Professionalism is a basis of medicine's social contract with society. In countries where national healthcare exists (obviously, not in the USA), physician unionization and strikes have occurred as part of the negotiation process.
As the USA heads forward with health care reform, these measures of negotiation may come into play.
The authors point out that physicians provide an essential service whose withdrawal is capable of causing great hardship to those they serve (patients), including potential loss of life. Physician strikes could lead to significant erosion of public trust and professionalism. Physician strikes are usually to better their own situation, and not for the sake of better patient care.
Physician strikes should be avoided. To do so, the medical profession must be represented and must influence negotiations at early stages. Discussions on the principles and controversies in physician negotiation should be a part of medical training, to better prepare physicians on these matters.
In the end, physician strikes conflict with medicine's professional values.
