Healthcare Provider Strike Preparedness and Response: Lessons Learned From Physician Strikes in New York City

Labor actions by healthcare workers are increasing in frequency and quantity, particularly throughout the United States. Regardless of their cause and size, these strikes could disrupt normal hospital operations and impact patient access to care, quality of care, and costs. Strikes resemble other large-scale incidents like natural disasters, pandemics, or terrorist attacks by shrinking a hospital's capacity to care for patients, forcing hospitals to pursue logistically complicated actions such as finding replacement providers, and impacting nearby facilities due to patient offloading. In contrast to these incidents, however, strikes are unique because they come with advance notice, reduce capacity by precise amounts with predictable provider losses, occur during defined periods, and do not necessarily increase demand for patient care. To maximize efficiency and minimize disruption in response to strikes, hospitals must properly plan ahead and successfully execute their plans. In this article, we recount the experience of a 2023 resident strike at NYC Health + Hospitals/Elmhurst in New York City and describe 6 core strategies that the facility implemented to maintain quality care: strike aversion and planning, increasing coverage, decreasing demand, internal and external messaging, external partnerships, and demobilization. We also provide a planning template that other hospitals can use to prepare for and respond to healthcare provider strikes. The information in this article was first presented as a poster, "Healthcare Labor Action Preparedness and Response" at the Preparedness Summit, March 25-28, 2024, in Cleveland, Ohio.