The competition sets the price of your services, whether medical or optical, it is the consequence of the “free” market place. The competition in medical plans is hard to find but fierce! 137 more words
by Dr. Lisa Shin [caption id="attachment_809" align="aligncenter" width="660"] Does Optometry Need a Union?[/caption] I came across Dr. Jim Amos' article "Thoughts on Doctors Forming Unions," and I wanted to share his thoughts, then offer my insights as applied to optometry. 1. Unions emerge out of the increasing discontent of physicians with outside control over their ability to practice. This month, a group of hospitals unionized in order to have more of a say in patient care and working conditions. There's been talk of the power of the union to curb their Maintenance of Certification (MOC) requirements. Dr. Amos has a bias against unions, given the uncomfortable images of picketing and striking. I agree with him. 2. Dr. Amos points out that when independent physicians join together to negotiate with payors, it looks like price fixing to the government. Setting up a minimum fee schedule would indeed be an anti-trust violation. Last year, AOA issued a grave warning about anti-trust laws, detailing the "wink and the nod" that could result in severe penalties. AOA, where's the beef? In 2013, the American Dental Association urged Senate support for legislation "eliminating the unwarranted antitrust exemption that grants health insurers special status..." In other words, if we're subject to anti-trust laws, health insurers should be as well. 3. Dr. Amos received several comments on physician unions, which included the idea that physicians should either change jobs or drop the 3rd party payers. AOA offered similar advice of carefully reviewing contracts before signing them, implying that we should reject them if terms were unfavorable. The problem that I see with this line of thinking, is that many of us are dependent on these 3rd party plans for patient flow. In a perfect world, optometry would be cash for service, but now with mandated health insurance, doctors and patients alike cannot escape 3rd party dominance. 4. Dr. Amos supports the recent AMA vote to not allow MOC to be linked to hospital privileges, insurance reimbursement, or medical licensure. However, this is too little, too late, and he is not renewing his AMA or APA professional memberships, citing, "They’re just too expensive and I don’t think either represents the interests of members on key issues which adversely affect doctors." Unfortunately, this sentiment among OD's is growing and captures my final point: If AOA were listening to and advocating for its members, there would be no need for OD's to form a union. Without this, optometry does need a union. Who else will speak up for OD's before vision care plans? However, I would urge my colleagues to proceed carefully. You will be much more effective with a willingness to compromise rather than a winner-take-all approach. At the negotiation table, what are you willing to give up in exchange for what the VCP is willing to give up? "We are not happy with this, but here are the proposed changes," rather than demanding elimination of the grievance. Optometry's union will be successful, and will go down in history as the only organization able to strengthen the relationship between OD's and VCP and effectively accomplish what AOA would not.