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.

We need to show that we can ratify a deal. For this, we need members’ support. Support is based on trust.

So, we need more than an agreement. We need: Trust, Unity, Excellence.

Trust

The OMA is nothing without members’ support. How can we win their trust and support?

To build trust, we must tell the truth, in everything, always. People know that healthcare has problems. When an 80 year old spends 20 days in a TV room, and when we hear dozens of other stories like it, people know there are problems.

We must find a way to tell the truth about healthcare, but with gentleness. We do not need to be rude or cruel.

In the same way that we are completely honest with our patients; we tell them bad news, all of it. We must tell the truth about healthcare.

But just like we talk with our patients, we need to share bad news with compassion and gentleness.

And just like with our patients, we need to offer hope. We need to offer solutions. We need to commit to stick with problems until we see them solved. We must not abandon them.

Winston Churchill said,

The truth is incontrovertible. Malice may attack it, ignorance may deride it, but in the end, there it is.”

We must tell the truth and stop sugarcoating it. It’s the first step in building trust.

Truth means transparency. We need to favour transparency over sharing knowledge only “On a need to know basis”.

Of course, there are times when we cannot tell every little detail about everything. People get that. We do that in our own homes, with our partners, in our families. But given the choice between transparency and ‘managing the messages’, we must err on the side of transparency.

There are other ways to build trust.

People trust us, when we trust them. We need to trust our members. They are the experts. They know their jobs. We need to serve them. The majority of doctors are good people. We need to find a way to listen to them, to serve them.

We must follow through on our commitments.

We need to build relationship. And not just so that we can get people to think and act they way we think that they should. No. We need to build relationship first, for its own sake. People will never change their mind or their behaviour unless we’ve built relationship first.

We must avoid cliques and favoured candidates.

We must give away power. We are here to serve members.

Unity

The next priority is to rebuild unity.

We often talk about us all being MDs, or say that, “We are all in this together.” Those are nice things to say in good times. They are almost useless right now.

We must build a profound unity that starts by addressing our fundamental differences and building a true partnership from there.

Think of the biggest problem—the biggest division—that comes to mind when you think about healthcare: for example, tensions between rural and urban; distribution of doctors; relativity.

Too many times, we jump to a solution to “fix” these problems. We rush to find a great technical solution. We survey the members and use evidence-based decision-making… and the solution fails.

We cannot fix problems with only great solutions. We need more. We need leadership, project management, plus a great technical solution.

If I try a great idea in my hospital, say, I close my waiting room; it will fail without great project management and great leadership.

Too often at the OMA, we have focused on great technical solutions, without placing as much emphasis on the management and leadership required.

Leadership might not completely solve our toughest problems, but it will certainly move us further towards a better solution.

So, what do I mean by a ‘true partnership’?

These ideas come from Peter Block’s work. He suggests that partnership must start with an exchange of purpose. Before we build a solution, we must partner together to decide what it is that we even want to discuss.

Partnership requires total honesty. We cannot hold information back because we worry that the other person will use it against us later. We need transparency.

Partnerships give each other the right to say No; especially the weaker partner. When big sections work with smaller sections, we must give the smaller section the equal right to say No, in a partnership.

Partnership means joint accountability. We both own the outcome.

It means no abdication. Neither of us can walk away when we do not like how things are going.

Excellence

Finally, we must demand excellence… And excellence starts with the Board.

We’ve already seen change at the Board. A major governance retreat and training session is booked for next week. We have new Board Directors.

Excellence requires even more than that.

We must empower our CEO. We have great staff. We have a great CEO. We must empower them, and then get out of the way!

We need to let them do what they are good at…. And keep them accountable if they mess up.

But we spend far too much time doing what they should do. If we jump in and make changes to everything they are doing, it will not help. It will make things worse. We will mess it up. It will create chaos.

We must figure out what our role is, here at council. We must understand what the Board is supposed to do. We need to know how our role is different—very different—from staff. And we need to empower staff and let them do their job.

Hope

These are exciting times. Many people have said how we are in the midst of major change.

In every change or crisis, people experience it differently. I want to share something by Dickens, from The Tale of Two Cities:

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair.”

Many of our long time members, who have served the association for years, are not hear today.

For them, this is a winter of despair. They sacrificed their jobs, their careers, to serve the members.

For whatever reason, they got caught in a crisis, a crisis in healthcare. Their careers have been changed forever. Just like we have many new members to council today. You have new careers in medical politics. Your lives have been changed.

So too, many who are not here today have had their career paths changed, too.

We are filled with hope. We are excited about change. We want to forget the old and move on with the new. But not everything behind us is bad. We need to find a way to remember what is good about the past, what good things those before us have done.

Dickens set his story during the French Revolution. He talked about London and Paris. He contrasted hope and despair. For some, it was a time of hope, for others, a time of despair.

We need to ask ourselves: What will we choose now? Will we choose hope, or despair? Will be embrace unity? Excellence?

