The paper by Reid et al. will be of interest to healthcare managers as it indicates how B.C. physicians successfully withdrew elective services, under specific conditions, to protest continued pro-ration of fees by government, to offset total physician billings exceeding a fixed-budget cap. The end result was an agreement that saw new funds added to the budget and the government's abandonment of pro-rationing. Will this type of protest now be followed in other provinces and by other professions? Healthcare managers would be wise to initiate plans which address this form of protest. While the process described would be deemed successful from the physicians‚ perspective, it would be of interest to know (i) the patient's perspective, including mortality or morbidity outcomes; and (ii) the overall economic impact on the province, including the financial impact on emergency departments during the rationing of services.

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