Category: Politics

We learn from our mistakes, at least some do. The Toronto Maple Leafs won their last cup in 1967.   Maybe the saying should be,

“Some people learn from their mistakes, but most rarely take the opportunity.”

Ontario’s doctors see 2004 and 2008 as big wins. By 2012, docs had finally caught up to inflation after losing since 1986. While everyone takes credit for the victory, the feds probably deserve most valuable player. They shovelled billions as Canada Health Transfers starting in 2004 growing at 6% per year, $13 billion in fiscal year 2015-16.

It created a new economy in healthcare. Relationships and collaboration ruled the day. Cooperation reformed primary care for the first time since Confederation. Bureaucrats and physicians partied at the same events.

But every binge ends poorly. Liberal governments have a fierce and jealous love of debt. Ontario now has more of it than any sub-sovereign borrower in the world.

MD-Government Relations

The economy collapsed in 2008, the biggest slump since 1930. It happened just after Ontario signed a 4 year deal with doctors. The government was too weak to renege, even though it tried in 2011. So government took revenge in 2012 and has abused doctors ever since. It looks like the fights of 1970-2003.

Doctors need to refocus, start over with reaffirmed thinking.

New Perspective

• Do we want a physician services agreement or the freedom for physicians to serve?
• Should doctors focus on special programs or basic principles?
• Do doctors value partnership with government more than self respect?
• Are some things more important than getting ‘stability’ or a small raise?

New Process

• Are we best served by a small group of physicians negotiating on our behalf?
• Do we need a Buzz Hargrove to guide us?
• Do we need new blood with innovative thinking?
• How should our structure change to deliver different results?

New Presuppositions

• Do we believe government bureaucracy can ever manage healthcare?
• Is more government better?
• Are doctors the cause of all, or most of, the problems in healthcare, or are they the solution?
• Does the Canada Health Act give government the right to usurp control of healthcare?
• Should public administration refer only to the collection and distribution of taxes?
• Should the government provide oversight or micro management?

Fail Fast

A great leader said recently, “Fail fast.” Pay attention to performance and abandon losing strategies. Failure is inevitable. Repeating failure is not.

Doctors fought hard in the 60s and 70s. But after a few years of Medicare, doctors could not deny that universal everything is a really nice way to practice.

Until the money runs out. And be sure of this, doctors will get blamed as services and access decline.

Will doctors try to mend relationships and recreate the glow from ’04 and ’08, more of the same? Will we become the Toronto Maple Leafs of medicine?

photo credit: thestar.com

Experts need 10,000 hours to perfect a skill. We inherit talent but acquire mastery.

Conflict requires its own training. Some professionals spend years developing the art of rhetoric and debate.

Doctors spend years learning to avoid conflict. They work to help and serve, not to pick fights. Doctors see people at their weakest; prostrated patients looking for relief, not conquest.

Medical schools choose students bent on service. Schools stopped accepting students with nothing more than a great transcript 30 years ago. Modern interviews try to identify the most gentle and selfless. Patients love altruistic servants. But self sacrifice leaves the medical profession weak and defenceless.

Doctors have little clue about real self protection. Schools pound the fighting spirit out of students. By genetics and training, doctors prefer compromise over victory.

Doctors Trained to Surrender

David Esser MD asked whether we select doctors, and train them, to sacrifice and give in? He said:

How we select and train physicians puts them at a disadvantage when dealing with Government. 

It’s difficult to get into medical school. 

Only a select few are admitted. 

Those that get in are dedicated and hard working, ready to sacrifice time and income to train and learn. Docs spend many years training; always being available; getting a small income.

At work, we are trained to keep our wits about us and work through a crisis without getting worked up; patience and persistence. 

What we have learned and practice daily acts as a major barrier to physician action. 

Calm and Reasonable

Calm people can be scary. They often look placid right before they fly into a rage. Pacifists never learn to wrestle. By middle age, they have only two faces, calm and crazy.

Most doctors hate fighting. If government handles them well, doctors lose every battle just to avoid the fight. Physicians have never practiced engaging worthy opponents.

Government should still tread softly. Everyone has a breaking point.

Despite an almost complete lack of fighting spirit, some doctors insist that they would fight for something they believe in.

How about:

• Multiple cuts to medical funding for vulnerable patients?
• Or unilateral actions that target new graduates?

Maybe all medical schools should include 10,000 hours of training on how to fight government to prepare doctors for practice in Canada? If doctors cannot fight, we need to find someone who will do it for us.

 

Andre Picard is brilliant. After several decades of reporting on Canadian healthcare, he knows doctors shrivel at the slightest reprimand.

Doctors value respect. Accuse them of behaving shamefully and watch docs slink away, tails between their legs.

Picard scolded doctors for complaining about cuts and caps on healthcare spending. Grow up doctors. Stop talking about your income. You embarrass us with your entitlement. And one other thing, stop attacking Minister Hoskins on social media. You ought to know better.

Isn’t that precious? A journalist scolds doctors for talking about income.

Premier Wynne and Minister Hoskins misrepresented doctors’ incomes from their first declaration of war. All major media outlets delight to print physicians’ gross billings.

Granted, honest reporters bury an explanation about gross versus net billings in the unread darkness near the end of their columns. Like CPR 20 minutes after cardiac arrest, it’s too late. Readers got the intended wrong message in the first paragraph.

Be sure of this, doctors hate discussing income. They learned in grade school that achievement draws envy. Better to stay quiet.

But after months of repeating lies like “Physician’s average income is $360k” and “Doctors got a 61% raise,” doctors have had enough. They cannot look any worse by telling their side of the income story. So individual doctors have tried to correct glaring errors.

How entitled of them!

Mr. Picard also shamed doctors for picking on Minister Hoskins. Picard must have some egregious example in mind. If it was enough to warrant copy in a national newspaper, I hope it paled the sneering attacks and snide criticism journalists write about politicians every day.

Maybe doctors shared rude pictures? Perhaps they dared to attempt a political cartoon? You know, the ones media uses that make the most confident people question their self image?

Yes, Mr. Picard is brilliant. He knows the best way to douse the fire the Liberals sparked with their latest cuts to healthcare. He knows about the 11,000 members that sprang up on a Facebook page 2 weeks ago: Ontario MDs Concerned About Continued Funding Cuts.

He must try to settle doctors down. His favourite politicians are in trouble. Who knows what might happen if doctors upset the public with the truth? I guess we can’t blame him for trying.

photo credit: www.theglobeandmail.com