The George Washington University doctor union threatened a strike to demand fair pay, better benefits, and a sustainable future in medicine.
I’ll never forget how burnout hit me in the early years of my career. Long hours, endless demands, and constant pressure—it felt like I was on a treadmill that wouldn’t stop. Back then, the idea of doctors striking seemed unthinkable. Weren’t we the ones who always showed up, no matter what? But fast forward to today, and physician strikes are making headlines.
In October of 2024, resident doctors at George Washington University (GWU) took to the picket lines, demanding fair pay, better benefits, and mental health support. Their fight isn’t just about them—it’s part of a growing movement among physicians nationwide, one that’s challenging the status quo of our healthcare system.
The Residents at GWU: From Picket Lines to Strike Votes
In October 2024, GWU residents stepped off the hospital floors and onto the picket line to highlight inadequate pay and mental health resources. Residents training in cities like Washington, D.C. face the highest rents in the country. On average, nearly half their take-home pay goes toward housing, leaving little room for savings or emergencies.
By early December, the resident doctors and fellows at GWU School of Medicine and Health Sciences escalated their efforts and a strike was authorized. It wasn’t a decision made lightly—walking out as a doctor raises ethical questions about patient care. Yet, as GWU residents explained, burnout, lack of mental health support, and insufficient pay ultimately compromise the quality of care doctors can provide.
After negotiations failed, these residents formally served notice of a three-day strike, shining a spotlight on issues that extend far beyond GWU and mirror those of healthcare workers across the country.
Luckily, George Washington University was able to avoid the actual strike by agreeing to terms with the resident physician union.
Why Now? The Perfect Storm for Unionization
For most of modern history, physicians didn’t unionize. They owned private practices, acted as their own bosses, and controlled their work environments. But over the past few decades, the healthcare landscape has shifted dramatically.
The 2024 PAI Report on Physician Employment Trends revealed that 77.6% of physicians are employees of hospitals, health systems, or corporate entities. This shift means that many doctors now find themselves in positions of diminished autonomy.
The corporatization of medicine is one factor. The COVID-19 pandemic threw gasoline on an already smoldering fire, forcing physicians to confront the toll of a strained healthcare system. Burnout rates soared, and cracks in the system became impossible to ignore.
Unions, with their long history of securing workplace protections like fair wages and reasonable hours, are increasingly seen as a path forward. For many doctors, collective action — including possibly going on strike — feels increasingly like the only tool available to be heard in their fight to advocate for themselves.
The Ethical Dilemma of Physician Strikes
Whenever doctors consider going on strike, one question always arises: what about the patients? It’s an ethical dilemma that strikes at the very core of what it means to be a physician. Who will care for patients if we don’t? This concern by itself is often enough to keep doctors working, rather than risk patient care.
In the case of GWU, the (potentially) striking doctors were residents, which means attending physicians and fellows were going to be able to step in to cover the gaps. This mitigates the immediate risk to patients but doesn’t address the bigger quandary: how do you balance professional ethics with the need to demand changes in the workplace?
As GWU residents have pointed out, current circumstances are not sustainable for doctors or patients. The healthcare system is at risk of losing talented physicians due to poor working conditions (either during residency or afterwards). If left unaddressed, this would just lead to worse outcomes for everyone.
Clearly, addressing these systemic issues in the present is essential to preserving the future of patient care.
What’s at Stake: GWU and Beyond
The narrowly averted doctors strike at GWU is part of a much larger trend. In September 2024, about 830 residents in Buffalo, New York, went on a four-day strike. Earlier in the year, 3,000 nurses in Oregon staged a three-day strike, and by October, physicians and nurse practitioners in Portland had also authorized a strike.
This growing wave of union activity is sending a clear message: doctors and healthcare workers are no longer willing to accept the status quo. Fair treatment and better working conditions aren’t luxuries—they’re essential for the survival of healthcare in the U.S.
These demands aren’t just about money or benefits; they’re about creating a system that works for everyone. A well-supported physician is a better physician, and that benefits patients as much as it does doctors.
A Personal Journey to Stability and Freedom
During my residency training, I also was part of a doctors’ union, but I never ran into an opportunity to strike during my training years. (Frankly, I would have been much too scared of retribution from my attendings to actually go on strike.) But times are different now.
I empathize with residents advocating to improve their circumstances—I experienced many of the same struggles early in my career. After I graduated residency, I realized that the demands of my medical career were leaving little space for personal or financial stability, and that needed to change.
So, I began my journey towards financial independence. I discovered real estate investing as a way to generate passive income, and the financial security I derived from those investments allowed me to practice medicine on my own terms—without being beholden to unreasonable demands.
Ultimately, my passion for real estate led me to create Cereus Real Estate, a community where physicians and other busy professionals can pool resources to invest in properties and benefit from a genuinely passive income stream. By building cash flow through real estate, investors can obtain the freedom to focus on what truly matters—be it patient care, family, or personal well-being.
Conclusion: A Movement Worth Watching
The GWU residents and others led an important fight for fair pay and working conditions, and their efforts resonate with doctors everywhere. Their actions highlight the challenges many healthcare professionals face in simply securing what they deserve. While these strikes won’t transform the entire healthcare system overnight, they are an essential step in creating fairer workplaces for physicians.
I hope this movement continues to gain steam. In fact, I’m an advocate for all employed physicians to join a national physician’s union.
In the meantime, it’s crucial for individual doctors to take control of their own financial futures. For me, that started with building passive income through real estate.
Wherever you are at in your professional life, one thing is clear: the way forward requires being an excellent advocate for yourself both in the workplace and in your personal life. Together, we can create a future where fair pay, financial stability, and professional fulfillment go hand in hand.
And remember: Financial freedom isn’t just a dream; it’s a decision. Let’s get there together.
Daniel Shin, MD
The Darwinian Doctor
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