I've just got to spend my own money. I think collective bargaining, in the classic trade-union model, is viable for certain physicians in certain markets where they don't have good IPA representation. Trade unions are not consistent with the spirit of the profession, which is more professional, entrepreneurial, and business oriented. There's also the broader issue that trade unionism is dying in this country. You can engage an employee in profit sharing and stock options even at the factory floor level.
Physicians get productivity bonuses and profit sharing.