The doctors Strike back.

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Workers in Canada going on strike seem to occur so often these days that we barely bat our eyes at it anymore. As you casually flip through the morning paper, you read about another Air Canada strike. You shrug your shoulders and grudgingly expect your next flight to be delayed. The post office is walking out? Better send that birthday gift by FedEx. The city garbage/recycling services are protesting? You mentally prepare for a couple weeks of stinky sidewalks and driveways with overflowing garbage.

You suddenly pause and do a double take, flipping back to the previous page. “Doctors planning to walk out beginning next week.” (If you haven’t been following the drama in B.C. recently, this will get you started.)

They aren’t allowed to do that … are they?

We seem to have a tough time with this possibility. It’s probably because deep down in our morality gauge, we struggle to balance two conflicting “rights”: 1)the rights of patients in a publicly funded healthcare system to have ready access to care without threat to life or limb, versus 2)the rights of healthcare providers, like any other workers, to negotiate decent terms of employment without having those terms imposed on them.

Currently most provincial governing authorities are agreeable to the concept of essential services, where a minimum level of service must be provided even in the face of a labour dispute. In healthcare, that translates to emergency cases such as life- or limb-threatening conditions. The proposed walk out by anesthesiologists in B.C. involves only elective surgeries and procedures – although there is certainly argument as to what truly defines an essential service. And what about full-time ER physicians and nurses? By definition they are an essential service 24/7 – do they then not get the right to strike?

Of course this is not the first time doctors in Canada have threatened and/or actually went on strike. However, the few times that they did, it always ended with mixed results (see the Ontario Doctors Strike in the 1980’s). This further highlights the tremendous sensitivity involved around the subject, both from the public’s and the profession’s point of view. Governments are hesitant to directly take on or “declare war” on healthcare bodies, at the risk of being perceived as directly attacking patient care.

As it stands now, it is extremely unlikely that all physicians across the country (or any one province) will collectively threaten to strike – the field of medicine has evolved into so many sub specialties with their own negotiating bodies, that any work stoppages in healthcare would never be total. So should we get used to the idea that any particular group of doctors may strike? And if so, what boundaries dare we impose on such situations? Those questions may never have to be answered, since many physicians likely view going on strike (at the detriment of patients) as violation of the Hippocratic Oath they each take during their medical training.

You can be sure then, if one day you show up at the hospital and realize that the physicians are on strike – something is terribly wrong with the healthcare system.

Edmund Kwok

Edmund Kwok

Emergency Medicine. Quality Improvement. Patient Safety. Change Management. Healthcare Administration.

Frontdoor 2 Healthcare

Frontdoor2Healthcare, founded by Dr. Edmund Kwok in 2012, provides editorial and commentary on issues affecting Canadian healthcare from the emergency department’s “front door” perspective. Frontdoor posts allow for open sharing of the diverse opinions and perspectives of emergency physicians from across the country.

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