Harvard study urges regulatory reform amid physician strikes: 4 notes

Harvard University researchers are calling for urgent regulatory reform to address the increasing number of physician strikes in the U.S.

The perspective, published Jan. 11 in The New England Journal of Medicine, cited increased physician strikes around the globe, including three in the U.S. in two years. More medical residents, fellows and attending physicians are unionizing over concerns about increased workloads, lower compensation and mounting financial pressures. This could lead to more strikes in coming years.

"Physician strikes are a growing reality that we can no longer ignore," lead author Tarun Ramesh, a research fellow at the Boston-based Harvard Pilgrim Health Care Institute, wrote. "We examined the impacts of these strikes on healthcare delivery and patient outcomes with the goal of finding potential solutions that, if implemented, can support all sides during times of unrest."

Here are four potential solutions, according to the researchers:

1. Address regulatory gaps. The U.S. lacks comprehensive regulation to manage strikes, including mandated minimum staffing levels during strikes to ensure patient safety. Some models have shown success in France and Italy.

2. Reduce legal challenges that exclude many physicians from unionizing. Modernizing the laws could allow more physicians to negotiate better working conditions without compromising care.

3. Prevent punitive action for striking physicians. Preventing punitive actions by aligning with  International Labor Organization guidelines can protect relationships, public confidence in the system and work conditions.

4. Engage stakeholders including hospitals, medical boards and medical associations in implementing these policies.

"Our findings underscore the urgent need for regulatory reforms to balance the rights of physicians with the imperative of patient safety," Hao Yu, PhD, senior author and Harvard Medical School associate professor of population medicine at the Harvard Pilgrim Health Care Institute, said. "By learning from international examples, we can develop policies that protect both healthcare providers and patients."

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