Why Physician Strikes Are a Form of Hospice

“Physician strikes are a form of hospice” sounds like a hot take you’d expect to see taped to a break-room fridge next to a
“Please stop stealing my yogurt” note. But it can also be a useful metaphorif we use it carefully.

This article isn’t calling patients “terminal,” and it’s not suggesting that anyone deserves less care. It’s arguing something
very different: when doctors strike, they’re often acting like a hospice team does for a failing systemnaming what’s not working,
refusing to keep up appearances, and shifting the goal from “keep the machine running at all costs” to “protect safety, dignity, and
what still matters.”

Hospice isn’t abandonment. It’s a goals-of-care decision.

In U.S. healthcare, hospice is a model of care focused on comfort, quality of life, and supportphysical, emotional, and practical
when curing the underlying disease is no longer the goal. Hospice care is not designed to speed up death or “give up.” It’s designed
to reduce suffering, respect patient priorities, and avoid interventions that add harm without real benefit.

Hospice is a shift in strategy, not a loss of compassion

Hospice care often includes symptom control, counseling, equipment, and a team approach. The point is to replace frantic,
low-value “doing more” with intentional, high-value “doing what helps.” It’s also honest. Hospice starts with a hard sentence:
“The old plan isn’t working.”

Now bring that lens to labor actions in medicine. A strike is not hospice care. But the logic can rhyme:
when a workplace becomes unsafe, unsustainable, and increasingly harmful, refusing to continue “business as usual” can be an act of
protectionespecially when the alternative is slow-motion collapse.

What a physician strike looks like in real life (and why it’s not a TV melodrama)

Pop culture imagines a strike as an empty hospital with tumbleweeds rolling past the MRI machine. Real life is messierand
more planned. In healthcare, strikes typically involve advance notice, contingency staffing, and special attention to emergency
coverage. Most labor actions target elective and routine services, not emergency care.

Patients still exist during a strikeso planning matters

Healthcare strikes are ethically charged because patients can’t “pause” their illnesses. That’s why many physician groups
emphasize safeguards: coverage plans for emergent needs, cross-coverage by non-striking clinicians, and rescheduling strategies
for procedures that can safely wait.

The ethical question is not “Do doctors care?” The ethical question is: What do you do when the system is pushing care toward
unsafe corners every single day?

The ethical knot: duty to patients vs duty to prevent systemic harm

Physicians have deep obligations to patients. Medical ethics emphasizes prioritizing patient welfare, respecting dignity,
and minimizing disruption to care. But ethics also recognizes that physicians are citizens and professionals with responsibilities
to advocate for policies and systems that protect patients.

That tension becomes unavoidable when everyday conditions feel like “quiet rationing”: understaffed units, chronic delays,
unsafe workloads, and clinicians running on fumes. At that point, “just keep going” stops being a neutral option. It becomes a
choice with consequencesburnout, turnover, worse continuity, and an exhausted workforce that can’t provide the care patients need.

Burnout isn’t just a feelings problemit’s a safety problem

Burnout is often discussed like it’s a personal wellness issue (“Have you tried yoga?”), but research consistently connects
difficult work environments to patient safety concerns and clinician turnover. When experienced clinicians leave, patients lose
continuity, teams destabilize, and remaining staff carry heavier loads. That’s not resilience; that’s erosion.

In training settings, there are formal limits on work hours (for example, the widely cited 80-hours-per-week average standard).
Yet “legal” does not always mean “livable,” especially when workload intensity, staffing gaps, and administrative burden stack up.
If the system’s default is “stretch everyone thinner,” the moral injury isn’t hypotheticalit’s scheduled.

So why call strikes “a form of hospice”?

Because in many cases, physician strikes function like a goals-of-care conversation for a sick institution. Not for patients.
For the workplace system delivering care.

1) An honest diagnosis: “This is not sustainable.”

Hospice begins with clarity. Physician labor actions often begin the same way: naming realities that polite memos can’t fix
chronic understaffing, unsafe patient loads, collapsing morale, and the quiet normalizing of “substandard as standard.”

2) A shift in goals: from volume to value

When clinicians strike, the demands are frequently framed as staffing, safety, and retentionnot only pay. Translation:
“We’re not fighting for a nicer break room. We’re fighting for a system where patients aren’t cared for by people who haven’t eaten since sunrise.”

3) Symptom control: reducing the daily harm while long-term fixes are negotiated

Hospice cares about suffering now. Strikesparadoxicallycan be a tool to reduce ongoing harm by forcing negotiations around
conditions that drive errors and turnover. If a hospital relies on perpetual crisis staffing, it may be “operating,” but it’s not
healthy.

4) A team-based approach: multidisciplinary by necessity

Hospice care is never one heroic clinician doing it all. It’s a team. Strikes also reveal the truth that care is collective:
physicians, nurses, residents, techs, environmental services, schedulers, pharmacistseveryone is part of the organism.
A strike is the system loudly admitting: “One part can’t hold the whole thing together forever.”

