Relax, the OMA Will Never Strike

Doctors believe patient stories. We think we catch liars. But we can’t. How could we?

If someone cries about final exams and talks about death, I believe her. If someone describes excruciating pain and grimaces when no one is looking, I believe him.

Doctors, for the most part, believe patients.

Wired for credulity, doctors want to believe. When the Ontario Medical Association talks about possible job action and strikes a working group to explore job action, doctors believe the OMA is thinking about job action. But is it?

Why the OMA Will Never Strike

The OMA has too much to lose. It wants to be heard. The executive wants to stroll around Queen’s Park. The President wants to be on TV. OMA wants applause from academics, nurse associations and unions. The OMA wants to be admired for its sophistication and prowess.

The OMA longs for praise from everyone else but its own members.

The OMA wouldn’t dare speak about government mismanagement of healthcare. So what makes anyone believe the OMA would ever lead job action?

Threatening job action is like threatening no supper for a month: It never happens, and your child knows it.

Reasons not to strike:

A. Doctors won’t follow. No one will adhere to any proposed job action. The action will fail. The OMA will be embarrassed.

B. Docs won’t agree to one specific job action. The OMA sets an impossibly high bar of support for job action. Discord undermines job action. We’d best do nothing; the OMA might be embarrassed.

C. Job action does not work. Remember the strike in ‘86? It failed. The OMA was embarrassed.

D. The public will hate doctors. Docs must keep patients happy all the time. If doctors strike, the public will hate doctors, and the OMA will be embarrassed.

To top it off, the OMA staff will never agree to job action. There are too few places for healthcare analysts and economists to work in Canada. Only staff with new jobs in hand can afford to be gritty. Job action would embarrass the staff in front of their future employers.

Doctors cannot strike because of internal issues, not because anything external prevents them.

Note: All healthcare staff are trapped in a system controlled by government. They cannot ever – never, ever, ever – criticize government if they hope to keep working in healthcare. OMA staff work tirelessly for doctors, but the staff cannot openly criticize government.

Medical Monopoly

Long before Medicare, doctors campaigned in the name of public safety to win a state imposed (coercive) monopoly.

State funded healthcare came along years later and threatened physicians initially. But it ended up working like a golden goose in the 1970s.

The OMA wants to keep the monopoly and rehabilitate the goose. Anything that undermines the current state undermines OMA hegemony.

But monopolies invite competition. Competitors dilute monopolies. Governments smile on anyone who promises lower costs.

So government lets NPs prescribe, admit and run NP-lead clinics. Pharmacists morph into clinicians and prescribe medications and order diagnostic tests. (Never mind if NPs cost more or pharmacists drive utilization.)

The medical monopoly wears thin and grotesque. It reminds us of what it once was but now offers few of the benefits. When docs wake to see what’s left of medicine, they will find themselves unfit to fight and unprepared to compete.

Bluffers

Even credulous doctors see through a bluff eventually. Professional poker players wear dark sunglasses and funny hats to hide their hands. Organizations use workgroups and surveys instead of sunglasses and hats.

But they have the same intention: They do not want us knowing what they intend.

Poker players bet and hope we are not the wiser. Organizations bet on doing nothing and hope we do not notice.

The OMA cannot strike. Most of the current leaders would sooner die. The staff would have their careers ruined overnight.

Until the OMA courageously speaks truth to power – publicly critiques a crumbling healthcare system – it seems an utter waste of time to listen to talk about job action.

Public critique is like wearing a ribbon, whereas job action is like starting nuclear war. If the OMA won’t even wear a ribbon, do not expect it to go to war.

The current OMA leadership should talk about system failures. Patients need it.

The current OMA leadership should defend doctors in the mainstream media, social media, with public demonstrations, coordinated education days, and maybe even civil disobedience. Doctors need it.

Doctors need the OMA to stop managing members’ expectations and start adding some practical benefit. Until then, relax: The OMA will never strike.

