Healthcare Provider Strike Preparedness and Response: Lessons Learned
from Physician Strikes in New York City
Abstract
Labor actions by healthcare workers are increasing in frequency and
quantity, particularly throughout the United States. Regardless of their
cause and size, these strikes have the potential to disrupt normal
hospital operations and could impact patient access to care, quality of
care, and costs. Strikes resemble other large-scale incidents like
natural disasters, pandemics, or terrorist attacks in that they shrink a
hospital’s capacity to care for patients, force hospitals to pursue
logistically complicated actions like finding replacement providers, and
impact nearby facilities due to the offloading of patients. In contrast
to these incidents, however, strikes are unique because they often come
with months of advanced notice, they reduce capacity by precise amounts
with predictable provider losses, they occur over defined periods of
time, and they do not necessarily increase the demand for patient care.
To maximize efficiency and minimize disruption in response to strikes,
hospitals must properly plan ahead and successfully execute their plans.
Drawing on the recent planning and response to a resident physician
strike at a New York hospital, this paper recounts the experience while
describing six core strategies and a planning template that other
hospitals can use to prepare for and respond to healthcare provider
strikes. These strategies include strike aversion, increasing coverage,
decreasing demand, internal and external messaging, creating external
partnerships, and demobilization. When properly planned for using
Appendix A: Strike Planning Template, strike consequences can be
mitigated to ensure that patient care and hospital operations can
continue with minimal impact to access, quality, or cost.