Current and anticipated changes in this country's health care system are likely to add momentum to the physicians' union movement, according to Grace Budrys. She documents the emergence and development of the Union of American Physicians and Dentists (UAPD), founded in the San Francisco Bay area in 1972, and suggests it may be a harbinger of renewed organizing efforts throughout the country.Representing both salaried and private practice doctors, the UAPD gained strength in the early 1980s during the crisis in malpractice suits, and surged again in recent years in response to steadily increasing medical corporatization. Budrys argues that the approach to modernization now favored across the country resembles that of the industrialization era. As health organizations become larger, more centralized, and more hierarchical, decisions are made further from the work site and some traditional responsibilities are delegated to lower-paid, less-trained workers.Nevertheless, the image of blue-collar industrial workers organizing into unions is not easily reconciled with our society's image of physicians as highly trained and highly skilled members of a profession long considered the bastion of individualists. Budrys suggests that doctors' unions in general and the UAPD in particular may provide a model for other nontraditional groups and occupations seeking solutions to contemporary problems in the workplace. After discussing the laws governing workers' organizing rights and their interpretation by the courts, she concludes with commentary on the organizing activity taking place among highly paid and highly educated workers.

Grace Budrys is Professor of Sociology at DePaul University.