Photo credit: Dallas Vintages Shop

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23 Replies to “Relax, the OMA Will Never Strike”

  1. The Government shouldn’t worry about the old hound dog by the fireplace. It needs to worry about the wolves just beyond the trees.

    1. Great point, David!

      The Liberal party oven scoops up all the nursing and medical votes. Healthcare is a core Liberal plank. Not anymore. The Wynne Liberals have created an army of doctor political activists.

      The OMA should take note…

      Thanks for taking time to read and share a comment!

      Shawn

  2. Shawn, you are absolutely right that the medical profession needs to collectively accept the fact and get the word out: the health care system is broken and failing. We should not worry about the crisis looming in the future – the future is now. This is the message our Association is failing to communicate. Now is not the time to allow fear of embarrassment to deter us from standing up and advocating for repairs to a system that serves so many so poorly.

    1. Great comment, Paul.

      We grow calloused to patient suffering due to waits, bureaucracy and waste. Who else can speak out about this? If not now, then when?

      Thanks for all you do for doctors in Ontario, Paul! I sure appreciate you taking time to read and share a comment.

      Keep it up!

      Shawn

  3. Wow Shawn. Your perception is so incisive. Doctors are indoctrinated into putting forward a cloak of professionalism and respectability that they sometimes forget that they are hiding behind it. It is one thing to be a ” moderate” out of fear of change (OMA) and another to be one out of wisdom. It appears that we are all finding out that wisdom is not following the status quo. Thank You Shawn for rocking the boat and tossing out some of the anchors.

    1. What an excellent summary, Sandra. Well said!

      We tend to avoid change, but some change brings joy: childbirth, marriage, a new job. We need to package the opportunity for change in healthcare in the same way we view childbirth: painful but wonderful. The current approach at the OMA does not work. Let’s admit that and do better.

      Doctors need a modern OMA. Patients need a modern OMA. Heck, even government could use a modern OMA. What are we waiting for?

      Thanks so much for taking time to read and share a comment!

      Best regards,

      Shawn

  4. Hey Shawn,
    Certainly disappointed by this blog to stimulate emotion. It is one thing to do it based on fact, but another thing when an opinion is likely to incite further discord.
    Really? Exec to strut around Queen’s Park. With two years on the executive committee, I can honestly say that I have NEVER (and I don’t use that word often) attended Queen’s Park as a member of our Association’s executive.
    And as an ex-Board member taking a pot shot at the staff at this time is also unnecessary.

    1. Hey Jim,

      Thanks for taking time to share your thoughts.

      As always, I write to stimulate discussion. I believe that this is the point of polemical writing. It’s designed to elicit reactions and uses extreme and controvercial comments to do so. Glad to see it elicited a reaction in you!

      I see too many people in leadership placing more value on their reputations with power than on serving members. The OMA has not fought for doctors with even a tiny fraction of the energy it fought to push through the failed contract last summer. If I have implied something untrue, please show me wrong by your passionate voice in the media on behalf of physicians.

      As for your comment about the staff, I stated a fact about the healthcare system, not a fact about their performance or character. Just like hospital administrators, staff in the OMA, or in any other stakeholder association in healthcare for that matter, cannot endorse a strong campaign against government. There are only 7 or 8 different places for people focussed on healthcare to work. Most of the work options include government funding (ICES, HQO, etc.). No sane staff member would support a strong critique of government mismanagement of healthcare, just as no sane hospital administrator would support a strong critique of the Ministry of Health.

      We look to you, Jim, to influence the OMA to change and start taking a strong public position on healthcare mismanagement. It would be wonderful if senior leaders would jump to correct mistruths in the mainstream media with the same enthusiasm that they jump to correct what they dislike in this blog.

      Thanks for all you do and thanks for taking time to read and share a comment! Grateful for the debate…

      Best regards,

      Shawn

  5. I was telling a patient ( who is also a doctor )about how doctor unfriendly the Wynn government was and that the sooner she is gone the better it will be for health care . This patient agreed…. but suggested that voicing this opinion to patients could be construed as conflict of interest !!!! So now we also have to fear a CPSO complaint because we are ” unduly influencing ” patients . There is no end to this . Retirement beckons .

