What Lessons Can Doctors Learn From The Dock Workers?


So, on Tuesday, October 1st. the ILA, International Longshoremen's Association, went on strike.  It was estimated that 45,000 workers went on strike.

They were demanding higher pay, a greater employer retirement plan contribution, and a guarantee of no automation.

Wow!  That's a lot to demand.

So, the average dock worker's annual income is $81,000 compared to the national average of all workers at $59,000.

However, it is reported that one-third of all dock workers make about $200,000 per year.

Despite their salary being higher than the average American's, they want more.

Prior to going on strike they were offered a nearly 50% pay increase in addition to a 3 times increase in the employer's contribution to their retirement accounts.

They turned that offer down.

They were demanding a 77% pay increase.

On the one hand, I have no sympathy for them.  To turn down a nearly 50% pay increase and a 3x increase of their employer's retirement contribution is outrageous! 

How many physicians would take that offer?  All of them!

On the other hand, they say they haven't had an adequate pay increase in years.  They report having to work lots of long hours and not feeling appropriately compensated for them. They report missing their kid's activities because of work demands and feeling guilty about it. 

They report having stayed on the job all through the Covid pandemic and feeling they were taken for granted and not adequately compensated for their work nor their risks.

They complain of the record profits reported by the shipping companies and the Maritime Alliance, yet they saw none of those profits despite their jobs being essential to such record profits.

As a physician, does all of that sound familiar?

You haven't received an adequate pay increase in years either. 

You work long hours and miss kid's activities and feel guilty about it, too. 

You stayed on the job during the Covid pandemic, yet you were taken for granted and were not adequately compensated for your work nor for the risks you endured, either. 

You sat by and watched the drug companies and health insurance companies report record profits, yet you saw none of those profits despite your work being essential to those companies' bottom lines!

So, I can understand the dock worker's point of view.

In reality, it is the same point of view of the majority of healthcare providers.

The only difference is, you, as healthcare providers, are not organized into a large union. Therefore, you have no voice in your reimbursements package and no say in your future. 

And, you currently have no leverage!

There has been a small movement toward organization.  Some nursing groups have formed a union. Some residents at certain institutions have formed a union.

The current laws prevent employers from forming unions. 

Unions are for employees, to protect their rights.

Well, it is reported that nearly 77% of all physicians are employed these days.

Isn't it past time for employed physicians to not just consider forming a union, but to actually do it?

That is the only way a collective majority of physicians can have any leverage.

Until that happens, you will continue to be taken advantage of and taken for granted.

Then, on Thursday, October 3rd, the ILA and the United States Maritime Alliance did reach a tentative agreement.  The union agreed to a 62% pay increase over six years.  

The tentative agreement only goes until January 15, 2025.  They still have to work out many other issues.

But, the bottom line is that, after only 2 and 1/2 days on strike, there has already been a significant wage increase.

Would you as a physician accept a 62% increase in your reimbursements over the next 6 years?  Of course you would!!

And why did that happen for the ILA?

Because that union has a lot of members. And their work is a skill that is not easily replaceable. And the docks and shipping companies can't function without them.

You doctors are in the same position.

You have large numbers, if you will just organize.

You are highly skilled.

You essentially cannot be replaced, because it would take years to train someone to replace you.

The healthcare system can't function without you.

So, you worry about going on strike and leaving patients in limbo?

You have trouble combining your oath to "Do no harm" with going on strike to demand adequate reimbursement for your work and risks?

Often just the threat of a strike gets results without the strike ever taking place.

But, even if such a strike did occur, could it possibly only last 2 and 1/2 days also?

Is it time to stop talking about it?

Is it time for doctors to learn from the dock workers?

What are your thoughts?


​Ben Holt, M.D.