As the deadline came and went twice this week for a walkout by the 64 nurses at the Group Health Association, both sides were kept at the bargaining table in part by the memory gaining table in part by the memory of the 11-day physicians' walkout at GHA last spring.
There was a feeling on both sides that the health maintenance organization, which serves 110,000 Washington-area residents, could not afford a second strike in a year, sources close to the negotiations said.
GHA executive director Dr. Edward J. Hinman would not confirm the reports, but he did say, "I think the members would have been very distressed if there had been a second job action in one year.
"When our contractual obligation is to provide services to our members. and provide services all year -- not 50 weeks a year -- then an interruption of services is extremely worrlsome."
A job action "reflects a problem in labor relations," said Hinman, who came to GHA last fall from the U.S. Public Health Service. "I would have been worried if there had not been enough of a sense of conciliation" to avoid a strike.
Since the physcians' strike last spring, the first such job action in the country by a group of fully trained physicians, "the spirit of the place has been a negotiating spirit," said Dr. Sandy Pomerantz, an internist who walked the 11-day picket line and who is a leader of the doctors' union.
"It's a spirit of trying to deal with the problems as they arise," said Pomerantz, "rather than dealing with them in a last-minute crisis atmosphere.
"But I've had a lot of emergency type services lately and I can only say that everyone here has been nice and cooperative, and I've gotten extra time from my physician," she said.
Kim Rubin, a nurse who has joined the GHA staff since the physicians' strike, believes "people do dwell on it sometimes, but (the memory of the strike) makes people stick together."
"I guess you find doctors with a bit more of a working-class attitude putting forward the things they need," said Dr. Linda Green, one of 22 physicians to join Group Health since the strike.
The fact that the physicians are employes, and are members of a union, "makes relationships between the doctors and the rest of the workers better" than they might be in some other health care institutions, she said. "Relations are better with the people you work with every day."
Group Health is not without its problems, however. Some physicians and nurses say, for example, that GHA's board -- largely composed of white members, the majority of whom are in their 50s and 60s -- is out of touch with the membership, which is getting younger and is 6k percent black. There is one black member on the nine-member board.
The board, these sources say, is still much wrapped up in GHA as the social experiment it was when founded in the 1930s -- despite bitter opposition from the medical establishment -- while the newer members are basically interested in getting the most health care for their money.
Hinman, who acts as official spokesman for the board and GHA, responded by saying that all GHA members may vote in board elections, and if they are displeased with the board, they can vote the members out.