9 Steps to Deciding on Doctors’ New Deal

Owen and Darren CloseupDr. Darren Cargill offers 9 steps to evaluating Ontario Doctors’ New Deal in this guest post.

I want share a bit of tool I am using to help me decide how to vote on this tentative deal.

  1. Separate the deal from the Liberal Party. If this vote was a referendum on the Liberals, we would all vote “no, No, a thousand times NO!” We would never vote yes. Frankly, we would never accept a deal. The Liberal mismanagement of the province would prohibit us.
  1. Make it explicit who you are voting for. Is this vote for you, a group, for patients, for the future. Voting for you means, “How will this deal affect me, my family, my practice that I have built?” Voting for patients means, “How will this deal affect my ability to care for patients?” Same for a group with more focus on a particular area. Voting for the future means keeping your mind open to possibilities inherent in both the “Yes” and “No” votes.
  1. View both sides of an argument with a dispassionate mind. I had to do this recently with the MAiD arguments. When the SCC ruled on assisted dying in February 2015, I signed up for both sides of the debate via Twitter, email subscriptions, blogs. For those of you who simply can’t invest the time, follow a few opinion leaders on each side that you feel you can trust.
  1. Separate the deal from our ego. By this I mean we will never get a deal that properly values our training, expertise, dedication and commitment. At least not under the Canada Health Act.
  1. Separate the deal from a referendum on OMA leadership. A “No” vote will not bring about change at the top of the OMA nor change at the OMA in general. If you want to change the OMA, you can do this by running for an elected position, joining a committee, get involved. This is not a referendum on Dr. Walley’s leadership as president nor the role of the OMA as our representative. It might be a referendum on the Board as a whole, as they have recommended this deal but the Board is made up of elected officials and decisions by the Board are not unanimous in most cases but moved by majority vote.
  1. BATNA. This is a negotiating term. It stands for “Best Alternative to a Negotiated Agreement.” While most would say this is simply what is most likely to occur with a “No” vote, it goes deeper than this. What does a “No” vote mean for future deals? Is a better deal more or less likely? Is the government likely to move on issues like Binding Arbitration and a fixed PSB or have they been consistent in their refusal?
  1. Forget the ideal “deal.” It simply isn’t there. There is no deal that will reverse all previous cuts with interest, fund unlimited demand, find FT jobs for all our grads, fully fund all growth and population increases and magically fix relativity in a painless wave of a wand.
  1. Have a “goal” in mind. Don’t simply vote “no” and not have a deal in mind. “If you don’t know where you are going, any road will take you there.” If this ISN’T your deal, what is? Is it a higher rate of growth? Is it the reversal of cuts? Remember, there is no ideal “deal” so you can’t have them all. What is the one thing for you that this deal MUST have, if it isn’t there already?
  1. Treat each side with respect at all times. Vitriol and frank “trolling” diminish us as a whole.

I hope this helps. I’ve tried to keep it short and sweet so please excuse the brevity but I think we are all suffering from reading “War and Peace” every night.

Darren works as a palliative care doc in Windsor. He has been published many times in his local paper and plans to launch his own blog very soon. We will share his web address as soon as it goes live. When you see Darren, please bug him to write a book on palliative care!

Photo: Darren and Owen

39 thoughts on “9 Steps to Deciding on Doctors’ New Deal”

  1. For me it comes down to this;
    1) Setting the wrong precedent – agreeing to this deal means that forever in our history it will be seen that we were willing to accept sole responsibility for overrun healthcare budgets. After any win at getting binding arbitration, any arbitrator will look to recent history and that’s a precedent I don’t think we want.
    2) The devil of “modernizing” the Schedule of Benefits is in the details – the details can kill you and completely reverse any benefits outlined with the one-time payments and 2.5% sub-inflationary budget increases. We are told we have half the table in deciding this but frankly, as our experience with the LHINs shows, being at the table doesnt guarantee an outcome.
    3) We have traditionally been providers to the system, “co-management” makes us complicit and responsible for the system. Do we really want that?

    1. Ernest, do you see any positives in the deal?

      The government is broke and the Deb may be $350B in 2020. No our fault, clearly, but given their position, what would you want and be willing to offer in their shoes?

