Philadelphia physicians join union

A move by Philadelphia-based Independence Blue Cross Blue Shield to lower reimbursement rates has spurred a group of Philadelphia-area surgeons to join a union in hopes of gaining better bargaining leverage when it comes to plan payment rates.

Since this summer, some 300 Philadelphia-area orthopedic surgeons, urologists, and ear, nose, and throat doctors have joined the Federation of Physicians and Dentists (FPD) union.

Physicians in Independence Blue Cross Blue Shield’s network keep an average of only 40% of each dollar they make, says FPD spokesman Michael Connair. On top of this, last July, the plan instituted a 2.5% across-the-board fee cut intended to dampen a recent rise in health care costs averaging 5% to 8% annually.

Surgical specialists were hardest hit by these cuts, who had to eat a 16% reduction in their reimbursement, says John Zamzow, vice president for contracting at Independence.

Because they are considered independent contractors, surgeons are restricted from collective bargaining by the Sherman Antitrust Act. However, they have agreed to pay the Fort Lauderdale, FL-based FPD annual dues in exchange for its consulting services relating to reimbursement and bargaining issues.

One such service being provided by the union is review and consultation on insurance company contracts, along with assistance in drafting counterproposals. FPD also will gather information on customary charges for key medical procedures and reimbursement rates of other insurers in the Philadelphia area.

"We’re now being paid about one-third of what we got paid five years ago for the same procedure,’’ says Michael Okin, MD, an orthopedic surgeon in Philadelphia. Affiliating as a group with a union like FPD to help give physicians more leverage in contract negotiations is "the only venue we have left to save our profession," says Okin.