The very difficulty in getting physicians to withdraw their labor in the way other occupations can do, hints at a fundamental difference between what it is to be a doctor, compared to pursuing other ways of making a living.
A doctor, the research on strikes illuminates, isn’t something you do, it’s something you are. This issue of identity is why it’s so much more difficult for doctors to simply discontinue practicing medicine. It’s a character flaw prone to exploitation by governments and employers, effectively frustrating standard union tactics.
The Minister of Health in the U.K., Jeremy Hunt, is opposing the doctors and their threats of industrial action; in a recent comment widely reported, he explains why the state wants to change doctors’ contracts, apparently to provide more medical cover of hospitals at weekends.
He said: “…three times less medical cover at weekends as they (doctors) do in weeks and that means that there’s a 15% greater chance of you dying if you are admitted on a Sunday, compared to being admitted on a Wednesday.”’
There is indeed something paradoxical about the data showing that being admitted to hospital when there are fewer doctors at week-ends leads to greater mortality, compared to the research on doctors’ strikes.
Could it be that the way medicine and health care are organiszd, rather than simply having lots of doctors around, is the fundamental issue? The UK Government may have cleverly distracted attention away from the deep problems over how healthcare is managed in the UK, by highlighting instead the issue of forcing doctors to be present at weekends.
Yet another irony is that the data from doctors strikes themselves indicate the issue isn’t as simple as just deploying more doctors means lives get saved.
But the outcome of the current conflict between doctors and their state employer in the U.K. may hinge on which side the electorate believes is genuinely most interested in looking after patients, as opposed to protecting their own interests.
If doctors don’t all go on complete strike, even when it could be in their financial interests to do so, this may signal to the public who to trust on this one – their doctors or their politicians.
Another theory as to why patients live longer when doctors go on strike, is that the profession finally shakes off the shackles of its employer’s restrictive practices, and returns, albeit temporarily, to practicing medicine freely, as it would really like to.
And perhaps, that’s actually the most effective sort of industrial action doctors can ever take.
Raj Persaud and Peter Bruggen are joint podcast editors for the Royal College of Psychiatrists, and also now have a free app on iTunes and Google Play store entitled “Raj Persaud in conversation,” which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.
Follow Dr Raj Persaud on Twitter: www.twitter.com/ (link is external)@DrRajPersaud
Patient hand photo available from Shutterstock