When one adds the control of decision making in medicine is being usurped by the managed care company, the degree of happiness and satisfaction a physician has with his or her mode of existence is reaching a nadir. Physicians clearly need help in dealing with this new changing economic environment. This is the attraction of unions. For the practicing physician the courts have so far clearly held that, with or without a union, the negotiation of fees cannot be carried out in tandem with other physicians. This does NOT negate the value of a union.
Fees are only one of many problems with managed care companies.
And the ability to make independent decisions to take care of your patient are paramount. They can be represented in true collective bargaining by union. Physicians in a clinic in Tucson recently won this certification from the National Labor Relations Board and Formed a physician union to negotiate a contract with their employers. This is currently under appeal by the clinic, but certainly is a beginning. Physicians employed by governmental agencies are already unionized.