Physicians for Responsible Negotiation (PRN), the labor union organized by the American Medical Association, closed a new deal last month to represent a group of residents and fellows in their contract negotiations with a suburban Chicago hospital.

The group of about 170 residents and fellows in training at Advocate-Lutheran General Hospital in Park Ridge, Ill., had approached PRN last summer after experiencing problems with Lutheran General regarding the absence of a grievance policy and deteriorating work conditions. The National Labor Relations Board approved PRN’s petition to represent the group in November of last year, and last month the physicians officially elected PRN as their collective bargaining representative.

The agreement with the Lutheran General residents and fellows is the third for the relatively young labor union. PRN was formed in November 1999 by the American Medical Association as a legally separate and independent national negotiating organization for nonsupervisory employed physicians and medical residents (Psychiatric News, January 7 and May 5, 2000).

The organization signed its first contract with physicians employed by the Wellness Plan in Detroit in March 2000. In September physicians employed with Concentra Managed Care within New Jersey elected PRN as their representative.

More deals are in the works. PRN is working with a large group of faculty and residents at Montefiore Medical Center in the Bronx, N.Y. According to Susan H. Adelman, M.D., president of PRN, "The faculty are pretty much on board, and the residents are being campaigned now."

If PRN successfully completes the campaign to represent the group, it will be the largest organized group of physicians at a private hospital in the United States.

"PRN was formed to give physicians a collective voice," said Adelman, a Michigan pediatrician who is also a member of the AMA’s Board of Trustees. "That is necessary to aggressively advocate for patients and for physicians in today’s managed care environment."

The union addresses issues involving patient care, hospital efficiencies, and the employed physician and resident work environment, he said.

Adelman believes that what sets PRN apart from other labor organizations that represent physicians is the strict adherence of PRN and its members to the AMA’s Principles of Medical Ethics. For example, although PRN is a full-service labor organization, its bylaws require physicians who join PRN to vow never to go on strike.

"Patient care is always regarded above the needs of the individual physicians or residents," Robert T. Bernat, M.D., J.D., executive director of PRN, told Psychiatric News. This is seen as a plus to PRN representation, Bernat continued, both from the perspective of physicians and employers. Both sides, Bernat believes, know that the union is absolutely committed to high-quality, cost-effective health care.

Although legally separate entities, the goals and activities of PRN and the AMA are often closely linked. PRN consistently includes employer-paid or -subsidized membership in the AMA or in state/county medical societies as a requirement in its bargaining, and so far it has enjoyed success.

PRN is also attempting to set up the equivalent of local affiliates through state and county medical societies. The Medical Society of New York is the first such example with its formation of "NYS-PRN."

In addition, Adelman said PRN has, to date, had discussions with two national specialty societies (although she declined to name them for Psychiatric News) about forming specialty-focused PRN chapters.

Many of these efforts are openly geared toward increasing membership of physicians in organized medical societies, not only the AMA, but also the national specialty associations.

In the last year, said Adelman, one thing is certain. "This business is not for amateurs. The take-home lesson is we need to know what we are doing, and we need to be in there representing the physician group from the start."

More information on PRN is available at its Web site at www.4prn.org. ▪