      If you can’t possibly contemplate a Freaky Friday scenario, imagine you are inherited this situation as a new government.

      1. They are only broke as far as physicians are concerned….not teacher, not police, not themselves. If they cannot afford funding health care on tax payers dollars find a better way of funding it other than on the backs of the providers.!!!

  2. It’s easier than 9 steps. It’s bad for patients worse for docs. And anything that will increase the chances of the liberals getting reelected is unthinkable. Vote no then stand behind OMA board to demand fair treatment. It’s not OMA fault we are being treated with disdain.

  3. Good analysis and very helpful. The issues relate to the vagueness of the agreement and lack of trust which has been eroded by the recent actions of a Government that should be honest with the public and inform them they cannot afford or deliver health care within the framework presented. It is not based on liking the OMA, Parties , people etc- the reality is there is lack of transparency of the economic crisis in Ontario as the root cause of having to ration healthcare, or deliver healthcare with doctors themselves subsidizing the true cost. This leads to manipulation and micromanagement which will be enforced in comanagement or independently by the MOH. By denying the reality of the crisis we are delaying the transparency of a declining system and by agreeing to co-manage on not deliver the metrics of expectations we will be complicit in deluding the public and be the fall guy for the Government mismanagement of the economic base and as a fall out the health care system.
    We are under an ethical and moral obligation to do our best within the capacity the system provides. As the system erodes further with an expectation of speeding access to care within 48 hours we are going into a significant trap that the Government can blame us for.
    They have mismanaged many programs and will offload blame to whoever is stupid enough to take it. By creating LHINS they will be immune from direct criticism for shortfalls in the system.
    The system will become lean with quality assurance outcomes and metrics to define reimbursment. The goal posts will be moved to ensure reimbursement can never be properly achieved. Performance outcomes will be the way to limit how we are paid. When the whole system develops inherent failures and demands from users are not limited the crisis is inevitable. There is no perfect agreement. We are not elected officials – we are providers of medical service and have to be paid for our work. If the bills submitted, that are reasonable and are not affordable by the Government are not reimbursed we will not be able to run an office overhead and be sustainable. We are not allowed to do a denial of service.
    Ultimately the services provided in toto will have to be reduced in a system that is no longer affordable. Rationing is inevitable. If you ran the system properly you would pay a package to have doctors leave the system- perhaps 2 years of annual billings and agree not to bill within Ontario thereafter. Utilization is 3 times more than other other equivalent jurisdictions.
    Health care has to be run as a business and if not affordable then copayment will be necessary and delisting of services. Testing has exploded in healthcare. We should not co manage the system – because we then become accountable for it’s inevitable failure. We need to be transparent to the public and like Concerned Doctors of Ontario have shown the reality of what is wrong with the funding model. Unless the economy improves- Fed transfers are set to decline we are heading towards tumultous times with or without an agreement. By agreeing we are going into bed with a Government that does not respect our autonomy we are destined to have more issues. Who will win in the modification of the LHIN legislation for our rights?
    Who will penalize us if we fail to see all patients who request to see us within 48 hours.
    Is this deal more directed at family physicians? It glosses over the fact high billers will be culled and billing profiles patterns will be scrutinized. It does not indicate what the ramifications will be. A lot of power will be handed over by the OMA to the MOH by “comanagement”.
    Ultimately whoever controls the money will dominate the comanagement model.
    Already they are taking a chunk away and adding a chunk. Basically we pay for the new funding arriving in the system. We have had a serious cut in pay already and either way more will come.
    Any fundamental changes in a crisis will precipitate a revolution – and the seismic shift is building within the membership. No political on message will now reverse this inevitability.
    Logical analysis in an era of outright disrespect will not work in appeasing the membership.
    We are delaying the inevitable if we accept this “deal” and will be exposed with consent to more grief than we already have had. Once we agree to it we have no recourse to reject impositions – equivalent to unilateral actions. The OMA our representatives will become the co-enforcers of rationed health care system. CoManagement should be termed CoEnforcement as a substitute for unilateral action , which will be far more odious, as we will do it to ourselves. Are you ready?
    We need to be more independent and autonomous in an era of fiscal austerity and demand payment for services rendered as self regulated professionals. Adding more layers of expectations via LHINS and terms of timing of delivery will be a huge issue of how we practice productively and is not defined by this “proposal”.

