Work stoppages by doctors don't increase patient deaths in wealthy countries, according to a new study published in The BMJ that researched several physician strikes around the world. In some cases, mortality fell, researchers noted.
Researchers from Harvard Medical School and Brigham and Women's Hospital in Boston cited several possible reasons patient mortality didn't increase during physician strikes:
- Emergency care was still guaranteed, although at a reduced level
- Many doctors continued to provide routine services to hospitalized patients even though they were supposed to be on strike
- Without elective hospital admissions, more doctors were available to treat emergency patients
- Elective surgeries were canceled
The researchers also theorized that doctors who continued to work were better rested and provided better care.
The findings come as a strike by British doctors looms, and in the wake of strikes this year in the U.S., Australia, India, Ghana, Nigeria and Venezuela, the study noted.
Researchers also pointed out that while mortality during strikes in high-wealth countries does not suffer, delivery of medical care can be significantly disrupted. Physicians "must carefully balance their duties to patients with their rights as individuals," they said.
"Some doctors will always feel that industrial action is fundamentally inconsistent with their professional obligations because of its inevitable impact on patients," the researchers concluded. "However, in balancing their competing priorities, doctors in high income countries can be reassured by the consistent evidence that patients do not come to serious harm during industrial action provided that provisions are made for emergency care."
Union activity is increasing at U.S. hospitals, with 77 percent of elections to unionize at healthcare organizations successful, FierceHealthcare previously reported. Hospitals with union elections had lower Hospital Consumer Assessment of Healthcare Providers and Systems or HCAHPS scores than comparable hospitals without elections and slightly higher readmission rates.
The same financial pressures that threaten hospital margins also threaten labor relations, experts say, as hospitals cut back on pay raises and eliminate jobs to save money.