5) Communication becomes the intervention

Hospice teams communicate relentlesslyabout goals, tradeoffs, and what matters most. During labor actions, communication is
similarly central: what services continue, how emergencies are covered, what gets rescheduled, and how patient safety is protected.
A strike done ethically is basically a giant handoff note, written in bold.

6) Boundary-setting: refusing futile “hero mode”

Hospice rejects futile interventions that prolong suffering without meaningful benefit. In a broken healthcare workplace,
“futile intervention” can look like endless overtime, unsafe panel sizes, or a revolving door of temporary fixes that keep
the spreadsheet happy while the clinic burns out.

Striking is a boundary: “We will not keep pretending this is fine.”

7) A push for dignityof patients and the people caring for them

Hospice emphasizes dignity. Physician strikes often highlight that clinician dignity is not separate from patient dignity.
A patient deserves a clinician who is present, trained, supported, and not carrying an impossible workload. That’s not a luxury.
That’s a prerequisite for safe care.

Do physician strikes harm patients?

The honest answer: they can, especially through delayed elective care and disrupted continuity. But the story is more nuanced
than the fear suggests.

What tends to happen during strikes

• Elective procedures often drop because hospitals postpone non-urgent cases to protect emergency capacity.
• Emergency care typically continues via contingency staffing and coverage plans.
• Delays and rescheduling can create downstream stressespecially for patients with limited flexibility, transportation, or time off.

What research often finds (with important caveats)

Studies examining strike periods have frequently found that overall mortality does not necessarily spike during short strikes,
particularly when emergency services are maintained and elective procedures are deferred. However, outcomes can vary by context,
patient population, and how well contingency plans are executed. In other words: planning matters, and “no harm” is not automatic.

The most ethical framing is not “Strikes are harmless.” It’s: “Strikes are risky, and the baseline is already risky.”
A chronically understaffed hospital is not a safe alternative; it’s a slow-burn emergency.

Three U.S. examples that show the pattern

Physician strikes are still relatively uncommon compared with other healthcare labor actions, but they’re becoming more visible
especially among trainees and employed physicians. Here are three examples that illustrate why the “hospice” metaphor resonates.

1) University at Buffalo residents (2024): a strike for a first contract

In 2024, more than 800 resident physicians and fellows affiliated with the University at Buffalo held a planned multi-day strike,
publicly citing compensation, benefits, and working conditions. The significance here isn’t just the walkoutit’s what it signals:
trainees increasingly see labor organization as a patient-safety strategy, not merely a paycheck strategy.

Residents are often the engine of hospital operations. When they say, “We can’t do this safely,” it functions like a clinical
consultation for the institution: the symptoms (staffing gaps, cost pressures, workload intensity) are becoming incompatible with
healthy function.

2) Providence Oregon (2025): a rare physicians strike inside a massive walkout

In January 2025, thousands of healthcare workers walked out across Providence hospitals in Oregon in what unions described as the
state’s largest healthcare strikean action notable for including physicians. Reports described physicians at a Portland hospital
participating while surgeons and emergency physicians were not part of the strike, underscoring the common strike ethic:
maintain emergency capacity while pressuring change elsewhere.

Later, a tentative agreement was reported after weeks of striking, with provisions described as including pay changes, more sick time,
and commitments to reform staffing models. Whether you cheer or cringe at strikes, that outcome speaks to the “hospice” analogy:
the fight is often about reducing suffering and stabilizing care delivery, not scoring a dramatic victory lap.

3) NYC Health + Hospitals attending physicians (announced 2025): understaffing as the headline

In early 2025, a physicians’ organization representing attending doctors at multiple NYC Health + Hospitals locations announced
plans for a strike framed around an understaffing crisis and patient-care risk. Even the language used in these announcements tends
to sound like a clinical warning: “This is unsafe. This is harming care. We need an intervention.”

That’s the hospice-like moment: recognizing that the current trajectory leads to worse outcomes, and forcing a decision about what
“care” should look like going forward.

How to do a physician strike with hospice-level ethics

If the metaphor is hospice, the ethical standard is high: reduce harm, communicate clearly, and protect what’s essential.
Here are practical guardrails often discussed in ethics and patient-safety conversations:

Protect emergency and time-sensitive care

• Ensure coverage for emergency departments, obstetrics emergencies, ICU needs, and critical inpatient services.
• Use contingency staffing plans that prioritize safety, not optics.
• Build escalation paths for unexpected surges (because healthcare loves surprises).

Make handoffs boringin the best way

• Standardize sign-outs for admitted patients and vulnerable outpatients.
• Identify “high-risk follow-up” patients (recent discharges, unstable chronic conditions, pending biopsies) and plan coverage.
• Document responsibility clearly so no patient gets stuck in the Bermuda Triangle of “Who’s on this?”

