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He makes a good living, and right now he's probably thinking about his next visit to the fashionable resort where he and his family spend most summers. My doctor is not, in short, a likely candidate for union membership.

Or is he? I thought about him the other day when the American Medical Association, a rather conservative group that long opposed national health insurance as a form of creeping socialism, voted to create a new labor organization for doctors.

The subject of doctors unions had come up when I saw him for a physical a few years ago. He handed me a photocopy of an article from the AMA Journal denouncing health maintenance organizations, managed care and the insurance industry, for encroaching on the physician-patient relationship and interfering with medical care to increase profits.

In a small gesture against his corporate oppressors, he was giving this article to all his patients.

Joe Conason Joe Conason's column appears in Salon News every other Tuesday. + Biography + Archives

"You guys might have been better off supporting national health insurance when you had the chance, instead of joining with the insurance companies to kill it off," I suggested. "Now you find yourselves working for them on their terms, and you don't like it. Pretty soon you're going to find out that the only way to resist them is to form a union."

My doctor reacted skeptically to that suggestion, though not with nearly the horror expressed recently by a Texas AMA delegate opposed to the unionization proposal. "We are not mere laborers, we are servants," cried Susan Wynn, a doctor from Fort Worth. "We are care givers. We are professionals. The banner that we must carry for our patients is not the union label; it is the oath we took when we became physicians."

Wynn is the exception. Most doctors are receptive to unions now when they never have been before, precisely because they see no other way to uphold the Hippocratic oath against the onslaught of Health Care Incorporated.

Had the United States moved to a single-payer model like the Canadian system, the doctors would have been able to maintain their autonomy and their personal ties with patients. The government would have mandated controls to hold costs down -- but unlike the strictures mandated by the corporate masters of medicine, the governmental controls would have been subject to democratic influence.

Next page | How to uphold their oath?