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IF RFK JR. DOESN’T RESIGN, PHYSICIANS SHOULD JOIN A LIMITED STRIKE
(OPINION)  
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Richard L. Kravitz
September 12, 2025
STAT News
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_ It’s a nuclear option — but it may be necessary _

Junior doctors take part in a strike on the picket line outside the
St Thomas’ Hospital in London in 2024., Kin Cheung/AP

 

On behalf of the misleadingly named Make America Healthy Again
movement, Health and Human Services Secretary Robert F. Kennedy Jr.
has launched an undisciplined assault on biomedical science and public
health: defunding research
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the National Institutes of Health, canceling mRNA vaccine studies
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government scientists, gutting the Advisory Committee on Immunization
Practices
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potentially the U.S. Preventive Services Task Force
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and trying to force millions off Medicaid
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Kennedy’s recent actions have, in less than a year, substantially
degraded the nation’s health security. The brouhaha between
Kennedy and (now former) Centers for Disease Control and Prevention
Director Susan Monarez is just the latest scene in this unfolding
horror flick.

Physicians committed to promoting human health within a scientific
frame need to start considering responses that would ordinarily be off
the table. Major medical societies like the American Medical
Association, American Academy of Family Physicians, American Academy
of Pediatrics, and American College of Physicians need to show some
brio. If Kennedy does not resign by Oct. 19, the beginning of
National Health Education Week, they should collectively declare a
limited physicians’ strike.

Americans like and trust their doctors
[[link removed]] (though
not necessarily the health care system as a whole). They also depend
upon physicians for disease prevention, care of acute and chronic
conditions, and guidance. Physicians have a responsibility not only
to inform current patients of the ongoing damage but also to defend
future patients from the destructive forces that Kennedy has
unleashed.

Physicians’ labor activism has a long history, with an uneven record
of success. As a second-year medical student in 1980, I walked the
picket line in support of residents at San Francisco General Hospital
during a two-day work action
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The strike was staged to protest nursing and support staff shortages
that endangered patient care. The residents’ gambit was risky and
morally fraught, but it worked: Critically ill patients continued to
receive care, and the hospital upped its staffing levels, ensuring
safer care well into the future.

Later, as a young physician-researcher, I studied the 1986 Ontario,
Canada, doctors’ strike
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The proximate cause of the dispute was the decision by the provincial
parliament to enforce a federally mandated ban on so-called “balance
billing” — opting out of the province-wide health insurance plan
in order to bill more than the provincial fee-schedule allowed.
Ontario physicians were divided over both the need to preserve this
economic escape-valve and the propriety of striking in response. In
the end, 42% of Ontario physicians participated in the 23-day
strike, with most physicians continuing to provide hospital and
emergency services while sharply curtailing physical exams and
elective surgeries. The strike failed to achieve its objectives, and
despite the preservation of critical services, the residue of public
bitterness over what appeared to be an act of professional
self-interest persisted for many years.

Other physicians’ strikes occurring in the United States, South
Korea, the United Kingdom, Israel, and Greece over the past 25 years
have had mixed results. A 2008 review
[[link removed]*27_strikes_and_mortality_A_review] of
international doctors strikes showed that mortality tends to stay
level or go down during strikes, an effect that has been ascribed to
postponement of elective surgeries.

But in terms of achieving strikers’ aims, the clearest lesson is
that strikes succeed or fail based on public perceptions.
Physicians’ strikes achieve success when they are seen as advancing
justice, not just for the profession but for the public. But
since physicians’ strikes inevitably involve delaying medical
services for individuals in need, it is hard to deny a violent kernel
at their core. Is Kennedy’s attack on public health sufficient
reason to effectively declare war?

Ethicists have long debated whether doctors’ strikes can ever be
justified. Borrowing from just-war theory, one framework suggests
physician strikes are only justified when there is legitimate
authority (consensus among doctors); just cause (such as preserving
public health institutions); a just endpoint (not razing Rome to save
it); virtuous motives (not just rage); no other options (last resort);
success probable (no Pyrrhic victories); means indispensable,
proportional, and respectful of the law (requiring careful planning);
and protecting the innocent (such as continuing to deliver critical
services). At a time when vaccine misinformation alone could result in
more than1 million additional measles cases
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the next 25 years, the mounting set of provocations may be nearing a
tipping point.

Physicians’ strikes can only be successful if they gain public
sympathy and minimize risk to patients. This is where lessons from
past strikes can be helpful. Physicians need to be clear that any
national work action is aimed at reversing policies that have created
dire public health threats to current patients (Medicaid cuts) as well
successive generations of Americans (like vaccine misinformation and
destruction of research infrastructure).

Professional organizations can play an important role by detailing the
precarity of the present moment and removing professional
self-interest from the conversation. To minimize harm, critical
services (such as emergency medical care and cancer surgery) should
continue, and any strike should be limited to, at most, a few days at
a time. The goal would be to emphasize the gravity of the situation
and mobilize the public, not to hold out indefinitely until Kennedy
steps down.

To underscore both commitment to public health and to harm reduction,
striking physicians should organize to staff safety-net clinics,
preventive health fairs, and immunizations sites at scale while their
regular offices and clinics are closed. 

To even consider temporarily withholding services from patients runs
counter to physicians’ professionalization and may trigger some
degree of moral distress.

But to paraphrase Hippocrates, desperate diseases demand desperate
remedies. If Kennedy does not resign, if science funding is not
restored, and if the government continues to place critical public
health functions in the hands of the willfully
ignorant, physicians need to act. A limited strike might be just
what the doctor ordered.

_Richard L. Kravitz, M.D., is a professor of medicine at UC Davis._

RICHARD L. KRAVITZ [[link removed]] was
appointed the director of the University of California Center
Sacramento (UCCS) in 2015 after serving as interim director for more
than two years. UCCS is a systemwide program managed by UC Davis, and
Kravitz has a dual report to the UC Davis provost and to the UC
systemwide provost. He also is a distinguished professor of medicine
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the Division of General Medicine at UC Davis Health, specializing in
internal medicine and geriatric medicine.

As UCCS director, Kravitz oversees programs in undergraduate education
and experiential learning, graduate student training in policy and
leadership, and public outreach aiming to translate research into
evidence-supported public policy.

Kravitz joined UC Davis in 1993 and served as director of the Center
for Healthcare Policy and Research from 1996 through 2006. He grew
that center from a small startup to a thriving organized research
unit, which at the time of his departure had 20 staff members, 100
faculty affiliates and over $3 million annually in research grants.

Among the many awards he has received are the Elnora Rhodes Service
Award from the Society of General Internal Medicine and the George
Engel Award for Contributions to Theory, Practice and Teaching of
Health Communication. He is also a two-time winner of Academy
Health’s Research Article-of-the-Year Award

Kravitz holds a Bachelor of Science degree in biological sciences from
Stanford University, a Master of Science in Public Health from UCLA
and an M.D. from UC San Francisco. He completed additional clinical
and research training at UCLA, where he served on the faculty before
coming to UC Davis. Kravitz is a fellow of the American College of
Physicians and Academy Health.

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* Healthcare
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* Health Policy
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* Robert F. Kennedy Jr.
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* Department of Health and Human Services
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* Medicaid
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* cdc
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* NIH
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