A patient might be taken aback to learn his doctor is a member of the International Association of Machinists. But that union and others which would seem to have no affinity with physicians are signing them up at a reportedly rapid clip. Observers say the reason doctors are affiliating with unions is that they are angry at health maintenance organizations (HMOs).

• Physicians in New York, New Jersey, California, Connecticut and at least 10 other states are moving to unionize at such a rate that the number of doctors in unions is expected by labor experts to grow by 15 percent or more each year.

• Already, medical experts estimate, about 35,000 doctors -- or 5 percent of the total -- belong to unions, up from about 25,000 in 1996.

• Even the American Medical Association -- long opposed to the unionization of doctors -- is setting up a unit to conduct collective bargaining.

• As the trend gains momentum, HMOs are often fighting back by asserting that doctors are independent contractors and therefore not allowed to unionize.

Most likely to join unions are salaried staff doctors at hospitals, both public and private. But hospitals are also fighting back, fearing lower profits.

At the same time, many doctors in private practice are joining in order to gain clout with HMOs. More than 90 percent of the nation's physicians have at least one contract with a managed care company. Under federal law, however, only employees have a right to collective bargaining. The Department of Justice has filed an antitrust suit against a group of doctors in Delaware -- accusing them of conspiring to restrain trade by joining a union and refusing to accept lower reimbursement rates ordered by a managed care organization.

More than half a dozen unions -- including the American Federation of Teachers -- are competing for physician members.

Source: Steven Greenhouse, "Angered by HMO's Treatment, More Doctors Are Joining Unions," New York Times, February 4, 1999.

For more on Union Membership http://www.ncpa.org/pd/unions/membership.html