"It's with a heavy heart that I'm here to read this," union president Dr. Norman Lieberman began at 1:50 a.m. yesterday telling the board of directors of the 109,000-member Group Health Association that the group's physicians had once again voted to go out on strike.
The 40 to 1 vote by the physicians followed two acrimonious confrontations with board members and came only 30 hours after the physicians had voted to return to work, ending after its 11th day the nation's first major strike by fully trained physicians.
The physicians were meeting last night to decide whether to resume their strike immediately, or wait 10 days. Federal law requires that health service workers give their employers 10 days notification prior to striking. Some GHA physicans contend that their earlier strike never officially ended, and thus they can immediately resume picketting.
A debate over the interpretation of two simple Latin words - pro bono - led to the name calling and nastiness Wednesday night and Thursday morning, and the disintegration of the carefully constructed agreement between the physicians and GHA.
The 60 members of the physicians union had been holding out for the right to practice medicine outside Group Health in their off hours, as long as they did nothing to compete or conflict with GHA.
What they won was the right to "engage in pro bono medical service, research and teaching. Any fees or payments associated with such Pro bono service . . . may be retained by the physician," they parties agreed Tuesday.
Pro bono work is usually thought to be work that a person - generally a professional such as a lawyer or physician - performs without payment for the good of the community, like the lawyer who defends the indigent client, or the physician who puts in time in an inner city clinic.
That, say** GHA board members, was their understanding of Pro bono. The negotiators for the board "were using a very narrow definition of pro bono work," said board member James Stockard yesterday," which in their definition and mine meant a very narrow range of work for the public good . . . I would applaud work doctors would do without compensation,"
However, continued Stockard, who was one of the members of the nine-member board who voted against accepting the contract until the term is clarified, "it's apparant to me that the physicians were using the Latin phrase pro bono as a cover for whatever they wanted to do in the way of outside practice."
In a statement telephoned to reporters yesterday, board president Harold Wool said, "the clear intent of the meaning of pro bono medical services - as declared repeatedly by GHA negotiators at the bargaining table - was that physicians could provide voluntarily or for minimal fees for needy groups in the community for the public good.
"Some members of the physicians' union negotiating team are now grossly distorting the agreement reached on this subject. The union is now trying to gain through distortion what it cound not gain through negotiation."
"That's a . . . lie," said Tom Gagliardo, attorney and chief negotiator for the physicians. "I will not negotiate in the media as Harold Wool wants to. We simply want the board to honor the agreement which they made."
The physicians have contended that pro bono work is simply any work which can be interpreted as being in the public good. This would, they argue include reading electrocardiograms for another physician or any number of other medical specialty services. The contract states, and the physicians have agreed, that the GHA medical director shall be the arbiter of what is or is not pro bono work.
While the board was closeted last night for almost nine hours going over the contract a clause at a time, the physicians were meeting in an office down the hall, telling GHA stories and talking about the future of GHA.
"I'll tell you," said one long-time GHA Physician, "we might as well just pack up and move across the street. We've got great group here, but this garbage (with the board) is just getting ridiculous."
His sentiments were echoed by a number of physicians who said they believe the board's actions are killing GHA.
"I think a good many people will leave," said Donald Mitchell, former GHA medical director and one of the physician-negotiators, "But forming another group is harder than they think."
At one point late Wednesday night when about 40 physicians entered the board meeting en masse, the hostility of the 11-day strike spilled into the open.
"You deceived us! You've lied to us! You must not care much at GHA," one young physician angrily lectured board members.
"They're going to bring down Group Health," Lieberman, his frustration mounting, told board member Brent Oldham in the hallway outside the meeting room. "Brent, they're destroying the place. They're literally destroying it."
Oldham, who had attempted to press the physicians cause to his fellow board members, returned to the board room shaking his head.