The 152-year-old American Medical Association (AMA), the nation's largest doctor's group, recently reversed its long-standing opposition to the creation of a union for its members who are employees of insurance companies, hospitals or health groups.
The AMA launched a large-scale PR campaign to present its case, with senior officials appearing on numerous TV and radio programs as well as making themselves available for interviews. CARMA International found that both the reasons for and the reaction to the June 24 vote were hotly debated in the media.
The media's coverage most often focused on the AMA's rationale that doctors want to have more autonomy and flexibility in their decision-making about what's best for their patients. The AMA portrayed HMOs as more concerned with costs than with the quality of care patients receive.
'Doctors are concerned that we cannot take care of our patients today, and that what we do oftentimes ... is dictated to be what's cheapest, not necessarily what's best,' explained Dr. Nancy Dickey, AMA president ('Face The Nation,' CBS, June 27).
However, many reports doubted the AMA's intentions of serving as public advocates for their patients, portraying the AMA's real motives as far less altruistic. These reports maintained that the AMA and its doctors were actually making a power play that would result in higher salaries, which have been cut due to the cost controls introduced by managed care.
Others presented the move as a threat to competition in the industry, which would result in higher prices for consumers.
The Seattle Times (June 29) quoted Michael Donio of the People's Medical Society, 'You want to test their advocacy? Go to some doctors' offices with no money, no insurance - and see how much of an advocate they are.'
Each day seemed to bring new opposition to the AMA's vote. Writers at the Atlanta Journal-Constitution (June 25), Milwaukee Journal Sentinel (June 26), San Diego Union-Tribune (June 28), and Chicago Tribune (June 30) argued in no uncertain terms that the establishment of a union was a 'mistake'.
The AMA's decision won cautious support from the editors at The New York Times (June 25): 'If doctors use collective bargaining to improve care standards, unionization may turn out to be a strong force against health plans that unfairly use their market power to limit quality of care.'
A few reports presented the debate in terms of the image of the medical profession, raising the issue that the integrity of the AMA and its doctors would be tarnished by the creation of the union. 'The medical association must restore patients' confidence that physicians still are more committed to the Hippocratic oath and compassion than they are to profitmaking schemes' (Chicago Sun-Times, June 25).
Given the initial reaction in the media to the AMA's vote, it seems that the AMA should step up its PR campaign to win support for its decision and convince the American public that its prescription is a healthy one.
- Evaluation and analysis by CARMA International. Media Watch can be found at www. carma.com.