations for physicians. The major change for physicians has not been the organization itself, but the principles by which it is governed. This fundamental shift is studied with its impact on physicians, by analogy, becoming more like serfs or more like citizens. A review of the general organizational direction and results of non-physician health care organizations is made followed by the statistical trends of physician groups. Historical comparisons of non-health care industries are made with current organizational choices of physicians and physician groups. Observations of physician decisions are made identifying the direction they send physician status along the continuum from serf to citizen. Physicians are unknowingly making decisions regarding the principles by which they will be governed in new organizations. The choices they are making give them less autonomy and less opportunity to make future choices. The seductive invitation to spend less time in administrative matters and more time practicing medicine is a siren's call that will diminish the status of physicians and the autonomy by which medicine is practiced.

Collective Bargaining↗