Can Doctors Rebuild a Working Relationship with Government?

Can a broken relationship be mended? When one party has done something really wrong, and the other has lashed back, can they reconcile?

Doctors in Ontario have been heckled in the legislature, slandered in the media and ignored for multiple pieces of legislation. Unexpected rounds of unilateral cuts have caused festering wounds. It makes caring for sicker patients with longer wait times almost unbearable.

Some doctors are so sick of feeling abused, they only want to mock the other side. A few prefer mutually assured destruction.

But most doctors just want to care for patients. Doctors want to be left alone to care for patients without worrying about the next crisis.

Can doctors find a way to rebuild a new relationship with government? Continue reading “Can Doctors Rebuild a Working Relationship with Government?”

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Patients Need Champions, Not Doormats

People love movies about underdogs. We like watching Harry Potter get picked on because we know that he fights back in the end.

Underdogs create great stories, but they do not stay under forever.

Medical schools look for students who seem able to care.

Do they have empathy? Are they lovers or fighters?

Journalism and law schools look for different things.

Med schools err on the side of sensitivity, even if it means that some gentle souls might burn out now and then. Better that than a class full of fighters and advocates.

It wasn’t always this way. In the olden days, good grades guaranteed a spot. Schools didn’t weed out the way they do now. Each class formed a cross-section of everyone who did well in school and wanted to become a doctor.

Medical school interviews changed all that. Doctors trained since 1990 have been selected for sensitivity. They have endured extensive psychosocial training. They have been selected and trained for professional deference. Continue reading “Patients Need Champions, Not Doormats”

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Equality, Relativity and Democracy

The World Record for solving a Rubik’s Cube is 4.73 seconds. My kids can do a 2×2 in under a minute. I have never solved a Rubik’s Cube.

Inequality has existed for as long as we have.

The Greeks developed philosophy, literature and architecture when Britain was filled with “…illiterate tribal peoples, living at a primitive level.”

The Chinese invented “…the compass, printing, paper, rudders and the porcelain plates that the West call ‘chinaware’…” centuries before Europeans (Wealth, Poverty and Politics, by T. Sowell).

Equality

Some use income to measure fairness and morality. High incomes indicate greed and oppression.

Economic egalitarians believe in equal economic outcomes, regardless of effort and circumstance.  Egalitarians oppose meritocracy. Continue reading “Equality, Relativity and Democracy”

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Change & The New OMA

People say that they hate change. But it’s not true.

We love babies, weddings and graduation. We love new homes and cars and retirement.

Everyone loves positive change that we control, but we get stressed when other people make us move.

So most of us avoid asking for change. We know it threatens people. Asking for change means we want something better, or different.

Change & The New OMA

The OMA started renovation this spring: a new group of Board members, a governance retreat/renewal and then a major strategy planning session. Now the hard work begins.

Change means we find new and better ways to act. It means we work in concert.

Kotter

Change interrupts usual workflow. We stop doing some things, start doing others and redefine ourselves in the process. Change is scary.  If it isn’t, it probably isn’t real change. Continue reading “Change & The New OMA”

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Political Survival in Medicare

Near the end of Wonder Woman, Steve, Diana’s romantic interest, steals a plane full of poison gas.

Warning: spoiler alert.

He blows up the plane, saves the world and dies a hero. Then Diana blows up Ares, saves the universe and grieves her loss, a tragic heroine.

It’s tempting to see life as a battle between good and evil.

Bad political parties make bad decisions, all the time, which is bad. We should fight them, all the time, because that is good.

If bad parties do something good, it probably isn’t good, because they are bad.  If we cannot see the bad in what they do, it is because they hid it, which is bad. So we should oppose them, which is good.

Healthcare is Political

After 50 years of state healthcare in Canada, some people can only see healthcare in black or white. They have watched governments twist healthcare left and right, with each election.

Politicians often twist it just to win elections. So some voters feel justified complaining about everything in healthcare, especially if they hate the party in power.

But no one is wrong about everything all of the time. Even a stopped clock is right two times each day. Continue reading “Political Survival in Medicare”

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Concerns About Binding Arbitration

A smart lawyer said he sees this all the time. People fight forever to get something. They sue. They protest. When they finally get what they want, they freeze.

There must be a trick. How could the other side agree? After abusing us for so long, how do we know this isn’t a trick?

Five years of fee cuts, unilateral actions, heckling and sloppy legislation have left doctors feeling abused. The relationship between doctors and government has been torn beyond easy repair.

Negotiators have started to mend a working relationship. They wrestled for months and finally got a framework each team could support.

The binding interest arbitration framework (BAF) represents months of debate and attempts to find common ground. They shaped a BAF that looks far better than many of us expected.

Some doctors wanted a framework that would guarantee a win in negotiations. They wanted a trigger that would be fun to pull. But neither side should want to go to arbitration. A negotiated agreement should always look more attractive than an arbitrated one, for both sides.

Concerns About Binding Arbitration

So after years of asking for it, doctors in Ontario have a BAF offer.  Some have serious concerns. Here are some of the things they tell me: Continue reading “Concerns About Binding Arbitration”

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Looking for Reasons to Oppose Binding Arbitration

Optimists see change as opportunity. Pessimists find change to be irritating, risky at best. Realists weigh change one case at a time.

Doctors face a paradigm shift in how they interact with government. Binding interest arbitration (BA) promises to fix a power imbalance between doctors and government. Many docs have wanted BA for years.

But will BA fix everything between doctors and government?

Are there reasons to vote against BA?

Reasons to Vote No

A few doctors believe that there are 4 insuperable reasons to vote against this contract. If you agree with these four, then you should vote No, too. Continue reading “Looking for Reasons to Oppose Binding Arbitration”

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Binding Interest Arbitration – A New Era?

After years of wrestling a more powerful opponent, doctors opened their emails to find that government had offered a truce.

I never expected to see this.

Who would give up such advantage?

Government used to rule supreme. It could legislate whatever it wanted.

Why would government change its mind and give up absolute power?

A part of me must have believed that this would happen. Why else would I have spent years lamenting government power and control?

In hindsight, things had to change.

Government was trying to lead a horse to water that would not drink. Continue reading “Binding Interest Arbitration – A New Era?”

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First Address to Council

Like the last post, many people have asked for copies of my first address to Council as President.

A number have shared bits and pieces on social media, so I thought it was best just to share the whole thing here.

This is just a starting point. I look forward to seeing where we – all of us – take this from here.

Shawn

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Thank you, Mr. Chair, Members of Council and Special Guests.

In my election speech, I offered three priorities for the OMA over the next year: trust, unity and excellence. I’d like to expand those ideas a bit more over the next few minutes. I offer these for discussion. I hope you will argue with me. I offer them as a starting point to a larger conversation.

Everyone agrees: We need an agreement. But we need more than that. We might get a wonderful agreement. But if we do not have a system—the excellence—to socialize it with our members, it will fail. Continue reading “First Address to Council”

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Whatley Election Speech

A number of doctors have requested my election speech, and others have posted parts of it on social media already. So, I though it best to put down what I said.

Doctors have a new hope for positive change. They are eager to build. It feels like we have turned a corner.

Thanks so much to everyone who worked so hard this weekend!

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Thank you Mr. Chair and Members of Council.

 

It’s time for change.

 

The OMA faced an unprecedented crisis:

We’ve been heckled in the legislature,

slandered in the media,

ignored for multiple pieces of legislation,

and now, after almost 4 years, we still don’t have a contract.

This is intolerable.

 

The OMA must do 3 things to fix this. Continue reading “Whatley Election Speech”

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