  4. First carefully measured words, now guest blog posts…Shawn is really stepping out of the limelight this week.

    I’ve already articulated my support for the deal, so there’s no point in cutting and pasting them here. I’m not even sure it’s worth putting thoughts on my own blog at this point, because I’m seeing rational arguments leading increasingly to people digging in their heels, rather than letting themselves be convinced.

    If I could make an observation that’s extremely worrisome, it’s that much of the opposition to the deal is accompanied by increasing signs of groupthink. There’s the general anger that in some instances is bubbling up into frenzied rants. At least one doctor quit the COD after being browbeaten for daring to think the deal was a net positive. We’re also seeing some of the OMA leadership answer all of the questions thrown at them, only to have the questioner and others turn around and dismiss the response with charges of spin/puppets/corruption, without scrutiny of the substance of the answers.

    It’s impossible to overstate how bad this is. Even setting aside the real issues of solidarity after the referendum and the hurt feelings that need redress, groupthink is the hallmark of disastrous decisions dating back to Classical Antiquity. Cooler heads *should* prevail, given how cerebral you need to be to get into medicine. I fear that is rapidly fading as a likely outcome. Ugly days ahead if I’m right.

    1. “If I could make an observation that’s extremely worrisome, it’s that much of the opposition to the deal is accompanied by increasing signs of groupthink. ”

      To call the myriad of opinions on COD Facebook “groupthink” is ridiculous. It seems that the “groupthink” epithet is much more applicable to the OMA’s pushing this agreement so strongly.

      “At least one doctor quit the COD after being browbeaten for daring to think the deal was a net positive.”

      I am not privy to the specific circumstances and while I have seen disagreements on Facebook, I have not seen personal attacks and nothing that I would remotely call browbeating. In a discussion, disagreeing even strongly, is not browbeating. What I have seen is strong disagreement and arguments on both sides with most of the posts urging a No vote. Disagreeing is not bullying.

      Most of those posting on Facebook are not directing anger at each other but at the OMA “insiders” for bullying members with dissenting opinions. There is a distinct feeling from those posting on Facebook that the OMA has not acted openly with its members; in fact, many of us are wondering why the OMA will not even allow COD access to the email addresses and fax numbers of our colleagues to get dissenting opinions out to the membership. Were Board Members who were not keen on the agreement allowed to tell members of this? Were Board Members forced to have their opinions hidden from the members via board solidarity rules? My feeling is that some Board Members would like to present a Minority Report with their misgivings over this agreement.

      “We’re also seeing some of the OMA leadership answer all of the questions thrown at them, only to have the questioner and others turn around and dismiss the response with charges of spin/puppets/corruption, without scrutiny of the substance of the answers.”

      How would you even know that the questioner has not scrutinized the answers? There have been numerous emails from the OMA and the President of the OMA promoting a Yes vote. The President of the OMA has posted her opinions and answered questions on the COD Facebook site. There has been a lot of scrutiny of the OMA answers and many of us are sceptical of what the answers.

      Those who honestly have reservations about the deal fear the consequences of this deal , not only for physicians but for patients as well, have been desperately trying to get out an opinion that is not the same as the OMA narrative. Is there place at the Road Shows for dissenting opinions? Cannot the answers of the OMA be disputed in front of an audience of members?

      Noam Chomsky said that “the smart way to keep people passive and obedient is to strictly limit the spectrum of acceptable opinion, but allow very lively debate within that spectrum.” The COD Facebook is not an echo chamber. There are diverse opinions there. Being offended is not being browbeaten.

      1. There are an awful lot of comments on the COD page that are pure vitriol. I haven’t seen personal attacks (apart from those directed at Eric Hoskins), but there’s enough “f**k the OMA” and aspersions on the OMA leaders on that site to cause worry that the normal rules of debate are falling by the wayside.

        And if Dr. Walley or Dr. Weir post answers to questions, only to see replies that include things like, “this is pure propaganda”, “this is the leadership betraying the members in cahoots with government”, you can label it special pleading, or moving the goalposts, or calling bulls**t. I see it as a sign of willful disinterest in the substance of the argument. If you’re not going to take an answer at face value, why ask the question?