      1. 🙂

        We have to keep speaking truth to power. We have to stimulate debate.

        Fear cements nonsense into our system. Patients suffer for it.

  6. The OMA does not need or seek praise from it’s members because it does not have to. It was gifted a 100% membership rate by government statute so has nothing left to gain by appeasing membership. So, for decades since 1991, it has not had to pay attention to this. It has to appease the master that gave it this gift. So the true master is not to be criticized – the government is not to be embarrassed as the physicians take the hit for all that is wrong with health care in Ontario. So, the government has been free to do what it wants with Ontario physicians…bound and delivered to the government by the OMA. The tired old rhetoric of ‘take this deal, it’s the best we could do’ and ‘be scared of what the government will do to us if we do not accept THESE additional cuts’ did not work with physicians this time.

    It is over for the old OMA.

    They can try to pretend all they want that is business as usual but it is not and never will be again. They have done such an absolutely lousy job of promoting and advocating for doctors in Ontario that we are now everyone’s favourite whipping boy. So go ahead…advertise for a ‘new negotiating team’ despite no binding arbitration…

    The attacks on the OMA are coming from everywhere…and no longer from so called fringe minority outsider groups. The latest attack comes from within. A normally Board compliant and obedient group from…gasp…within Council is leading that charge with the threat of another general membersip meeting looming. They can no longer run or hide. The time for being called to account is now. The Board Executive, and others on the Board, who crowed about reasons why we should have accepted that secretly negotiated abomination of a tPSA in videos, tweets, blogs and speeches should have done the right thing and stepped down. They simply could not get over themselves…and did not. But they will be called to account not of their own volition. It might happen at this special Council meeting. If not, it will happen at a general membership meeting. And it will happen at election time.

    Those of us demanding an accountable OMA that promotes and defends Ontario physicians are coming…

    1. Well said, Paul. Well said, indeed!

      Doctors have been patient far beyond expectation. The OMA Board could save a few million dollars by insisting on a few resignations. Then, it should modernize the OMA just as the expensive governance experts have told it to.

      No one is happy with the performance of the OMA. Past Presidents, past members of council/board/committees, current members of council/committees and some current Board members…generalists, specialists, even students… The OMA must change. It must modernize. It must act differently. This would go much easier for the OMA if the membership didn’t have to force the OMA to change.

      Thanks so much for your comment!

      Cheers

      Shawn

      1. “…….Then, it should modernize the OMA just as the expensive governance experts have told it to…….”

        Um……How come as a Delegate to Council I haven’t seen any of these reports? Do you know how I can access them.

        1. This comment refers to folks like Glen Tecker and all the special leaders’ meetings we had a few years ago. Most of the advice was given in presentations. I can’t remember if you were there… Glen was one of a number of experts we’ve had in over the years.

  7. Shawn, thank you for this piece. The OMA should take notice when a doc who served for years as a board member is calling for change, with the best of intentions.

    The last 18 months have been one disappointment after another from our ‘representative organization’. Sadly all they actually represent is a toothless body afraid to bite the hand (gov’t) that feeds it.

    The mammoth size, subcommittees, organizational layers, all allow buck passing and wheel spinning. What will it take for the governance of oma to strip it to its essentials? So it becomes an agile, nimble, responsive leadership?

    As Eleanor Roosevelt said: no one can make you feel inferior without your consent. OMA has given tacit consent to gov’t to walk all over doctors and treat the profession with disdain.

    It’s time we took our power back. Thank you for shining light on this malignant organization.

    1. Great comments, Deepa.

      I really like what you said about ‘tacit consent’. That consent comes when we refuse to hold the government accountable for its mismanagement.

      There are plenty of good people in the OMA trapped in a structure that rewards friendship with government. Unions have figured out how to survive. Maybe it’s time the OMA did, too.

      As I said earlier, this a piece of polemic commentary. When plain facts and reason get ignored, we need to amplify the rhetoric and challenge people to prove us wrong.