This is up to us. You are here. You want this. We can rebuild a better OMA: one that will be better next year and better the year after that.

Now let’s get to work, together.

Thank you.

 

 

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8 Replies to “First Address to Council”

  1. Congratulations on your election. There are so many of us who have been given hope by reading your blogs and have secretly wished that one day the OMA will be led by you. That day has come and along with that comes hope for the profession at long last. The previous OMA leadership seemed to completely forget that they were dealing with the government, an organization that has their own agenda and uses the media to achieve their end game. As you well know they will lie, cheat, deceive, obfuscate, and then stab you on the back. But that is what the government is supposed to do. The major failing has always been the OMA leadership seldom if ever in the recent years to step and confront the biggest bully’s lies in a vigorous push-back manner to counter the numerous lies spewed and by doing so defend the honour of the profession. The unintended consequences of the failure of the previous OMA leadership is the Stockholm Syndrome. Many colleagues have grown weary and have given up and practice “why bother” medicine instead of “giving a damn” and being there for the patients. I cannot find myself willing to criticize them but I understand why they do so. It is my wish to see that the new OMA under yours and Nadia’s and the “New” OMA will be able to effect changes that will rejuvenate the profession. When we as physicians have an 80% rate of encouraging our children to join us in this noble profession (instead of the reverse trend), that is the sign that the OMA has been successful. All the very best.

  2. I missed the first part of this speech.

    This is an incredibly unique speech of depth.

    A one year time period as President insufficient to deliver. We need a President staying on for 2 years.

    We need though substance behind the style, and hope for discrete deliverables from the OMA.

    Honesty requires that we recognize that physicians will face declining incomes as long as it is illegal to source income outside OHIP, understandably because governments have limited budgets and taxation is at an all-time high.

    Furthermore, giving us the ability to bill outside OHIP provides permanent leverage against a ruthless dictatorial government such as that of Eric Hoskins.

    Even the expert the OMA had for the Adam Linton lunch recognized a unique unseasonable rigidity of our system, outlawing forms of privat care.

    In any case, the evidence is that the best performing health care systems in the world, such as the Netherlands, allow private payment, and also protect the poor.

    Barriers to system reform include media, specifically the Toronto Star and, many times, the Globe and Mail, zealously activist health care providers, who dismiss the evidence in favour of ideological rigidity, and government elected Ministers of Health, both Federally and Provincially, who will play to their electorate, over doing what is right and what is honest.

    Honesty also requires that we acknowledge that making private care illegal, forces us to increasingly ration care, delay the arrival of novel evidence-based therapies and diagnostics, and have government dictate to people about choice for they care of their own bodies.

  3. Congratulations. Excellent thoughts clearly expressed. It will take much courage, humility, perseverance and wisdom to see this through. Thank you for being willing to take it on.

  4. Shawn, congratulations again. I see that there are many who are expecting you to fix everything that they see wrong with the OMA and the Healthcare System. Each of us sees things from our own perspective and may not see that some of the diverse wishes are actually mutually exclusive.

    You have asked for input from others and you are starting to get it. My suggestion is that you listen to all these suggestions, make a list and then put together your plan from the suggestions and what you have learned from your years of experience. You will not be able to please everyone but I know that you will do your best to make things better for physicians and patients. Take your time, make your plan and move forward.

    Most of my comments are directly mainly at those making the suggestions. Having known you for five years now, I have little doubt that you knew all this already.

  5. Shawn, kindly pay attention to what is happening in Manitoba. The article is in the Medical Post. An excerpt for you especially:
    “Dr. Chiu didn’t seem entirely opposed to finding some savings from physician pay but maintained that it was only appropriate to do so within the context of official negotiations—something that now seems impossible with the introduction of a law known as the Public Services Sustainability Act.

    Also known as Bill 28, the legislation freezes pay on all public sector employees in the two years after their current contract expires. It then limits any increases to their funding in the two years after that to 0.75% and 1%, respectively. For physicians, the new law will come into effect when their contract expires in 2019.

    Manitoba physicians have enjoyed binding arbitration since 1995 but in the event that they can’t reach a new contract with government, an arbitrator won’t be able to award them any increases until 2021, and even then, nothing above the rates specified by the law. The legislation would supersede any arbitration ruling.”

    http://www.canadianhealthcarenetwork.ca/physicians/news/manitoba-doctors-try-to-steady-the-ship-as-relations-with-government-grow-turbulent-49746#comment-17119

    1. “No man’s life, liberty or property are safe while the Legislature is in session.” Gideon Tucker 1866

      BUT physicians always the Nuclear Option: Sanctions

  6. What a fantastic speech. Truly inspiring. In particular, your emphasis on truth and transparency speaks to me as that has always been my own style in life and work.

    I agree with others who have suggested that a one year term for the presidency is not sufficient. I feel at least two and perhaps three years would be more appropriate.

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