Sandy Pomerantz is a 29-year-old physician nine months out of his residency who does not approve of strikes by physicians.

Ted F. Silvey is a 74-year-old retired printer, a founder of the American Newspaper Guild and a member of the International Typographical Union, who believes wholeheartedly in the principle of physicians having the right to strike.

But yesterday Pomerantz found himself picketing the Group Health Association's Pennsylvania Avenue NW clinic carrying a sign that read "GHA Phycicians On Strike."

And Silvey was in a counter-picket line, pacing the same hunk of side-walk and carrying a sign supporting the position of the group plan's managers because he was outraged by one of the physicians' demands. Therein lies the basic conflict in the nation's first strike by physicians against a health maintenance organization, a strike that is a week old today.

While there are three main inssues still separating the members of the association and the "workers' like Pomerantz, none has the emotional impact, particularly with longtime GHA members, of the issue of outside employment for their doctors.

It is the issue that so enraged one 35-year member that he screamed "Dirty b - s!" at the picketing physicians Thursday. "They're all blood-sucking leaches," the man told a reporter. "They make three times what I do and they want to be able to go out and make more."

Silvey has difficulty seeing himself as a member of management, although that is what he and other members of the health cooperative are.

"Management, in terms of traditional trade union practice, has been an employer looking for excess private profits," Silvey said. "You were fighting a bunch of . . . publishers who were trying to make you work for $14 a week for as many hours as they could keep you awake. That is management.

"The management of cooperative organization," he continued, "exists for the benefit of its members and is not an exploitive organization. And doctors are not being exploited.

"The real issue," said Silvey, "is whether they're (to be permitted to work for the association while being) in private practice for profit. That's the only reals issue. The others can be settled. If (a doctor is in outside) private practice for Profit then (he's) using the organization for his purpose. Suppose my doctor has a private practice outside and he has a patient with an emergency when I have an appointment. There's a conflict and he's going to go to the private patient for a fee.

"A doctor who's got $5,000-a-month income, with all the things this institution provides, and he wants to go into private practice in addition? He's nuts!" said Silvey with a laugh.

By all measurable indicators, the great mass of GHA's 109,000 members are still basically uneffected by the strike, which also involves such issues as malpractice insurance and physicians' work hours, with none being denied emergency service at the Pennsylvania Avenue clinic.

According to the Civil Service Commission, which arranges health coverage of the 70,000 government workers and dependents who belong to GHA, there were no complaints the first week of the strike, and only about two dozen inquiries all week.

That does not mean that the commission won't be faced with a major problem of the strike drags on, and it doesn't mean that things are easy for Silvey or Pomerantz who, unlike Silveys image of physicians, grosses $37,000 a year and has about $20,000 in debts acquired in pursuit of his education.

It took Sandy Pomerantz a week to decide he was willing to talk about what brought him to the picket line. But he said he was finally convinced to tell it by his fellow striking physicians in hope it would make GHA members understand why their doctors are walking a picket line. Roughly two-thirds of GHA's approximately 90 physicians are on strike.

"I had been very sympathetic to the union position . . . But I had a great deal of difficulty with the idea of belonging to a union and doctors being on strike because it's a quesiton of long term personal gain versus the possibility of short-term harm to patients," he said.

"I made a decision (the Friday night before the strike began) that I would honor the picket line but not join the union. Saturdays I've always returned to the office (on his day off) to check on lab results on patients." Last Saturday he followed that practice, being particularly concerned about a woman whose results had not come back Friday afternoon.

"I went to my office but the results hadn't come in yet>" said Pomerantz. A supervisor came into his office and asked him if he was working.

Pomerantz said that after a semantic discussion over what was meant by work, the supervisor said "If I was not working in the minor inuries unit I would have to leave the building."

After discussions with two other GHA officials, Pomerantz said he went outside, saw his GHA patients who were hospitalized "and then sat down and wrote out a check" for the $50 union initation fee and $40 monthly dues.

Later that day Pomerantz "called Dr. Harvey, who's acting chief of medicine, and told him that I was now an active union member." harvey then checked the lab results of Pomerantz's patients and saw that they were taken care of.

"I would not have thought that the strike would last as long as it has," said the young internist, who said he views the older, longtime GHA leadership as "New Dealers trying to grapple with the health care problems of 1978."

The irony of the situation is that GHA was started during the New Deal by members who banded together to gain control of their health care, outraging the medical establishment, which tried to force the fledgeling "radical" organization out of business.

Yesterday it was those early members of GHA who were demonstrating against what they view as the physicians' desire to establish outside private practices.

Late yesterday afternoon, however, the physicians issued a statement in which they said they want outside "professional activity permitted" only if it does "not hurt patient care at GHA, is approved by GHA's medical director and in no way conflicts with their duties at GHA.

Asked about fears of patients like Ted Silvey, who worries that his physician won't be available when needed, Dr. Donald Mitchell, one of the physicians negotiators, said that patients "can't get their doctor when he's out in the middle of the lake fishing either, but we're always covered" by another doctor no call.