An effort by a majority of doctors employed by the Group Health Association to sell their services to GHA as a corporation rather than as individuals may be decided by this week's election of three trustees to GHA's governing board.
Opponents of the physicians' attempt to incorporate say the move would mean a profound change in the spirit and direction of GHA, the largest prepaid health plan in the Washington metropolitan area and one of the first such groups formed in this country.
Supporters of the move, who include GHA's excutive and medical directors, describe it as a way of improving the quality of medical care given to the group's 102,000 members by making physicians directly subject to the pressure of their peers.
The balloting by GHA members concludes today, with the results expected to be determined by this evening. According to one knowledgeable observer, who asked not to be identified, it is probable that either a procorporation slate or one opposed will sweep the election and thus provide a clear majority on the nine member board either for or against the corporation.
GHA was formed during the Depression of the 1930s as part of the then-burgeoning consumer cooperative movement. One of the central ideas in the formation of GHA was that members could get better, cheaper health care by hiring physicians and paying them a salary to provide care for the group's members. The doctors were employees of the group, which was run by its memberships.
Opponents of the corporation proposal argue that allowing the doctors to contract with GHA removes the membership control that is part of GHA's guiding philosopy.
James G. Stockard, one of three candidates running on a slate opposed to the corporation concept, said he is "unalterably opposed to abdicating the idea of a member-owned and operate organization. . . The gulling thing to me is that they (the physicians) would take over "the prerogative of hiring and firing staff."
Another slate of candidates, referring to itself as the "common sense" group, argues that GHA must work with its professional staff in a spirit of cooperation.
About 60 of GHA's 80 full-time physicians appear to be ready to join the corporation if GHA agrees to contract with it for professional services.
According to Louis J. Segadelli, GHA executive director, the "main thing" is to have an independent group of physicians who contract with the organization and "who then have the authority and responsibilty for the success of the program." Segadelli said that "professionals tend to work better in that kind of a setting," rather than being "employees on a production line."
Segadelli said the decision to allow the doctors to incorporate would be a "relatively minor change" that would benefit GHA members. "You can't require people to perform their best," Segadelli said. "You've got to have a willing relationship, and I think the best way to do that is to have independent groups of people contract with the board. They would feel freer, less submerged, less under the control of those not trained to deliver medical care, and I think that's the key issue involved."
Harold Wool, an incumbent board member who is not up for re-election and who opposes the corporation, said he is concerned that incorporation might "whittle away at the scope of services offered to members. Some of us are not totally impressed with the way corporate medicine has operated in other parts of the country. We don't necessarily think this is the way of the future."