Doctors Need a Good Agent – OMA Negotiations

We hire a real estate agent to help us find a house. She only gets paid when a deal closes.

Good agents try to find something we will like.

But that takes time.

Agents have to ask questions, listen to us and then test what they have heard by showing us a few houses.

Often, agents hear wrong, or we do not explain ourselves very well.

Good real estate agents spend time and money to learn how to represent our interests with confidence.

Bad agents try to close a deal as soon as possible.

The OMA is negotiating a dispute resolution process with government, right now.

Doctors want this.

We hope the dispute resolution process will be fair and reasonable. The OMA tells doctors that it is moving along well.

But as soon as the OMA and government agree to a dispute resolution process, the government will want to begin negotiations on a physician services agreement (aka contract).

Who could blame it?

An election looms.

The government finally wants to resolve labour problems with doctors. It does not want to drag negotiations into the fall, or next year.

The OMA will face immense pressure to enter negotiations as soon as they have settled a dispute resolution process. Government will, no doubt, offer a better deal, if the OMA agrees to settle on a physician services agreement, as soon as possible.

Good Agent

The OMA used to spend months developing a negotiations mandate. The OMA would do whatever it took to find out what members thought, as any good agent would do.

Negotiations are not just about money and raises. Negotiations shape patient services.

For example, if doctors find that elderly patients do not get care, because there is no fee code to incentivize care for the elderly, then doctors try to negotiate a fee to fix this problem, during negotiations.

The last time the OMA fully refreshed its mandate was 2011. The OMA used the same 2011 mandate, with minor changes, in the failed 2014 negotiation.  [Note: italics in last 2 sentences were added for clarity after Dr. D. Weir’s comment below.] Then, in the 2016 negotiation, the 6-page tentative contract had no room for any mandate, other than the government’s mandate for fiscal certainty.

The OMA faces a major problem if it enters negotiations without knowing what doctors want.

At best, it is shortsighted; at worst, it is arrogant and blind.

A group of us discussed this on a conference call on Monday. An email from the OMA, yesterday, suggested that the negotiations team has thought about a mandate.

But thinking and doing are not the same.

Doctors need the OMA to find out, as soon as possible, what doctors think. If the OMA does not, it will feel pressured to go into negotiations without knowing what doctors want.

This would solidify doctors’ impression of the OMA as being insensitive to doctors’ needs and wishes. It will confirm members’ lack of trust in the OMA.

Let’s hope the OMA does whatever it takes to find out what doctors want/need in negotiations. If the OMA skips this step, it will make it much harder for members to accept any tentative contract the OMA negotiates.

Then again, maybe the OMA does not expect to negotiate anything at all?

Maybe the OMA has already resigned itself to the inevitability of an arbitrated contract?

Even so, the OMA should find out what doctors want the OMA to fight for. It is the least any good agent would do.

Postscript: Great news! The OMA emailed out a plan, on May 2nd, for consulting members about developing a negotiations mandate, as discussed above. Things are looking up. Thank you, OMA!

Photo credit: sec.theglobeandmail.com

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6 Replies to “Doctors Need a Good Agent – OMA Negotiations”

  1. As always, great post Shawn.

    I personally think that we will never get the chance to vote on the future TPSA. The details of binding arbitration are being worked out now. Once that is done, both sides will attempt to negotiate an actual contract, with likely no success. This will eventually lead to arbitration, and we will get what comes from that, without ever voting on the contract. I’m sure both sides will try to argue that this would be the best scenario.

    1. Me too, Harpaul.

      I would not be surprised if there’s nothing to vote one. Not sure if this is good or not. Many arbitrators have hedged their decisions on government’s ‘ability to pay’, which, of course, is based on how much they have already spent on buying votes from everyone else. We are the last to feed at a shrinking public trough.

      Thanks for taking time to share!

      Shawn

  2. The OMA’s old guard that has hunkered down creating a ” deep state” within the OMA , walling itself off from the revolting membership —it knows what the government wants and will continue to promote its interests before that of the membership.

    A good real estate agent is honest and represents his/her client in the best possible way, presenting the truth to the client so that the client benefits from the agent’s knowledge.

    Nothing is worse than a dishonest and unethical real estate agent pretending to represent the client whilst, at the same time, working in the interests of the other party.

    There is no question , judging by the results of decades of mal representation , that the OMA’s shady old guard have served the government and its interests well and the membership of the OMA poorly.

