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
Well said. Thanks.
A good defence is offence.
Mr. Picard did a good job for his master but we have to fight on.
Well said, Michael. Doctors must not lose steam in this battle.
Excellent response to Mr. Picard’s article. I doubt it would serve to make doctors “settle down”. Made me furious. Just a little more feedback – I am getting more and more responses from FB friends on the doctors on call posts (I share all of them). And tonight a friend posted one that they had initiated from the doctors’ FB page that I had not seen yet. It felt like a small “victory” of sorts for me, after weeks and weeks of posting with little response. But it is finally starting to happen. Even on twitter people start to follow me based on the stories that doctors are so generously sharing with the public. I truly think many people just were not aware of so much and they have been subjected to a lot of smoke and mirrors, double speak and outright lies. Of course there are still the naysayers and there always will be. I think too that doctors sharing their stories in a very important way lets people know that doctors are human too – they have lives outside of their professions, kids, spouses, friends, family. Intelligent, thinking people can put two and two together to realize that many doctors (and their families) make monumental personal sacrifices for their patients. I doubt they can think of any other profession that requires such dedication and commitment. I am surprised that Mr. Picard, being an intelligent, thinking person, did not temper his “scolding” with an acknowledgment of these sacrifices and what has led to doctors finally speaking out, and trying to get the truth across to the public. It would not surprise me if this backfired on him. Not that it will matter much, but I lost a lot of respect for him with that article.
Thanks for that, Shawn.
Frankly, I respect Andre Picard’s health issue knowledge a lot. I have read his articles and watched him on tv. He does know his stuff. I am not sure that he has any ax to grind. I think he just believes what he says.
He can read a lot but he can’t literally go through all the stats and check the data for himself. Where does he get his information? He gets them from government releases and other media I suppose. If the government keeps repeating the same lies and equivocations and no one like the OMA refutes this, why would he not think the information he reads is incorrect.
I see the things the government says about our billings, expenses, earnings etc but they don’t make sense to me. For an honest reporter or opinion writer, what other information does he have to go on?
Well said, Gerry. I respect him too and value his input into all things healthcare.
Regardless of his desire to do it, I found his scolding unhelpful and condescending.
As always, great comments!
Thanks again, Shawn
Reporters prefer to call themselves “investigative journalists” ~~ Their mandate is more typically to unearth information to present. This regurgitation of political propaganda while touched with a small element of truth is not reporting.
Agree, they tread a very fine line. Generally, this journalist does a very good job. It must be tough trying to get an accurate sense of an industry without working inside it. Having said that, I felt this most recent article tried to put out the fire that’s raging against the Liberal cuts, which fits with your points.
Thanks so much for taking time to read and comment!
Cheers
Shawn
As someone wisely said : “a lie told often enough becomes the truth”
Thank you Shawn and Ontario doctors for speaking the truth to open patient’s eyes about government spin and lies
“A lie told often enough…” Very wise and applicable to this fight. Thanks for reading and sharing it! Best, Shawn
Thank you for such an encouraging comment, Valerie!
This wave of change in opinion makes politicians panic. This might make them decide to talk with doctors instead of slashing spending on medical services. Patients need to know there’s some stability.
I really appreciate you acknowledging that doctors are people. After months of slander, cuts and otherwise getting blamed for all that ails healthcare, they have started to cry out.
Thanks for all you do, Valerie! Truly awesome.
Warm regards,
Shawn
The first rule of politics on social media: you can only lose votes on social media, you will not gain them. Say bland positive stuff, and do not feed the trolls, you will embarrass yourself. This is exactly what has happened, and individuals like Picard who was initially dubious of the argument that docs are paid too much are now turning against those docs. His article was right on the money, even if the headline writer was overly inflammatory. People should have taked his column as free PR advice, instead they added him to the hitlist with Wynn, Hoskins, the OMA, and Justin Trudeau (who despite being not involved in his at all, has still been dragged in by the social media neophytes). Picard went from being relative to docs, to writing a somehow at negative be article, to being outright hostile towards docs on Twitter. Rather than learn from the exchange, some are taking a victory lap. Words were exchanged, and the “setting things straight” argument got out. The fact is, some people might be responding to some of these social media posts. But that is truly a Pyrrhic victory.
Wise comments, Raj.
I’ll push back a little. Doctors are people too. We’ve been attacked mercilessly and responded calmly for 8 months. Finally, our patience ran out. This is harming patient access, doctors can no longer do more with less and it’s not fair to patients or doctors. Revolutions get messy after polite discourse fails.
Wynne started this, not doctors. I expect they’ve sparked something that won’t be easy to put out.
Thanks so much for taking time to write! Readers love the comments and want to see the balance that you offer….keep them coming!
