Commentary: Professionalism, Unionization, and Physiciansʼ Strikes
Bibliographic record
Abstract
Professionalism is the basis of medicine's social contract with society. The details of that contract are influenced by the presence or absence of a national health plan. In countries with such a plan, unlike in the United States, negotiations are dictated by the nature of medicine's contract with society and take place between the medical profession and society directly. This system has required that medicine be represented at the negotiating table, and, in most instances, it has resulted in the unionization of physicians. To influence these negotiations, the medical profession has used various forms of collective action, including strikes. As the United States continues on the path toward health care reform, it seems likely that the American medical profession will also require an organization to represent it at the negotiating table and will be under the same pressures to strike as are physicians in other countries. Because both unionization and strikes pose potential threats to the professionalism of students, residents and practicing physicians, such issues should be a part of the medical education curriculum at both the undergraduate and postgraduate levels. The authors briefly review the literature on strikes and job actions and share personal experiences to support this discussion. Students and residents should have an opportunity to consider these issues in a safe environment, both to understand the potential impact of a strike on patients and the profession and to determine their own personal course of action should such a situation arise.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.008 | 0.004 |
| Scholarly communication | 0.003 | 0.005 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.089 | 0.046 |
| Insufficient payload (model declined to judge) | 0.005 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".