Why Don’t Physicians Strike Like Nurses?

Part of Nurse.org’s Nurse Strike Intelligence data series, built on a proprietary database tracking a decade of U.S. registered-nurse strikes (2017–2026). This piece looks across the aisle: why the physicians nurses work beside almost never strike, why that’s starting to change, and what the difference reveals about where nursing’s voice can be heard.

Our Nurse Strike Intelligence database has confirmed 108 nurse strikes in the United States over the past decade. Over the past fifty years, physicians have struck fewer than a dozen times.

Same hospitals. Same patients. Same frustrations with staffing, pay, and corporate decision-making. So why does one profession walk the picket line a dozen times a year while the other almost never has? The answer says less about courage or ethics than about how each profession is paid. And for nurses, that answer is worth understanding, because it points directly at what nursing has been missing.

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Physician strikes are rare everywhere, not just in the United States. The key North American strikes fit in a short list:

• 1962, Saskatchewan. The first physician strike in North America: doctors walked out over a new government insurance law.
• 1975, New York City. Resident physicians struck at hospitals across the city.
• 1976, Los Angeles County. Physicians staged a work stoppage over rising malpractice insurance costs.
• 2003, West Virginia and New Jersey. Surgeons in West Virginia staged a work stoppage over the soaring cost of malpractice insurance, with New Jersey doctors following weeks later.
• 2023, New York City. Resident physicians at Elmhurst Hospital struck for three days, the city’s first doctors’ strike in more than three decades.
• 2025, Oregon. Roughly 150 physicians and advanced practitioners joined the first physician strike in that state’s history. More on that one below.

One more piece of history explains a long silence in that list. In 1976, the National Labor Relations Board ruled that resident physicians were students, not employees, which stripped them of federal union protections. That decision stood until 1999. For 23 years, the one group of physicians most likely to organize legally couldn’t.

Three structural reasons kept physicians off the picket line.

• They were owners, not employees. For most of the last century, physicians owned their practices. You can’t walk out on yourself. Nurses, by contrast, have almost always been employees, which is precisely why they’ve always had both the right and the reason to organize.
• The law kept most of them out of unions anyway. Federal antitrust law treats independent physicians who band together to negotiate prices as illegal price-fixing, not union activity. And labor law doesn’t protect supervisors or independent contractors, categories that covered most practicing physicians even as hospital employment grew.
• Leaving was easier than fighting. A physician unhappy with a hospital could open a practice, switch systems, or pick up temporary assignments almost anywhere. High incomes and portable careers meant the exit door was always open. A nurse tied to shift work in a facility has fewer exits, so nurses learned to use their voice instead.

And the biggest reason: they didn’t need to. Physician influence in American healthcare has never depended on labor tactics, because it is built into the payment system itself. The American Medical Association owns the CPT code set that defines how medical services are described for billing, and an AMA-convened committee (the RUC) recommends how much work each service represents. Medicare’s administrator, CMS, then sets the actual payment rates. Given it has historically accepted the large majority of those recommendations, physicians, through the AMA, can exert influence over how their own work is valued. A profession that writes the billing language and helps set the prices doesn’t need a picket line. Its influence is exercised in committee rooms.

Strikes, in other words, are what a profession does when it has no seat where the money is decided. Nursing has struck 108 times in a decade by our count, and staffing is the most common reason by far: named outright as the primary issue in 62 of those strikes, with another 33 classified as mixed disputes. Staffing is what suffers when a profession is treated as a cost rather than a source of value. Nurses have been striking over the symptom of the very thing physicians never had to worry about.

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Physicians are becoming employees, and employed physicians are turning to the same tools nurses have used for decades.

A set of studies published in JAMA counted every union petition involving physicians filed with the federal labor board this century: 44 in the 23 years from 2000 through 2022, then 33 in 2023 and the first five months of 2024 alone. The yearly rate rose more than tenfold, and the share of those campaigns that succeeded rose from 54% to 77%. The largest union of resident physicians has doubled since 2020, to more than 37,000 members, and in a national survey, 63% of nonunionized residents said they would vote to unionize.

When researchers examined why physicians organized in 2023 and 2024, pay came last, cited in just 4% of campaigns. Working conditions came first at 85%, followed by lack of voice in management at 81% and patient care concerns at 54%. Physicians are not organizing for money. They are organizing because employment took away their sense of control. As one physician ethicist told Medscape, when you put doctors in an employed environment and treat them as widgets, they will act like employees of Amazon and Starbucks and join together to push back.

At Stanford, resident organizing took off after an algorithm left residents out of the first round of COVID vaccine distribution. One of the most prominent resident union campaigns in the country was set off, in part, by a machine’s decision about who counted.

Oregon’s Providence Strike: Physicians and Nurses Walked Out Together

If you want a picture of where this may be heading, look at Oregon in January 2025.

Nearly 5,000 healthcare workers struck all eight Providence hospitals in the state plus six women’s clinics. It was the largest healthcare strike in Oregon history, and, according to the Oregon Nurses Association, the first physician strike in the state’s history. About 150 physicians and advanced practitioners walked out alongside the nurses, including some 70 hospitalists at Providence St. Vincent who had unionized in 2023 and were fighting for their first contract.

Something else changed in Oregon: the math of the strike itself. Hospitals routinely weather nurse strikes by paying premium rates for replacement nurses. Providence itself acknowledged there is no equivalent replacement workforce for physicians. The system capped admissions and postponed procedures. After 27 days, the hospital physicians won a first contract with raises, more sick time, and a commitment to reform staffing models.

Physicians and nurses, striking together, over staffing, and winning. Labor analysts called it a sign of what’s coming nationally. One more Oregon detail makes the state worth watching: it is also one of the rare places where registered nurses can now bill Medicaid directly for some services. The same state is testing both of nursing’s possible paths at once: organizing on the picket line, and recognition in the payment system.

What Physician Strikes (and Their Absence) Mean for Nurses

Physicians rarely struck because their influence was built into the payment system: codes they wrote, values they helped set, revenue that followed them wherever they practiced. Nurses strike frequently because they have none of that. Nursing’s work is bundled into the hospital bill, invisible to the systems that decide budgets, so the bedside becomes the only place nursing’s voice can be felt.

Now the two professions are converging. Physicians, most of whom are now employees rather than practice owners, are picking up the tools nurses have long used: organizing, bargaining, and, when necessary, striking. And nursing is pursuing what physicians always had, a visible identity in the payment system, at a moment when federal regulators are asking the public how the system that sets billing codes and payment values could be improved.

Strikes work. Our own research shows it, and nurses should never apologize for using them. But the profession that never needed strikes is the one that owned the billing language. The deepest leverage in American healthcare has never been the picket line. It is the payment system behind it. Physicians built their influence there. Nursing’s next chapter may be written there too.

Related Nurse Strike Intelligence Analysis:

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