Doctors Who Went on Strike for Weeks Hope to Inspire Others

Physicians who were part of a historic strike in Oregon that recently came to an end after 46 days told MedPage Today they hope to be an inspiration to others in their field.

The strike was believed to be the largest involving healthcare workers, and the first involving physicians, in state history, according to the Oregon Nurses Association (ONA), which represented the workers.

Though hospitalists at Providence St. Vincent Medical Center in Portland voted unanimously in favor of their contract on Feb. 8, they expressed their solidarity with their nurse colleagues, remaining on the picket line until eight RN bargaining units ratified their own contracts on Feb. 24.

“I don’t think any of us set out on this path, [saying] ‘we need to make history, we’re doing this for notoriety,'” Tula Top, MD, a palliative care physician, told MedPage Today, adding that he hopes to have “stoked a passion and a fire” in other physicians.

There’s a need to “start taking control of the profession that this once was,” and “deconstructing the industry profit-finding directive that healthcare has become over the last several decades,” he said.

Jahnavi Chandrashekar, MD, an internist, noted that “obviously, no one wants to have the hospital running at a reduced capacity for any length of time. We would have loved to have avoided it if we could have, but we were kind of forced into this position.”

When the strike began on Jan. 10 with nearly 5,000 healthcare workers participating (mostly nurses, but also other workers and physicians like Chandrashekar and Top), the ONA said that the diverse group was resolved in its “demands for fair contracts that will invest more in patient safety, follow the [state’s] safe staffing law, decrease physician caseload, and offer regionally competitive wages and benefits to be able to recruit and retain more staff.”

Chandrashekar said the contract ratified by hospitalists at St. Vincent was a good start, noting that one important provision is a commitment to bolster staffing if agreed-upon patient numbers per position are exceeded.

However, having the contract in place “doesn’t mean our work is over,” she added. “There will continue to be better change that we need to push for, and now we have a voice to do that.”

Top pointed to the pressure physicians often face to see more patients and boost productivity, priorities that can have a negative impact on patient care and advocacy.

So, “we’re very pleased with some of the improvements that have been written into the contract, and we’re hoping that, for our group, it sets us up to have an ongoing seat at the table, which is something we’ve never had before,” he said.

Chandrashekar said that a significant priority has been “making sure that, as we continue to grow — as the hospital has over the past decade or more — that the physician group that is required to care for those patients also continues to grow in concordance, and that the expectations that are set for our group are met, rather than consistently exceeded.”

Striking for an extended period of time was not without sacrifice. The physicians did not receive pay from Providence during the strike, though there were limited union hardship funds available.

As the strike continued on for weeks, support from the local community and colleagues helped their efforts, Chandrashekar and Top said. One person who stood out to Chandrashekar was an older man who came to the picket line at St. Vincent every day, rain or shine, expressing how grateful he was for the care provided to his family over the years.

There was also camaraderie among staff. “Our nursing colleagues have been fighting for change for a long time,” Chandrashekar explained. “We’ve tried to do things behind the scenes with the administration, thinking that we have a stronger voice, and we’ve seen over the years that that input has just been diminished progressively over time.”

Ultimately, physicians’ involvement in the strike helped with nurse morale, but the sentiment went both ways, she said. “It helped us as well to have such a huge sense of community and support, and everyone kind of having the same priorities of offering better care to our community.”

Top concurred. “I’m hoping that, if we’re the first pebble thrown in the lake, that the ripple effects will really start to multiply with other efforts around the state and the country.”

At the time the strike ended, Providence stated that it was “pleased that union-represented RNs at all eight Oregon hospitals voted to approve new contracts and end their strikes.”

“We recognize the challenges faced over the past 6 weeks and are proud of these agreements that address issues the union bargaining teams identified as priorities during negotiations,” the health system added.

In subsequent emailed remarks, Providence noted that “a few hospitalists had not taken part in the strike. After the vote, some returned. Others came back after the nurses ratified their contract at [St. Vincent], but before those nurses returned to work. The remaining hospitalists returned when the nurses came back, beginning Feb. 26.”

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