      Thanks so much for taking time to share a comment!

      Best regards,

      Shawn

  8. You’re getting feistier by the day, Shawn!

    You and I would almost certainly disagree on the utility of job action (though we’re 100% in agreement on it’s likelihood). That said, there’s one part of the picture you left out. Even if the members bring in an entirely new OMA leadership, even if the execrable state of affairs courtesy of the Wynne Liberals ends, the self-righteous mercenaries of the College will NEVER let disruptive job action happen. Government might be the adversary, but their attack dogs at the CPSO have all the power to wreak misery (unrelated to money).

    Cheers
    Frank

    1. Excellent point, Frank!

      The CPSO is bound by the threat that government can take over the CPSO senior leadership at any moment. It’s in legislation.

      Just to be clear, I suggest that the OMA start critiquing government mismanagement of healthcare. The OMA must show that it has enough gumption to speak truth to power before it could ever attempt any kind of coordinate job action. Right now, it’s a lame duck.

      Thanks for taking time to read and comment!

      Cheers

      Shawn

  9. Shawn
    The OMA doesn’t have to call a strike (the ultimate job action)
    It simply has to instruct all the family doctors and specialists on AFP`s, (including the Academic Alternative Funding Plan) in Ontario, who will be facing so called contracts in the coming months not to sign the contracts – because they will NOT be contracts.
    They will be a gun to the head that states –“do this or else”. And the “do this or else” will be “we will otherwise not pay you”.
    And with that we can all go home and wait it out, because we will not have taken a job action, we will simply have been given a pink slip.
    The CPSO has no legislative mandate to make us work, see patients, or run our overheads – FOR FREE!
    A contract is supposed to be a win-win not a win-wynne.
    If I am required to work overtime and on weekends, they had better not expect that it will happen for the same price as we are paid today.
    And I would want to add a few items into a contract, vis a vis. the contract that the GP`s in the UK have – and number one on the Agenda would be a pension.
    Not just any old pension, but the same as our Ministry bureaucrats.
    Usually these contracts are vetted by the OMA Legal team, but this time around, since we have no PSC and are not negotiating with the Ministry, (or at least the OMA should not be – for ANY reason), it would be unlikely to happen. So if anyone signs one without legal advice they would be seriously jeopardizing themselves
    The OMA could also advise that, since we have had a cut of approximately 15% in gross income and we have a 33% overhead, we will no longer take that whole 15% discount from our net income.
    Instead we will split the difference and take 10% from net and 5% from the overhead
    How do we make those savings?
    Step one – Turn off our fax machines
    Step two – Turn off our phones
    Step three – Put our secretaries on EI
    The cost of postage to deliver all the paperwork that we deal with will boggle the Ministry`s, Hospitals and Agencies minds. The delays for referral appointments and results will increase.
    Patients will be seen on a first come first served basis and the doors will close a 3.30pm.
    To reduce our overhead – We will turn the lights off at 5pm!
    Sounds sketchy…but I would bet that it would get the point across- personally I tired of political counselling with patients and posters and …. Well…. you all know what I mean.
    If the Ontario government wants a return to how our forefathers provided care so be it.

    1. Great comments, as always, JT!

      I like the map you’ve laid out for civil disobedience. We need these kinds of creative solutions to deal with the miscreants in parliament right now.

      I wish the OMA would take the opportunity to win the support of members before members dream up their own schemes. The OMA should be in the mainstream media EVERY week. They should stomp all over social media. Right now, we hear more ads on the radio from the nurses than from the OMA. And the nurses aren’t even in negotiations!

      Always great to hear from you, John. Have you considered running for President from the floor of council? You’d have a good chance! At least get yourself back on the Board. Enough of this milquetoast nonsense.

      Be well,

      Shawn

      1. Didnt know that the special council was about electing a new board or executive from the floor.
        Is there an agenda I`ve missed

        1. Hi John:

          You are correct that no new Board members will be elected in the upcoming Special Meeting of Council. I think Shawn is referring to Spring Council.

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