Should doctors strike?

To the Editor, In her editorial,1 Dr Susan Adelman states, “Physicians for Responsible Negotiations will be heard.” I doubt that managed care or anyone else will be listening. Physicians for Responsible Negotiations (PRN) came out of the American Medical Association (AMA), an organization whose membership totals less than one third of all physicians. They purport to represent employed physicians, but before 1989 had viewed employed physicians as pariahs not worthy of recognition. My appeal to the AMA for help in 1994 when I was fired from [my employment with] a health maintenance organization (one with which Adelman is familiar) for opposing a destructive chief executive officer fell on deaf ears. By deciding not to strike, PRN has sacrificed any leverage it may have had and will be little more than a paper tiger. The obvious solution, a “strike” against all managed care companies, would cripple the industry, but I know few physicians who have the courage to confront their tormentors directly. More likely, we might see a gradual shift to a freemarket health care system. But who is willing to take their hands out of the cookie jar? I abandoned full-time practice in 1997, at age 42, having become totally disgusted with the health care system. I now work part time as a locum tenens physician, which allows me to do what I enjoy most, take care of patients. You couldn't pay me enough to return to being some bureaucrat's minion.