        1. Well said, Dr. Warsh.
          I would add that Ontario’s health care bureaucrats have a role in shaping Government behavior, and the OMA’s “process” for representing members to OMA and representing OMA to members is flagged. I’m guessing as I make this point, but the tone of the comments does not indicate people feel represented or that they are willing to “delegate” the power to their representatives. “Trolling” is not a means that contributes to any useful societal “end.” I’d like to suggest we call each other “out of order” when someone makes a personal attack.

        1. I never agree with Chomsky but the strategy that he uses to suppress opinions differing from his own just seemed so appropriate to the current situation and discussions.

          I wish we could have heard the private discussions by the Board of Directors prior to sending it to the members. If any of the Directors disagreed with what was decided by the majority Board vote, then I wish they would present a Minority Report so that members could hear their concerns.

  5. “To avoid groupthink, it is vital for the group leader to become a statesperson or conductor instead of a partisan virtuoso.” The OMA if presenting a proposal from the MOH, that has actively disrespected the membership and will incite groupthink to protect the membership.
    When a threat appears groupthink will be a natural outcome to withstand the threat.
    Groupthink is not to be feared in this situation, but if it develops indicates the precipitants are severe and this is the natural response to remain cohesive. It can lead to uniform conclusions to deliver a strong message and diversity of opinion will be minimized in a crisis , not created by the members. Groupthink has strengths and weaknesses and if it disrespects members with divergent opinions it has become toxic. However not all Groupthink will cause this to happen.
    We have acted in groupthink fashion to accept bad agreements in the past – as cohesion is a desired outcome, even if it proves to be the wrong decision. The YES message has attempted to create a groupthink response to support the agreement by disarming the recipient into believing they are welcome to make an informed decision, when in fact the marketing message is telling them the deal is the best choice. The agreement and lack of Agreement has a visual presentation from the OMA to sway NO to YES with fear of the unknown- just released today.
    If you are sitting on the fence it would induce you to say YES. The NO message is not promoted whatsoever in the communication from the OMA and on balance groupthink dynamics because of lack of trust and betrayal will move the dominant group to NO. This is not irrational thinking
    but is be part if groupthink dynamics. But using the groupthink phraseology is a layer to make a person believe they are not making their own decision without undue influence.
    Most NO supporters are vocal because the voice of the silent majority who fear disruption of groupthink of the status quo OMA need to feel they are not irrational in seeing this deal as it is -fundamentally flawed.
    The NO side is not using groupthink tactics to get conformity , but the groupthink development is spontaneously arising because collectively a majority believe this is a bad deal, one baked by the MOH, no input from NAC and will be counterproductive in it’s form and content.
    The NO side healthy groupthink needs no incendiary or leader to incite , or rant. It is there and unstoppable. There is in reality no YES or NO – we are collectively vulnerable to a MOH with an agenda that is unstoppable without us defining who we are, and demanding autonomy and not co-managing an underfunded system. The OMA is a stronger organization if the NO vote has a majority. In life it is harder to say NO than YES to any proposal. It takes courage and I admire those who can openly say NO to this agreement when the expected de facto groupthink machine was rolled out. The chance of a YES vote being achieved will paradoxically be less like the more it is desired by the OMA. So from a strategy point of view neutrality in reality would reduce inciting groupthink reaction to become NO.
    The OMA is transmitting psychologically the message of the oppressor -the MOH and that is why groupthink NO grows- classical “shoot the messenger” and this is not readily reversible. The OMA has to allow the message of rejection to be transmitted back to the MOH without dilution, so the OMA as representatives will regain the trust of the membership and this would be the best outcome of this debacle. In reality no statement on endorsement of any proposal should be done without all members voting. This would be the best empowerment of the membership. The structure and process needs to be revamped to avoid the scenario we currently have. The MOH precipitated the agreement to be ratified at board level to allow it to be released. This is unacceptable and demonstrates the relentless desire to control our ability to negotiate a real agreement with clarity of all aspects.
    There is far more on message focused broadcasts of the OMA communication and if you observe rants that indicates the diversity within the NO groupthink this is healthier than the YES side that exerts consistent groupthink YES on topic, but cannot be passionate because there is nothing to be passionate about on the YES perspective. This is the sad reality that frustrates the YES group.
    Groupthink may save us this time paradoxically!

