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Real Economic Considerations in Today's Medical Environment
October 16, 2014

Michael Q. Davis


Executive Director, Pennsylvania Podiatric Medical Association

Assistant to the President, Guild 45, Office and Professional Employees International Union AFL CIO

While I am not a podiatrist, I have been asked to write a few words on the alliance between the Office and Professional Employees International Union (OPEIU), and the American Board of Multiple Specialties in Podiatry (ABMSP). I will try to do that without violating the tenants of the Champions of Podiatry Distinguished Authors Series.

Pursuant to discussions between the leadership of the OPEIU and ABMSP, these bodies have reached an accord through which the members of ABMSP shall be members of the OEPIU. This agreement entitles ABMSP members to the benefits and the advantages that the membership in a union offers. The OPEIU has been the representative of podiatric physicians through Guild 45 for over fifteen years. Through this relationship the value of a partnership with organized labor has been clearly established.

The alliance between medicine and organized labor is incredibly important and incredibly beneficial to both. The OPEIU offers the profession of podiatry both leverage and access which its existence as a medical provider alone does not offer. That leverage is a result of the fact that organized labor represents over twelve million members located in every state in the nation. With family coverage, that means that the number of “paid lives” represented by organized represents about 20% of the indemnity coverage in the country. The paid lives represented by labor are a very important income stream to virtually every major healthcare plan. The Blue Cross Blue Shield Labor Committee webpage indicates that labor families represents over seventeen million paid lives within the Blue system.

This fact means that healthcare plans pay attention to organized labor and the economic strength that it represents. The relationship between podiatric physicians and the OPEIU allows podiatry to leverage this relationship between labor and healthcare. We are now much more than “another provider.” We are a part of a much larger group which represents workers in a broad spectrum of professions and industries. That means that the profession of podiatry can leverage its position within the economic and political models within which we all deal.

On a political level, as an executive director of a podiatry association, I now have membership in the state federation of AFL CIO unions. I also have access to the political and industrial connections which that membership provides.

This relationship translates to our membership having a voice that is more than the voice of one thousand providers of medical service in my state. In Pennsylvania, there are just over one thousand podiatric physicians. There are over thirty five thousand MD’s and DO’s. Our alliance with OPEIU and through OPEIU to the Pennsylvania State Federation of AFL CIO unions, gives us the ability to gain political and industrial access at a much different level than an association representing one thousand licensees without that relationship would otherwise gain.

This relationship has provided benefits in the legislative and regulatory process. It has also provided benefits in our relationship with healthcare companies. I am not going to use this forum to make “lists or accomplishments.” That is available elsewhere. I want to use this forum to address the political reality that all medical professionals must now face. In today’s world, unions have been placed on the opposite side of the growing “conservative/liberal” divides in our political system.

What all physicians have to realize is that the membership in a union is not a philosophical issue, it is an economic issue. Whether you are a Republican or Democrat, you can not divorce your practice from the industrial realities which you now face. Today, in a far too realistic manner, medical professionals are becoming commodities. Your professional services can be used or discarded by healthcare companies. While the healthcare company advertises its panels as “our doctors,” it will discard that doctor who, in any way, becomes recalcitrant in his or her relationship with the company. The healthcare company has successfully inserted itself between the doctor and the patient and any threat to that separation can result in the doctor being dismissed from the panel.

It is this reality that the Guilds within OPEIU address. While a company can feel free to dismiss one podiatric physician, it can not feel free to alienate the body of organized labor to which that one podiatric physician belongs. This is not a guarantee that every problem can be solved in a way that our member wants, but it is a guarantee that we will get more attention because of our union membership than we would have gotten without it.

We welcome the members of the ABMSP to the OPEIU. We will not guarantee universal success, but we will guarantee tireless effort and diligent pursuit of your Board’s goals. You are now a member of a much larger family and one family that looks out for each other.