Communicate with patients like adults who deserve clarity

• Provide plain-language explanations of what services are affected and what remains available.
• Offer rescheduling pathways and medication refill processes.
• Avoid spin. Patients can smell spin from the parking lot.

Focus demands on patient-centered outcomes

The strongest “moral case” for physician labor action is when demands clearly connect to patient safety: staffing levels,
manageable caseloads, protected training time, and retention. In hospice terms: reduce suffering, improve function, and stop
interventions that make things worse.

If you’re a patient and a strike is happening, what should you do?

You shouldn’t have to become a project manager for your own healthcare, yet here we are. Practical steps that can help:

• Confirm appointments early and ask if telehealth is available for non-urgent visits.
• Request medication refills ahead of time (especially if you’re close to running out).
• Write down key info: current meds, allergies, diagnoses, and recent test results.
• Ask about urgent coverage: who to call if symptoms worsen or you need same-day advice.
• If it feels emergent, seek emergency caredon’t wait for a scheduling update email.

Bottom line: the metaphor is provocative, but the point is practical

Physician strikes are controversial because medicine is not a normal industry. But healthcare also isn’t a magical realm where
human limits don’t apply. When chronic understaffing and burnout become the operating system, patients pay the pricethrough delays,
errors, turnover, and fragmented care.

Hospice is about honesty, priorities, and dignity. When physicians strike, the most defensible interpretation is not “doctors
walking away,” but “doctors refusing to keep a failing system on life support with their own bodies.” It’s a demand for a safer,
more humane planone that treats patient safety and clinician sustainability as the same project, because they are.

Real-world experiences related to “Why physician strikes are a form of hospice”

Ask clinicians why the hospice metaphor lands, and you’ll hear the same theme dressed up in different scrubs: we reached a point where
“just push through” started to feel like actively participating in harm. Not dramatic harm. The quiet kindmissed meals,
rushed conversations, delayed discharges, and the constant sense that the day’s plan is held together by caffeine and vibes.

One common story (especially among residents) starts with the pager. It goes off while you’re writing a note, then again while
you’re answering a family’s questions, then again while you’re trying to remember whether you actually drank water today. None of
the pages are “fake.” Every request is real. The problem is volume: too many patients, too few hands, too much documentation, and
a system that treats “normal overload” as if it’s a personality trait you can overcome with grit.

That’s where the hospice analogy shows upnot as a joke about death, but as a pattern of thinking. Hospice teams are trained to ask:
“What is the goal? What actually helps? What harms without benefit?” Clinicians in struggling workplaces ask similar questions,
just with different symptoms:

• Symptom: chronic understaffing. Question: Are we providing careor are we triaging a permanent disaster?
• Symptom: endless overtime. Question: Are we preventing harmor postponing it by exhausting the workforce?
• Symptom: high turnover. Question: Is “continuity of care” even possible when teams constantly reset?

Clinicians who’ve been through strike authorization votes often describe a strange emotional mix: relief, guilt, and a sober kind of
determination. Relief because someone finally said out loud what everyone whispers. Guilt because patients will be affected, even if
emergency care is protected. Determination because the alternative feels like slow institutional decline.

You also hear about the conversations that happen in hallways and call roomsthe ethics debates that don’t fit neatly into a policy memo.
People argue about responsibility: “We can’t abandon patients.” “We’re not abandoning them; we’re trying to keep care safe in the long run.”
“What about the patient who waited months for surgery?” “What about the patient who can’t find a primary care doctor because everyone quit?”
These are not easy conversations. They’re hospice-style conversations: painful, honest, and rooted in tradeoffs.

Then there’s the administrative burden that clinicians love to roast because humor is cheaper than therapy. Many describe feeling like
they’re practicing medicine inside a billing algorithm: clicking boxes, fighting prior authorizations, and explaining to patients why
the “system” says no to something that makes obvious clinical sense. Over time, that creates a different kind of exhaustionless
physical, more moral. The strike, for some, becomes a refusal to keep pretending that the paperwork-first model is compatible with
patient-first care.

Finally, people who’ve lived through a labor action often say the most unexpected moment is the calm. Not everywhere, not alwaysbut
sometimes. Elective schedules pause. Units focus on essentials. Communication tightens. It can feel like the system briefly remembers
how to prioritize. That’s the hospice parallel in its most constructive form: stripping away the noise, naming what matters, and
insisting that the plan be sustainablenot just for this week’s metrics, but for next year’s patients.

If “hospice” sounds too grim, you can rename the idea: a strike is the healthcare system asking for a safer care plan. Either way,
the lived experience behind the metaphor is consistent: clinicians don’t strike because they stopped caring. They strike because they
care enough to say, “This cannot be the standard of care for the people we serveor the people who serve them.”