    Read more: http://www.referenceforbusiness.com/small/Eq-Inc/Groupthink.html#ixzz4Ev5cLRfR

  6. One doctor quit COD? Thousands of doctors want to leave the OMA.
    I would argue that the public pressure brought to bear by COD on the MOH led to the MOH wanting a deal that gets the MOH off the hook for responsibility of fully funding medical care in Ontario, or exploring other options as to how to pay for medical care, as the current system is unsustainable. COD advocates for and defends ALL Ontario MDs, something the OMA has not done for years. It was the PR campaigns of some specialty groups 4 years ago, that led to a “deal”, yet those groups were most affected by the OMA “modernization” of the fees schedule.

    The OMA’s appeasement over the last 30 years has brought us to this sorry point at which the OMA says 1)it’s a good deal to underfund medical care in Ontario, and, 2)Ontario MDs need to shoulder the cost of utilization over 2.5% or 3.1% which ever number you believe. OR ELSE… it will be worse if ON MDs don’t agree. Our own organization is using scare tactics to get the result it wants, rather promoting the tPSA on its merits, which are lacking.

    The reality is MDs can’t control increase in utilization which has gone up every year for years, even if we practice according to some hypothetical perfection and, patients will still suffer and die waiting for life altering/life saving treatments due to underfunding of the current system.

    If your work depends on a properly functioning hospital, you know that closed ORs, lack of nurses and beds, seriously curtails your ability to provide medical care and earn a living. Maybe that’s why the number of specialist groups recommending a NO vote is growing. Family doctors in my area are voting NO

    Keep in mind the public’s perception and point of view. Doctors support the cuts and agree to more of them, or, doctors are standing up against underfunding.

    Enough is enough. This time vote NO

    1. Pam, I wanted to make your comment about the option to leave COD vs those who cannot leave the OMA. You beat me to it. Good for you.

      1. Hey, I’d happily leave the OMA if they wouldn’t just take the money anyway. Might as well get the car rental discount and CMAJ Holiday Special.

        With regards to people quitting the COD board, I pointed it out as a sign to reflect on tone, not the significance of one person’s vote either way. If people no longer feel that their opinion will be respected, it’s no longer a forum for discussion.

  7. Where was the negotiation? At least one member of the OMAs negotiating committee has come forward to state this 6 page document was presented to them and there was no negotiation.

    So what we have is the government dictating the terms and the OMA acting as their lap dogs.

    We continue to be abused by this government and what is proposed is yet another death nail to our professional autonomy.

    Here is another question to ask, is this deal consistent with what MDs in other provinces would accept?

    It’s time Ontario MDs wake up and take charge of their futures. The OMA leadership has time and again proven themselves out of step. This debacle is the latest example.

    1. Hi Deron,

      I think the challenge of comparing this deal to other provinces is circumstances. No other province has this government, this level of debt. While we didn’t create the circumstances, we live in them.
      If we don’t like them, we can move, get involved, or vote in a new government in 2018.

      Thanks for your comments.

  8. Seems to me that most of the nine steps are about giving up and giving in. Forget about wanting and demanding more or better for our patients and ourselves; just accept what is offered and be grateful. As physicians, we should rise above such discussions…

    Then, there is the usual insult to all of us in the opposing camp, that we are unable to formulate our own thoughts and must rely on group think to make decisions. One wonders how do we practice medicine every day with such limited intellectual abilities.

    I could tolerate reading/discussing opposing views to my own if the preamble did not usually begin with accusations of cyber bullying, absence of dispassionate discourse, and spreading misleading information. Unfortunately, I do not believe that any of those supporting the tPSA of 2016 are any holier than myself.

    Most of what I have read opposing this deal point to the weaknesses in this contract. There have been many reminders about previous PSA deals that turned out very poorly for the profession indeed. Supporters of this current deal have not even attempted to respond to those most valid concerns, which is most alarming. If we have not learnt from our previous mistakes, then we are doomed to repeat them.