Highest regards,
Shawn
I have been reading these posts and blogs for the last few weeks with great interest. It’s high time we realize that the elephant in the room cannot be ignored any longer. I am a specialist pediatrician in full-time practice for over ten years, and I routinely learn of new medicine grads walking into adult medicine jobs that pay them double or triple what I earn after expenses. I work hard. I bill fairly but aggressively. I get NO money to teach residents and students, NO money to be on call, and despite the ridiculous income disparity that exists, I will not refuse to see a refugee claimant without OHIP, nor do anything that will make patients suffer more than they already do in this broken system of “free” Canadian health care.
While we are all over social media raging against the Liberal machine, maybe we should spend some time addressing things like the letter I read in the Peterborough newspaper where a Canadian veteran writes that his cardiologist recently informed him that he will no longer be able to see him because of the “cuts”, and that he will need to go back to his GP for his cardiac follow up.
It’s high time that we start to acknowledge the big picture. Not everything we do in our job will be “worth it”. But if you are taking home well over half a million dollars in a socialized health care system, and (hopefully) doing a job you love and enjoy, while making 7-10 times what the average well-paid full-time non-physician employee makes, and double or triple what an ER doc, pediatrician or other underpaid specialist makes, maybe things are not as bad as they seem.
Maybe that veteran deserves a “free” visit in the meantime.
I am not saying that the scenario outlined above reflects the attitude of all (or even most) doctors, but while we are busy laying claim to the moral high ground in this fight, maybe we need to do a bit more to acknowledge that our argument is not as uniform and strong as we want it to be.
I see the value in staying united to strengthen our voice at the (currently non-existent) negotiation table, but ultimately my “fight” is not the same as a specialist who brings home $500,000-$750,000, no matter how much I try to pretend we are both fighting for the same thing.
Thanks for taking time to write such a thoughtful comment about a critical issue(s), Paul!
Relativity does more to undermine a functioning system than we care to admit. We need to address it. We cannot expects others to do it for us with legislation.
While I agree with your comments about patient you mention, I’d be very careful adjudicating without hearing the other side. Maybe the doctor has so many other sicker veterans that he/she cannot safely continue caring for the one in the article?
Again, you’ve offered some great comments to spark discussion. I know they will get 100s of people thinking as they read through. Thank you for taking time to share them!
Best regards,
Shawn
Of course there are two sides to every patient account of how a doctor treated them. That is a fair comment. Having said that I am not sure your spin on it is any more likely than the letter writer’s version. I doubt that there is a sudden surge in the number of elderly veterans needing cardiology consultation in the Kawarthas. It just seems unlikely that this turn of events could have eerily coincided with the timing of huge cuts to Ontario physician billings.
Agree. I just cringe at passing any judgement without hearing the other side. After years of reviewing complaints that make you say, “How could they be so stupid!?” I’ve been proved wrong over and over.
Either way, I sure appreciate you taking time to comment! Awesome. I love the pushback, too!
Have a great day,
Shawn
Paul, relativity is a different issue. Infighting by doctors for the pie is one of the major reasons the government has been able to divide and conquer. Comparing fees and incomes among specialities and individual practices is next to impossible tondo properly.
http://healthydebate.ca/opinions/is-the-oma-an-appropriate-vehicle-for-negotiating-doctors-fees
You do not know ins and outs of other specialists’ incomes. For one specific doctor to do something immoral but not illegal, is not a fee issue.
Gerry
I’ve got to pile on here. We ignore Picard at our own peril. We cannot simply listen to the comments that say what we think, and ignore the comments that are contrary to what we think. Like it or not, his column is a fair assessment of public reaction to doctor’s social media campaign to date. I don’t buy the idea that Picard is trying to appease his political masters. I see no evidence of this in his past work. Remember his key message is that if we make this about our fees, we lose. If we make it about fair treatment, we can win. Remember your previous post about physicians and their blind spots Shawn!
Hello Jon! Great to have you share a comment…I’m always smarter having heard what you think.
You make an excellent point that fades without repeating. Talk about incomes turns people off. Especially in your corner of Ontario, people have no appetite for anyone earning “Toronto incomes”. (My parents are visiting now from Thunder Bay.)
I’ll push back on one comment you made. I’m not sure we even win if we talk about fairness, as you suggest. I think very few people care about fairness for doctors. But everyone cares about access to care.
At this point, the Globe’s entitlement article tried to put a wet blanket on doctors’ recent enthusiasm to fight back. I felt the weight of it all day. Then I said, “Wait a second. This is wrong. Finally we have doctors mobilized to get the government talking and finding solutions.”
I see the end as getting government to fulfill their promise to fund medical services in Ontario. At this point, we need to use every means possible to do so. Each day further erodes the system for vulnerable patients. Whatever we try will be messy.
Thanks SO much for taking time to read and share your thoughts. As you know, readers love the comments especially.