    Our academic colleagues have enjoyed , over the last 16 years , an alternative funding program (AFP)negotiated outside the OMA framework—it has worked well for them , we should emulate them.

    1. Thanks for your thoughtful insight, as always, Andris.

      Good observation about the academic AFPs. Very interesting how the academics get nice contracts and always shout the loudest in favour of the ministry.

      I used to think, like you, that the OMA old guard was ‘shady’ as you say. I think a number were: dyed in the wool party supporters who would never fight anything delivered by their favourite government. But I think most of the ‘old guard’ were just clinicians trying their best in a political world. They kept being told that if they criticize government at all, then government would punish doctors. For the most part, I think they were right. In our single payer system, the first rule of success is to never criticize the single payer.

      This must change. We need to reform the OMA in such a way that it has freedom to advocate for problems in the system, all the time. We need to separate advocacy and negotiations. I am not sure if this is entirely possible. Perhaps we could have a good-cop, bad-cop approach with an official spokesperson. The spokesperson could always be conciliatory and the President could be more aggressive. Or perhaps the reverse situation would be better.

      Regardless, the milquetoast obsequiousness that everyone believes is the best course of action just feels wrong. It is wrong. It must change.

      Thanks so much for taking time to share a comment!

      Cheers

      Shawn

  3. As a former OMA Board Director you should know that your statement “The last time the OMA refreshed its mandate was 2011. The OMA used the same 2011 mandate in the failed 2014 negotiation.” Is false.

    Dr. Whatley is talking about the 2011 process to obtain a mandate for the 2012 negotiations. The OMA again went through mandate development in 2013 for 2014, including meeting with all the sections – the OMA did not simply “reuse” the prior mandate. Dr. Whatley should know that because as a Board Director he would have been involved with the Board approving those mandates.
    Following the rejected agreement in 2014, the OMA surveyed membership, and are currently developing a consultation plan as the OMA has communicated to OMA members.

    The OMA agrees, consultation is necessary to develop a mandate, and that is what the OMA will do, and what the OMA has communicated they will do.

    The update to the membership does not say “we are just thinking about it”. It states:
    “…the OMA Negotiations Committee is developing its plan for consulting with members to inform the development of our next PSA negotiations mandate. We are committed to undertake extensive consultation with members, and we aim to utilize various communications tools to gather input and facilitate discussions to identify priorities and the substantive content for the next PSA.”

    Dr. Whatley is well aware of all of the above and it is unfortunate that he is spreading such misinformation.

    Doug Weir

    1. Thank you, Doug, for taking time to offer a correction!

      Let me start by saying that I am so sorry to have given the impression that I am “…spreading such misinformation”, as though it were done with malevolence. A quick note to say where I’ve gone wrong, or remembered incorrectly, is all it takes to get us back to the issue at hand.

      A few comments:

      1. I agree. The OMA undertook a fulsome process to develop a mandate in 2011 for the 2012 negotiations. The OMA did not repeat the same, fulsome process in 2013, as far as I recall. If you have information to show that there were major changes between the 2013 and 2011 mandates, please share it. Indeed, it would have been wasteful for the OMA to repeat the full, mandate setting process in 2013 after having just spent thousands of dollars doing the same thing in 2011. But you were President then, so perhaps you remember approving the expense of a fulsome mandate development process in 2013.

      2. I also agree that “…the OMA has communicated they will [consult the members].” This offers us hope. As of the negotiations teleconference from last night, they have not done so yet. Also, the negotiations team members on the call stated that there would be substantial pressure to get into negotiating a PSA, as soon as a binding process was agreed upon. A number of us asked if there would be time to establish a full mandate consultation. The team did not commit but felt hopeful.

      In other words, the negotiations team confirmed the whole point of this post: The OMA will feel pressured to get into formal negotiations, which will make it a challenge to develop a negotiation’s mandate in a compressed timeframe.

      3. Finally, I also agree that the OMA has committed to consulting with the members. Your quote is from the email I mentioned in the post.

      I have updated the post to add specificity, given your comments [italics added]. I also credited you with the input:

      “The last time the OMA fully refreshed its mandate was 2011. The OMA used the same 2011 mandate, with minor changes, in the failed 2014 negotiation.”

      Thanks again for taking time to read and share a comment. As a Past President and child psychiatrist, I appreciate your input. I hope that next time you might find it appropriate to simply correct my ignorance without attributing malevolence.

      Best regards,

      Shawn

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