Intended for healthcare professionals

Feature

Why don’t east Asia’s doctors go on strike?

BMJ 2023; 382 doi: https://doi.org/10.1136/bmj.p1437 (Published 14 August 2023) Cite this as: BMJ 2023;382:p1437
  1. Ember Chiu, freelance journalist
  1. Taipei
  1. pumpkinsfool{at}gmail.com

Workforce and pandemic pressures have pushed east Asia’s doctors to breaking point. But cultural attitudes to medicine and industrial action mean that strikes are still a challenging option to trigger. Ember Chiu reports on China, Taiwan, Japan, and South Korea

Taiwan has over 10 different medical professional unions and hospital labour unions, with a total membership of over 8000 people. During the pandemic, healthcare professionals took to the streets many times to protest for compensation for working during the pandemic. But one thing they have never done is strike. In the context of headline making strikes by peers in countries around the world, including the UK,1 some US cities,2 and France,3 this may seem surprising.

Chang Heng-hao, a representative of the Taipei Doctors Union—established in 2017 and the first physician union in Taiwan—says he would not expect to see doctors going on strike in the next 10 to 20 years. The reasons are not just limited membership but culture, both in terms of the way that labour disputes are mediated and also the fact that many healthcare workers still find the idea of going on strike morally challenging.

Bureaucratic barriers

However, things are slowly changing. Medical schools today arrange speeches by the doctors union for students, for instance. Hospital managers and government departments regularly speak to unions, in part thanks to the growing influence of well known physicians in the media.

But despite a growing awareness of labour rights, only a small percentage of Taiwan’s doctors are members of unions, even in hospitals with existing enterprise unions (unions that combine employees from the same employer, no matter the occupation).

The Taipei Doctors Union, for instance, has grown from an initial 70 members to 450 this year. However, this is still less than 5% of the more than 10 000 …

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