Title: Strikes, AI, and the Future of Medical Labor: Are “Compassionate Strikes” the Solution?

In early 2024, a three-day closure of 14 major ports along the East and Gulf coasts of the U.S. created significant ripples across the American economy. This strike, orchestrated by the longshoremen’s union, ominously hinted at the potential influence of workers in essential sectors—while also highlighting rising tensions between humans and technology. The key issue at stake? The employment of artificial intelligence (AI) and automation in the loading and unloading of cargo, a shift that jeopardizes both economic stability and the livelihoods of workers.

If such resistance to automation can bring trade to a standstill, it poses a challenging question: What occurs when the healthcare sector—indisputably one of society’s most critical industries—encounters analogous disputes? Would physicians ever consider executing the drastic measure of a strike, similar to dockworkers? And if not, what alternatives are available to articulate their increasing concerns regarding burnout, administrative burdens, and diminished independence?

The Surge in Physician Burnout

Medical professionals have consistently been viewed as the champions on the front lines of public health. However, behind the curtain, numerous doctors are grappling with significant challenges. Burnout levels among healthcare personnel have skyrocketed. The issue begins early during medical education, where residents frequently endure over 80-hour workweeks. Unlike the typical American worker, practicing physicians often log an additional 10 hours weekly, facing pressures that exceed clinical responsibilities.

One of their primary grievances: red tape. Physicians invest nearly two hours each day inputting data into electronic health records (EHRs)—a chore perceived as administrative rather than medical. This unremunerated work detracts from valuable patient interactions and contributes to an expanding identity crisis within the profession. Many physicians feel more like data processors than caregivers. Unsurprisingly, this diminishing sense of purpose propels more doctors to contemplate unionizing.

Unionized Medicine: A Dual-Edged Sword

Physicians who join unions gain significantly enhanced bargaining power with healthcare facilities and insurance firms. Unions can advocate for improved working conditions, manageable hours, and representation in policy matters. They also provide legal assistance and advice in navigating intricate regulatory landscapes.

Evidence supports the advantages: overstretched physicians are more prone to clinical mistakes, which can jeopardize patient safety and amplify litigation risks. By stabilizing physician workloads, unions indirectly foster better patient outcomes—a crucial reminder that healthier doctors equate to healthier patients.

Nevertheless, union affiliation isn’t without its challenges. A primary drawback is the compromise of professional independence. Union resolutions are made democratically, which can result in dissenting opinions being overlooked. In addition, union dues and membership costs can impose financial strains on a group already dealing with student debt and the high costs associated with maintaining medical licenses.

Most critically, the concept of doctors striking brings forth ethical dilemmas. In contrast to a port closure, a strike by healthcare workers poses a direct threat to human lives. This ethical quandary has largely deterred physicians from abandoning their posts, even amid considerable stress.

Compassionate Strikes: A Balanced Approach

Dr. Neil Baum, a practicing urologist and commentator on medical labor challenges, suggests an intriguing solution: the “compassionate strike.” This approach seeks to harmonize the advocacy for physician well-being with an unwavering dedication to patient safety.

Here’s a potential framework for a compassionate strike:

1. Advance Notice:
Legally, unionized physicians must already provide 10 days’ notice prior to a collective work withdrawal. This timeframe affords hospital administrators an opportunity to prepare and implement contingency plans.

2. Emergency and Inpatient Services Preserved:
Striking doctors would commit to maintaining emergency services and inpatient care, ensuring that no acute medical situations go unattended.

3. Ongoing Impact Assessment:
Physicians would continuously evaluate the effects of their collective actions on patient safety, making necessary adjustments to avert any unintended harm.

4. Utilization of Non-Digital Systems to Challenge Bureaucracy:
Doctors could maintain routine patient care while choosing to document data manually—on paper charts. This would disrupt billing systems reliant on electronic documentation, exerting pressure on administrators without compromising care.

This strategy, both ethically sound and symbolically significant, would illustrate doctors’ frustrations with digital medicine while safeguarding patients. If revenue cycles face disruption due to inefficient billing practices, hospitals and insurance companies may be more inclined to heed the concerns of physicians.

Collective Bargaining Beyond Strikes

While strikes are the most visible instrument in labor negotiations, they aren’t the sole option. A physicians’ union could contest mandatory implementation of specific digital systems, resist the expansion of uncompensated administrative duties, and advocate for policies designed to alleviate burnout. Negotiation is often more effective and less perilous than confrontation when pursued by a cohesive, organized body.

The Fundamental Message: Purpose Over Profits

Ultimately, any choice to unionize—or to engage in a strike—must prioritize patients. This does not imply physicians should compromise their own well-being, but rather that their advocacy should encompass a focus on enhancing the systems that