http://www.huffingtonpost.co.uk/dr-raj- ... 13689.htmlNot a single study found death rates increased during the weeks of the strikes, compared to other times.
For example, in a strike in Los Angeles County, California in January 1976, doctors went on strike in protest over soaring medical malpractice insurance premiums. For five weeks, approximately 50% of doctors in the county reduced their practice and withheld care for anything but emergencies. One analysis, quoted by Cunningham and colleagues, found the strike may have actually prevented more deaths than it caused.
It's the fact that elective, or non-emergency surgery, tends to stop during a doctors' strike, which seems to be the key factor. It looks like a surprising amount of mortality occurs following this kind of procedure which disappears when elective surgery ceases due to doctors withdrawing their labour. Mortality declined steadily from week one (21 deaths/100,000 population) to weeks six (13) and seven (14), when mortality rates were lower than the averages of the previous five years.
However, as soon as elective surgery resumed, there was a rise in deaths. There were 90 more deaths associated with surgery for the two weeks following the strike in 1976 (ie when doctors went back to work) than there had been during the same period in 1975.
Israel: Mortality did not increase during or after the strike, even when elective surgery resumed.
The problem with drawing conclusions remains that the strike did not involve the whole scale deprivation of medical services.
Cunningham and colleagues summarise their review of research assessing the effects of doctors' strikes on mortality, finding that four of the seven studies report mortality dropped as a result of medical industrial action, and three observed no significant change in mortality during the strike or in the period following.
non-emergency surgery which is usually most effected in a doctor's strike, it could be the mortality findings reflect an impact of elective surgery. The findings might be important because they perhaps illuminate the relatively high risks of elective surgeries, which may actually increase mortality.
Another sobering possible conclusion is that the public, and perhaps doctors themselves, overestimate the ability of medicine to stave off or have an impact on mortality.
http://www.ncbi.nlm.nih.gov/pubmed/18849101Doctors' strikes and mortality: a review.
Cunningham SA1, Mitchell K, Narayan KM, Yusuf S.
A paradoxical pattern has been suggested in the literature on doctors' strikes: when health workers go on strike, mortality stays level or decreases. We performed a review of the literature during the past forty years to assess this paradox. We used PubMed, EconLit and Jstor to locate all peer-reviewed English-language articles presenting data analysis on mortality associated with doctors' strikes. We identified 156 articles, seven of which met our search criteria. The articles analyzed five strikes around the world, all between 1976 and 2003. The strikes lasted between nine days and seventeen weeks. All reported that mortality either stayed the same or decreased during, and in some cases, after the strike. None found that mortality increased during the weeks of the strikes compared to other time periods. The paradoxical finding that physician strikes are associated with reduced mortality may be explained by several factors. Most importantly, elective surgeries are curtailed during strikes. Further, hospitals often re-assign scarce staff and emergency care was available during all of the strikes. Finally, none of the strikes may have lasted long enough to assess the effects of long-term reduced access to a physician. Nonetheless, the literature suggests that reductions in mortality may result from these strikes.