LMC leaders have narrowly backed moves for disengagement from clinical commissioning to be included in any industrial action on the Government's pensions reforms.
In a passionate debate at the annual LMC conference, delegates overwhelmingly supported industrial action as a means of registering the profession's anger at ministers' raid on GPs' pensions.
But in a narrow 48% to 37% vote, LMC representatives also backed plans to include the option of withdrawing their engagement in commissioning in their armoury for possible industrial action.
The vote comes as a boost for Pulse's Say No to 30% campaign, a key strand of which calls on the BMA to consider a boycott of non-clinical work.
Dr Terry John of Waltham Forest LMC, who proposed the motion, said: 'It is important for this conference to send a message. We need to take a stand. All doctors will suffer if these proposals go through. To be timid would not be to our advantage.'
Dr Anthony O'Brien, from Devon LMC, said he did not support striking, but backed moves to include clinical commissioning in any action.
He said: 'Disengaging temporarily from clinical commissioning would have a dramatic effect. The health act gives us power. We should use it. We have a massively powerful tool.'
GPC veteran Dr Fay Wilson also backed industrial action, and issued a firm rallying cry to LMCs. Dr Wilson said: 'If we are not prepared to stand up and be counted, they'll be back next year. We are being blackmailed because of our devotion to patients. Grit your teeth and walk the walk.'
The vote was carried despite the GPC warning that withdrawing from commissioning would work against the profession.
Dr David Bailey, GPC negotiator, cautioned delegates: 'If we go down the route of withdrawing from clinical commissioning, it would totally work against us. It would leave the door open for enthusiasts, the 5% of our profession who think clinical commissioning is a way of controlling the rest of us.'
In a separate motion, GPs called on the Government to reconsider its controversial pension reforms and return to negotiations with the profession.
LMCs also supported a separate strand of the motion warning that 'there is a danger of workers of all ages leaving the NHS' because of the changes.
Dr Mark Sanford-Wood, chair of Devon LMC, who proposed the motion, said: 'There is a real danger of doctors throwing away the towel and walking away in disgust. The [Government's] behaviour is illogical, unnecessary, mean and it is wrong. It is a shameful way for society to treat our healers.'
Click here for more from the LMCs Conference 2012
