Governance Renewal – Ask Why Before How

Action expresses priorities – Ghandi

Every doctor has seen or done something horrible to an old, dying patient.

Armed with good intentions, we spot a gasping 95 year old and jump into action. We snap open a laryngoscope blade, hoist her jaw into the air and shove in a tube to relieve her “upper airway obstruction”.

Our technical prowess is matched only by our moral purity. But we accomplish something grotesque and wrong.

Doctors must learn to identify sick patients and how to resuscitate them. But these skills cause harm if doctors do not learn what comes between diagnosis and treatment.

Before treatment, we must ask: Why?  

Purpose Before Process

A governance expert entertained a large group of doctors in Toronto this weekend. He summarized a graduate textbook on board governance in 40 minutes, for a group who had very little board experience.

It was brilliant, funny and almost useless. Continue reading “Governance Renewal – Ask Why Before How”

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Should Doctors Form a Union?

Sports fans love to see an angry coach shove his belly into an umpire’s equally large gut, screaming F-bombs.

The Toronto Star loves to watch doctors and government shove each other, too.

It’s good for business.

After months of media writing about “fat-cat doctors” screaming at an inept, “Walking Dead” government, social media has moved on to other things.  Articles dribble into print, but I doubt anyone has met with MPPs in the last few weeks.

When the majority stands against freedom and responsibility, those values, once lost, cannot be regained without major upheaval or catastrophe.

Doctors’ best hope lies in unionization. (Heaven forefend!) It lies in becoming salaried clock-watchers. It rests in becoming collectivized seekers of uniformity, mediocrity. Continue reading “Should Doctors Form a Union?”

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Regular Working Doctors – New Hope for OMA?

Halley’s Comet flashes by once every 75 years. The OMA changed 18-20 years ago, and again last night.

On Tuesday evening, the world of medical politics turned. Some say it has spiralled since last summer, but yesterday, doctors saw a ray of hope, for change and renewal.

Over the next few days, new officers will digest what occurred and consider what they hope to see changed.  What makes things different this time? Continue reading “Regular Working Doctors – New Hope for OMA?”

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Fundamentalism in Medical Politics

Fundamentalism simplifies life. It turns a messy world, full of grey, into a crisp, clean existence of peace and clarity. Even dogs and colour-blind people can see black and white.

Fundamentalism uses publicists to guide true believers.

Some news columnists, ersatz journalists, make their living as publicists. They sell words that paint the same, stark plot: Everyone is good or bad, oppressed or oppressor.

Stylites in the Main Stream Media chant their sermons, while the choir nods in unison.

Doctors are oppressors, arrogant and powerful.

Liberal members of parliament are warriors for social justice.

Not even Odysseus could sail between the publicists and warriors unscathed. Black and white makes life so simple.

Most people expect news-papers to report the news, not create it.

Now, many newspapers only write about events that support their narrative. Continue reading “Fundamentalism in Medical Politics”

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Doctor Patient Magic

All great stories include magic. Characters dance around rules or constructs that define their world.

For example:

Guess my name and you may keep your child.

Find love before the last pedal falls or remain a Beast forever.

Never say the name of he-who-must-not-be-named, or Death Eaters will find us.

Magic applies to non-fiction, too. We buy books about real, faulty people who win despite their flaws.

We want stories about people struggling and limited in the same way that gravity limits us. Limits and faults make real life and fairy tales come alive. Gravity is magic by another name; no one knows what it is.

Doctor Patient Magic

Medicine has its own magic, the doctor patient relationship, that defines and controls medicine every bit as much as gravity rules us. Continue reading “Doctor Patient Magic”

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How to Energize Your Career or Change It Completely

A colleague one town over died recently. After 50 years, he had a huge practice.

His patients say that he often called them on Sundays with results. He loved medicine.

He saw 40 patients one day and died the next.

Doctors used to work until they got too blind or dull to carry on. Seeing more patients was the best way to shake off malaise and stay energized. It gave instant rewards, decent pay and didn’t feel like work most of the time.

Today, old docs say that young docs don’t want to work. The old-timers are partly right, but for the wrong reasons.

Very few doctors can survive old-time clinical medicine: 60 hours a week for 50 years. Modern clinical medicine has too little medicine left in it. Continue reading “How to Energize Your Career or Change It Completely”

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Doctor Derangement Syndrome

Some people hate cows.

Cow haters often have good reasons for feeling so.

Perhaps they had a bad experience with a scary cow. Now they tell everyone that cows are smelly and bad for your health.

Occasionally, cow haters pretend to support the dairy industry, but only if it leads to increased regulation of cows in general:

Cows are such a precious resource that we need government to control them.

Other people love cows above all else and put them centre stage at every state fair. They push for more pasture, just for cattle. They re-write food guides to support the dairy industry.

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Some people hate doctors.

No doubt, doctor-haters have deep reasons for feeling so. Perhaps they had a bad experience with a scary doctor.

Now, they write nasty columns in the Toronto Star about doctors.  All the inspiration they need is a tweet, by a famously unpopular Premier from the 1990s. Continue reading “Doctor Derangement Syndrome”

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Lame Duck Leadership

“The term lame duck generally refers to one who holds power when that power is certain to end in the near future.” (Legal Dictionary)

Lame duck leaders do not face the consequences of their actions; they will soon be gone.

Other politicians do not worry about what a lame duck does or says, as long as the lame duck leaves them alone.

Lame ducks can do great harm, but for the most part, everyone sits back and waits for new management.

Vote of Non-Confidence

On Sunday, the OMA Council, Ontario Doctors’ governing body, debated the following motion:

“That OMA council express to the OMA Executive Committee that Council has lost confidence in the leadership provided by the Executive”

Council voted 55% in favour.

Usually, 25 Board members and 7 student representatives vote, en bloc, in support of whatever the Board advises [Correction: Past Presidents don’t vote]. Considering that, the non-confidence motion had the support of an overwhelming majority of working doctors.

For the first time ever, Council said that it did not trust the current Executive to lead doctors in Ontario. Continue reading “Lame Duck Leadership”

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The OMA is on Fire

In 1880, doctors got together and built a house called the OMA. It was a small house with a big living room and magnificent doors that were always open.

The house helped doctors. That was its only purpose.

Over time, caretakers of the house found that friendship with power helped doctors. Soon the house was full of courtiers, with the doors closed. And soon after that, the doors stayed closed all the time.

The magnificent doors came to represent the whole building. They protected the building. It was their fiduciary duty.

Today, the OMA is on fire. Politicians lit the fire. But once the fire started, those in charge of the OMA ignored the smoke. In fact, many say that the caretakers could have prevented the fire altogether, if they had spent less time wringing their hands and courting power. Continue reading “The OMA is on Fire”

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Something New? Special Council Meeting

In a year of unprecedented events, doctors look forward to another historic weekend.

OMA Council, the governing body for 42,000 doctors in Ontario, meets to debate the first ever vote of non-confidence in the Executive Committee of the Ontario Medical Association.

Six motions follow: one for each member of the Exec asking that each one resigns immediately.

First ever. Unprecedented. Unheard of. 

Speakers at the OMA often quote Einstein,“The definition of insanity is doing the same thing over and over again but expecting different results.” Will OMA Council do something new?

Special Council Meeting

Council meets to debate the performance of the Executive Committee.

But people will twist it into a debate about individuals and personal integrity. Others will shame their colleagues for being divisive and petty. Still others will focus on forensics designed to assign blame.

Council needs to focus on one thing: Based on performance to date, do the doctors of Ontario believe that the leaders of the OMA can effectively serve the membership? Continue reading “Something New? Special Council Meeting”

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