Kind regards,
Shawn
Hi Shawn, As you know I have been following along your blog for a long time, but naturally like to keep my commentary to under 140 characters! However, I just had to commend you on this post because this is how I felt when I read that Picard article. I don’t see how doctors expressing their opinions on what clearly even Picard acknowledges is unfair treatment is entitlement. I think the bottom line is that doctors do have a right to a fair income and if that is entitlement so be it. I know the public is never going to see if that way, but you and I both know how much it takes to become a doctor. Why shouldn’t a doctor make a fair income after spending upwards of 12 years in post secondary education with significant debt? The training is taxing, no one can deny that, but I guess we know the public don’t care. They do not understand the opportunity cost of being a physician. Friends my age have been working for years, while I am only starting to make an income. You hit the point exactly when you say achievement draws envy. It’s a shame that we can’t think we deserve to be fairly compensated without being called entitled.
Keep up the great work!
I sure appreciate you taking time to write that, Christine!
You make a solid point. For doctors in the darkest hours of debt load and looming qualifying exams, it must feel especially demoralizing to be treated so poorly by government.
Meritocracy used to encourage excellence and effort. These days, egalitarian voices slander effort as greed, excellence as illusory and merit as immoral. “Everyone has won, and all must have prizes!” said the Dodo bird in Alice in Wonderland.
Keep speaking up. It’s terribly nerve wracking to open ourselves up to criticism and disdain by voicing opinion. But it’s the only way to influence change.
I sure appreciate you taking time to read, consider and comment! You make the post so much better by adding your thoughts!
Kind regards,
Shawn
I don’t believe that appealing to fairness will win anything for us in the end. Why? Because fairness is a relative term. It is in the eye of the beholder. That doesn’t mean we shouldn’t mention it but don’t expect it to win this battle with the government.
Gerry
Well said, Gerry. I think many people assume we’ve got not fight and no hope of winning. So at least we can protect our Milquetoast image. I’d rather go down fighting.
Yes, we have simply got to lay down and accept what the Ministry deems acceptable and thats OK. – How about NO means NO!!… We will not be raped by the Ministry and vilified by the media for complaining. There is a fair, reasonable and respectful way of negotiating and there is disrespectful, high-handed violation. Which would you prefer ??…
Well said, Rob. Well said indeed! How dare you speak up when bullied. How entitled. We’d love to have respectful cooperation. Wynne threw that out long ago.
Best regards,
Shawn
I found this via Andre’s FB posting. I was involved in the fight for access to billing numbers in BC in 1987-88. The interns and residents association was leading the public battle which was focussed on the unfairness of the system to new docs. While this was true, it was perceived as whining by the entitled and gained no traction with the public. Government was happily winning the public’s support or acquiescence with this approach. The association was challenging the government in court at the same time and was expecting that a judgement in our favour would be sufficient to win the day. Several affected docs formed an ad hoc group and started getting some media attention. We shifted the argument from unfairness to individual docs to restriction of access to the health care system for the public. “If you find it hard to access a doctor now, it will be harder with billing number restrictions”, “This is not about doctors being able to work, it’s about your ability to access a doctor”. Both the government and the association were furious with us. When the judgement was finally rendered it was in our favour. Later I met one of the law clerks who wrote the judgement and she said that our public campaign was highly influential in the decision. My advice to my Ontario colleagues is to focus the debate on the needs of the public, not the needs of the doctors.
Wise advice, Dr. Wortman!
No question, the public rallies when they understand that caps and cuts on spending create hardship for patients. But patients haven’t felt the cuts yet. A number of local doctors have already had to close their offices in favour of lower rent. Patients get this.
I wrote this piece after feeling like the media had thrown a giant wet towel on the first spark of passion we had seen from grassroots physicians. All spontaneous groups will be uncoordinated and messy. But the message is finally getting out about cuts.
Comments like, “There’s the door” demand a response, when a national newspaper prints them. Several hundred doctors voiced their agreement.
You are right. We win by focussing on patient needs. I hope you have time to see that >90% of the posts on this site talk about the need for change in the system that puts patients first.
Thanks so much for taking time to share your experience! Very wise and poignant advice.
Best regards,
Shawn
Picard is free to write what he want and I think that we should take it with a grain of salt or more. It simply exposes the complexity and public/media ignorance of physician compensation for service rendered. I am sure that a lot of people feel the way he does and have nothing but envy and contempt for the profession and see our battle as nothing more than a fight for MORE money.
So be it.
We need to push on.
We need to push on in the name of fairness. No other group compensated by the government gets treated this way. They do this because they can and because legally physicians have no recourse.
We need to push on for our patients. They are the ones who will pay the price for cuts to physician funding as physicians retire, leave and adjust their practices to deal with the new reality.
We also need to push on to expose the inadequacies of a resource starved system that purports to provide every service to everyone when they want or need it. Wait times will grow precipitously as funding is cut while needs and wants continue to soar.
We need to push on regardless or what others say, do or write. Because it is the right thing to do. For us. For our patients.
Hear! Hear!
Very well put, Paul. We must push on for our patients, for fairness and for the next generation of physicians who have to live with the mess we fought to fix.
Thanks for sharing this!
Shawn