    The option to try to participate in town halls or attend road shows is not feasible to everyone who needs to share their view points or have questions heard. There is no other option than to turn to social media. I have yet to receive a return email from the president of the OMA.

    1. “Groupthink” is by no means a charge that doctors are incapable of making their own decisions. The issue is that people arguing for the deal (that are by far in the minority on the COD Facebook site) are not seeing their arguments debated to completion. Conversely, the people opposed to the deal, however passionate, haven’t entirely made the case that as a long-term strategy rejecting the deal makes sense.

      *Nobody* is disputing that doctors are getting the shaft on this. Nobody is disputing that doctors haven’t gotten a raw deal in the past. I honestly feel for the docs just trying to keep their offices running with less and less money, and the specialists being named-and-shamed for doing their jobs and getting paid. But the point is, dissenting opinion needs to be invited and discussed. The OMA leadership, to its credit, is on that Facebook page each day facing fire, as well as doing however many town halls. I’m just not certain that their comments are being taken at face value.

      For the record, I’m not on any OMA Council, Board, or committee, nor do I have any intention of running for such a position. I personally think someone in the OMA leadership should probably “fall on their sword” over the deal, whether or not it’s ratified, but that’s not germane to the conversation. You will not find anybody in the province more cynical or crass about government and health care institutions. But proper debate is necessary to reach a consensus decision.

      1. What long term strategy would make sense to you? NO means we’ve had enough and we’re not going to be complicit in the continued underfunding of medical care in Ontario which has led to clinics closing, waits getting longer, and people are denied life altering and life saving treatments

        1. Agreeing to the contract is not any kind of endorsement of the cuts or underfunding, and the public really won’t care after a few days. You can agree to a suboptimal deal and continue to decry the cuts. Moreover, accepting the deal isn’t being complicit, because the OMA wins a permanent committee to help decide how money is allocated or de-allocated to health care. Voting no might be the more noble decision, or the right decision based on principle, but I can’t see how it makes much business sense. Maybe I’m wrong, but is that a chance you want to take? Is 2.5% vs. 1.25% really the hill you want to die on?

          How do I answer the charge from a member of the public that clinic closures are the fault of the OMA for playing along with the government? I say, “The government was threatening to cut more than $1 billion to health care services, which would mean even longer waits and more doctors’ offices closing. They also planned on siccing their LHIN puppets on doctors to create more red tape getting in the way of primary care. I voted yes on a deal that would result in less cuts, keep the useless pencil pushers out of doctors’ faces, and would ensure that doctors get a say in how the government spends your tax dollars on health care.”

          What makes sense to me? Take the deal as the lesser of two evils, because there really is no solid alternative put forth by the membership. Damping down the anger and anxiety over cuts will go a long way towards doing the work that needs to be done. Reform whatever processes and by-laws needed in the OMA so the membership never need feel like it was sold out. If the leadership of the OMA won’t make changes, change the leadership of the OMA. Overhaul the OMA’s internal structure so there’s no more threats from individual sections to take their ball and go home if they don’t get what they want.

          OMA legal counsel has advised that the case for arbitration is strong, but the case for getting the money back lousy. So see the arbitration case through. Assuming you win, it’s there in your pocket for future negotiations, the soonest being 2020. By then, even if the government is the same, the Minister of Health will almost certainly be someone else, and very likely the DM as well. Hire the most aggressive, rat-bastard negotiators out there with the 70 million the OMA siphons each year, instead of the pointless ad campaigns that do nothing.

        2. Honestly, a hybrid system.

          Every OCED system ranked ahead and us has a mix of private and public.

          Robust public system offers medically necessary care while private system helps t subsidize and/or take pressure off public service when needed.

          We fear the term “private” because all we think of is the US Health Industrial Complex. But Europe and Commonwealth is full of much better examples.

      2. Interesting that you are not suggesting the proponents and supporters of the tPSA suffer from groupthink; that is left solely for the opponents of the deal.

        I still prefer no deal in the short term than a poor deal in the longer term, not to mention what this PSA implies for future negotiations as a starting point.

        So, if nobody is disputing that physicians are getting the shaft, why would you expect the majority to submit to it, because that is exactly what is being promoted, submitting to getting shafted again.

