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Nurses are striking. Where are the physicians?

Strikes are not in the DNA of physicians.

In March, members of the New York State Nurses Association (NYSNA) at New York’s “big four” hospitals (Montefiore, Mount Sinai, New York Presbyterian-Columbia and Mount Sinai West/St. Luke’s) voted by an overwhelming 97% margin to authorize a strike. The nurses’ fight centers around conditions for patient care, including safer staffing ratios inside hospitals so that nurses can adequately care for each patient. Throughout NYC, nurses are forced to work long shifts and are chronically understaffed. The nurses who recently threatened to strike recognize that these working conditions are part of hospital executives’ push to squeeze greater and greater profits out of workers at the expense of patient health — and they have had enough. New York nurses are fighting just as teachers across the country did earlier this year — including the tens of thousands of Los Angeles teachers who struck last January for better conditions for in schools. They are also taking up the example of health care workers around the world, including the 40,000 Irish nurses who recently struck. Nurses are recognizing they have the power to fight and win better patient care. But while nurses across New York are standing up for themselves and their patients, a big question remains: Where are the doctors and why are they not threatening to strike together with nurses?
Why are the physicians on the sidelines?
Strikes are not in the DNA of physicians.

Physicians see first hand every day how our dysfunctional health care system is simply not built to adequately address patient and community health. For many doctors, these frustrations manifest in burnout and dissatisfaction within a field they once loved. Today there is an epidemic of burnout among physicians, with some studies suggesting burnout affects up to half of all physicians. After training for years with the desire to help others, doctors come to experience medical system that values profit over all else and rarely gives them the tools to make a difference in the communities where they work. This can leave doctors feeling hopeless, and combined with other factors, can lead to depression or even suicide. Today physicians are committing suicide at two times the rate of the population as a whole. Yet, even at this moment of frustration and anger, they continue to keep their heads down, providing validity to this broken system. We see nowhere, among doctors, a resistance like that now being organized by nurses.
Strikes are not in the DNA of physicians.

In order to analyze why doctors are not throwing down their stethoscopes and finally saying enough is enough, a review of the U.S. medical education process is in order. As longtime public educator John Taylor Gatto highlights in his book, “The Underground History of American Education,” the education system is built to create “tools for industry.” Gatto points out that this system conditions those who pass through it to take direction well and to not question authority. At the same time, education aims to instill the importance of profit and continually reinforces the legitimacy of the capitalist system. Health care education is not excluded from this, and both patient and community health remains secondary to profit maximization nonetheless.
Strikes are not in the DNA of physicians.
Physicians have seen themselves as managers in the past...the head of the team, executives, leaders.  Leaders do not strike.  Only until recently have physicians seen their management roles go away, and not by choice, rather by economic penalties and/or perverse incentives. Within the hospital, doctors typically adopt an individualist mentality in which they consider only how they can personally make an impact on their patients’ health while ignoring the need for systemic change. Until physicians begin to put individual endeavors aside and begin to organize collectively, they will continue to see their patients harmed by the "health care" system. though it is important to note, physician control is ever decreasing as health care becomes more corporatized.
If a physician ever thinks of organizing collectively to withhold his/her labor in order to demand better conditions for her patients, employers declare that doctors are “abandoning” those in need of care. The Hippocratic oath taken by physicians to “do no harm” is cited. This argument obviously disregards the fact that it is the employer and ownership class which is directly harming patients every day in pursuit of profit— denying care, pushing individuals into bankruptcy, pursuing unnecessary treatments, neglecting systemic causes of illness, etc. It also ignores the fact that by continuing to focus the treatment on narrow individualistic explanations for disease and illness, the physician helps to redirect the patient’s attention away from the larger issues that are truly causing his or her suffering. Physicians may consider abandonment as an issue, so too will attorneys who would have the legal means to defend innocent patients, which has been accomplished many times.  It is considered prima facie evidence for medical malpractice
Strikes are not in the DNA of physicians.

Physicians around the world have organized and withheld their labor for better conditions around patient care in the past. 
It is an issue for moral and ethical reasons, for physicians and is a conundrum for most physicians.

Recent strikes in other countries indicate the real dangers to patients and the public in general.

In the past doctors and/or nurses have threatened strikes over inferior patient care due to understaffing and other hospital issues.  Rarely has it revolved around pay.

Michael Pappas is a family medicine resident. This article originally appeared in Left Voice.

Nurses are striking. Where are the physicians?: Until physicians begin to put individual endeavors aside and begin to organize collectively, they will continue to see their patients harmed by the "health care" system.

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