Doctors will defy orders to refrain from industrial action, striking for the first time in decades following almost a year of unsuccessful talks.
But both sides of the dispute at least agree the impact on patient care in public hospitals should be minimal.
The NSW doctors' union on Wednesday said it would continue three days of planned industrial action beginning next week, in the face of an industrial court's orders to halt.
The rare walk-out is expected to impact hospitals across NSW, with doctors in major Sydney hospitals and regional areas voting to strike from next Tuesday.
Union director Andrew Holland said doctors were striking for the first time since 1998 over unsustainable workloads, chronic under-staffing, and unsafe working hours.
"The decision hasn't been taken lightly. The decision is a last resort," he told reporters outside Sydney's Royal Prince Alfred Hospital on Wednesday.
Intensive care specialist Behny Samadi said doctors were at breaking point.
"This is not something we want to do," she said.
Dr Samadi said the strike would not endanger patients and they would understand why doctors were taking action.
"We're actually doing this for their best interest, because we want a well-functioning, sustainable public health system that treats them well," she said.
The union, known as the Australian Salaried Medical Officers' Federation (ASMOF), expects to face fines for defying the court orders.
It has told doctors they will not be personally liable and directed them to press on to force further bargaining with the government.
"As expressed by many thousands of members who have said they will participate ... not taking industrial action will achieve very little," Mr Holland said.
The exact form of the industrial action is still being determined.
"Patient safety will be maintained ... critical care and emergency areas will not be affected," Mr Holland said.
Doctors announce strike on 8-10 April 2025 Watch full press conference here: www.instagram.com/reel/DH7F6QJzRrN/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==
NSW Health said the Industrial Relations Commission had ordered the union to cease organising and refrain from taking any industrial action for three months.
"If ASMOF members breach the (industrial court's) orders and proceed to action, all local health districts have plans in place to minimise any disruption to patients and hospitals,"
a spokesman said in a statement.
Health Minister Ryan Park said the government went to arbitration after negotiations made no progress.
"The umpire ordered the doctor's union not to strike, however the union has chosen to defy the independent umpire,"
he said.
The government is also in a prolonged industrial dispute with the state's nurses which has prompted strikes.
Mr Park partially blamed those strikes for cancelling hundreds of elective surgeries when recent data showed waitlists back over 100,000, approaching COVID-19 peaks.
A separate dispute with psychiatrists in the state's public hospitals is due back before the commission on Friday.
Opposition health spokeswoman Kellie Sloane said the government had lost control of a health system in chaos.
"There will be longer waits in already stressed emergency departments ... for elective surgery,"
Ms Sloane told reporters.
"This is a problem created by Labor having a chaotic industrial process, bargaining with everyone on different terms, giving some people substantial increases, but not doctors and nurses,"
she said.