        As someone else has pointed out, the devil is in the details…the lack of which engenders much concern to many of us. How much worse can it get…a yes vote will let us find out at the hands of the government and the OMA together.

        1. If I saw evidence on groupthink on the part of proponents of the deal, I’d be the first one to call it out. The OMA leadership toeing the party line isn’t groupthink, it’s their mandated duty as a Board and Executive. I give them credit for holding however many meetings and fielding as many questions as they are. Most negotiations I’ve seen don’t entail nearly as much engagement on the final say.

          If you vote no, okay. You’ve made a decision. I respect it wholeheartedly. As they say, just because you’re right doesn’t mean I’m wrong.

          Why would I support doctors getting the shaft? I don’t. But I don’t see this vote being about whether or not doctors are getting shafted…it’s a vote on the size of the shaft.

          1. Frank, we do agree that there are pluses and minuses. We vote as we see fit.

            It appears that we cannot reconcile our differences with regard to the word groupthink. You cannot even know if there is groupthink within the the Board as you are not privy to their discussions. The Board Members are elected so who exactly makes the party line?How can members vote for representatives if we do not even know how they have voted on issues we care about?

            In any case, a Minority Report by Board Members should and could be made.

      3. “The issue is that people arguing for the deal (that are by far in the minority on the COD Facebook site) are not seeing their arguments debated to completion.”

        Dr. Weir and Dr. Walley have answered questions, made points and thanked for their coming onto the Facebook site to voice their opinions. No one on the Facebook Group appears to have the ability to censor posts so arguing to completion is possible. I do agree that insults and ad hominem arguments don’t add useful information; in fact, I believe they distract from and weaken your arguments. When someone calls me names during a debate I know that I have won the argument and smile.

        Your opinion that “the people opposed to the deal, however passionate, haven’t entirely made the case that as a long-term strategy rejecting the deal makes sense,” may well be true. By the same token, the OMA has also not entirely made their case. No one knows what the OMA and government will do after a No vote so details of the next steps are difficult to make.

        Vitriol is not my style but I truly don’t much of it on the Facebook posts. I accept your not being happy with the tone of some people.

    2. Hi,

      I don’t believe this was meant as an exercise in surrender. Rather, I was hoping it would help undecided MDs.
      Those who are firmly yes or no are unlikely to flip at this time. There are plenty of good analyses and opinion pieces out there on both sides so I didn’t see the point in simply repeating one or the other.

      This was simply my way of contributing to the process. Some will find it helpful, others not.

  9. Thanks to everyone for offering content!

    I apologize for the delay in responding to comments. I’m leaving the first responses for the author, Dr. Darren Cargill. He has promised to jump in later today.

    Thanks again,

    Shawn

  10. To increase the chances of a fair vote, the OMA needs to allow the dissenters access to emails and faxes of the membership and funds to campaign (from our money). The one sided show smells. So even without hearing the facts, I will vote NO.

    1. Thanks Deepa!

      Many people agree that we could use more balance. Some believe the messaging needs to be even stronger! I hope every doctor takes the time to dig in and make an informed decision.

      Cheers

      Shawn

  11. Darren, your points are very good and especially useful to the undecided just as you have said. Thank you.

    1. Thanks Gerry. That was was target audience. Many in the Yes and No camps have made up their minds. I wa to help the undecided.

  12. ” What is the one thing for you that this deal MUST have, if it isn’t there already?”

    Binding arbitration and input from the full OMA negotiation team would be a start.

    This was the impression that OMA council members were left with. Then democracy apparently went on summer break.

    RM

    1. Hi Rob,

      I worry that if BA was written into a PSA, it could simply be legislated away in the future like Nova Scotia.

      A Supreme Court ruling is much hard to ignore.

      But your point is well taken. I think this was a compromise.

      OMA wanted to continue CC. Government didn’t want black mark of “unconstitutional behaviour” on its record.

      Thanks for the comments.

    1. I’ve seen the petition and signed it. I support a process that leads to further engagement and more fruitful discussions. Although the timeframe to decide this vote is typical for other PSAs, this is not a typical PSA.

      Thanks for posting.

Comments are closed.