Dr. Hoskins noted that in the high-profile work actions in the UK over the past years, the discussions of longer work actions took time to manifest, time that allowed support to be built. Further, physicians there were able to make their point by having “junior doctors” (British nomenclature for qualified medical practitioners working while still undergoing postgraduate training) conduct the actions.
“This makes sense, because by definition residents cannot be considered essential services,” he said, later adding that the years-long effort “had the benefit of capturing public attention while maintaining public support for the cause.”
But how can management make a work stoppage work? “If you are in management, then I would hope to do everything I can to prevent the strike,” Dr. Hoskins said. “If inevitable, then provide coverage of essential services to allow for the safety of all involved.”
Know the Ramifications
Work actions in healthcare do, of course, happen. Nurses strike. Support personnel strike. But what actually happens if physicians—and, particularly, non-emergency physicians such as otolaryngologists—decide to strike?
“The patients who are affected are those scheduled for elective procedures,” Kemp said. “Mr. Smith, who has prepped for a routine colonoscopy, must be turned away because the gastroenterologist is not working,” he added. “Mr. Lee is unable to schedule his regular checkup because the family medicine service is not working. Ms. Jones, who is ready to be discharged, must stay several more days because the attending physician refuses to complete the discharge notes.”
But that’s the impact in one medical institution, Dr. Hoskins said. “Individual specialty services holding job actions is probably less effective than all the doctors of a region taking action together,” he added. “When only individual services take action, the disruption will be largely felt by colleagues having to accommodate. If all physicians act together, then the disruption is absorbed more by patients—which is presumably where the impact is designed to be focused.”
Richard Quinn is a freelance medical writer based in New Jersey.