Ironically, behind all this is a misconception that we're actually constantly working on with our patients. The truth is that the clinics would function better and we could offer better therapy if, for example, we weren't so overworked and enough staff were employed. But in order to achieve this, we would have to make decisions again and again in specific cases, which are less pleasant for patients in the short term. Specifically: saying no to our employers more often, strikes, and in the worst case resignation. Sensible in the long term, unpleasant in the short term. For our patients. And that's the crux of it.

Unfortunately it is always easier to discover those mistakes in the thinking of others. I have met dozens of colleagues who avoid fighting for better working conditions for precisely these reasons (while advising their patients to avoid this error in particular). And clinics of course know this and take advantage of it.

So better negotiation skills are really only party of the solution (although also very important). I think in the long term we need better education and more focus on socialist ideas, specifically on how and why employee rights (and the ability to self-care) are such an integral requirement to a job well done.