Public Relations Strategy or Just Tell the Truth?

Most doctors want to see patients, not fight government. Doctors pay dues so that their medical associations will speak for them.

Is it even possible for a medical association to tell the truth about problems inside healthcare?

Can doctors speak about problems, without fear that the government will punish doctors for doing so?

Public Relations in Medicare

Everyone in our single payer system wrestles with what to say. Hospitals, associations, unions and patient groups must choose carefully what to say about:

  • Patients suffering on wait lists.
  • Provincial budgets that fall short.
  • System mismanagement.

One option is to only share good news, all the time. If you have something bad to say, do not say it publicly.

This is the most popular approach. Nothing panics hospital administrators more than hearing that one of their nurses or doctors has sent bad news to the media. Continue reading “Public Relations Strategy or Just Tell the Truth?”

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Doctors Need a Good Agent – OMA Negotiations

We hire a real estate agent to help us find a house. She only gets paid when a deal closes.

Good agents try to find something we will like.

But that takes time.

Agents have to ask questions, listen to us and then test what they have heard by showing us a few houses.

Often, agents hear wrong, or we do not explain ourselves very well.

Good real estate agents spend time and money to learn how to represent our interests with confidence.

Bad agents try to close a deal as soon as possible.

The OMA is negotiating a dispute resolution process with government, right now.

Doctors want this.

We hope the dispute resolution process will be fair and reasonable. The OMA tells doctors that it is moving along well.

But as soon as the OMA and government agree to a dispute resolution process, the government will want to begin negotiations on a physician services agreement (aka contract).

Who could blame it?

An election looms.

The government finally wants to resolve labour problems with doctors. It does not want to drag negotiations into the fall, or next year.

The OMA will face immense pressure to enter negotiations as soon as they have settled a dispute resolution process. Continue reading “Doctors Need a Good Agent – OMA Negotiations”

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10 Tips to Survive Online with Strong Opinions

A notorious doctor yelled at my friend, another doctor, “Why don’t you step outside so we can settle this?!”

Two hundred and fifty doctors at the OMA council meeting had watched the angry doc march across the front of the auditorium. His red face, clenched fists and raised voice gave him the spotlight he craved.

My friend had said something at the microphone. The angry doc took offence. He demanded an apology or else.

I secretly hoped that the little man would attack my friend, so that I could jump to the rescue: like breaking up hockey fight.

But nothing beats the excitement of medical politics over the last five years in Ontario. Continue reading “10 Tips to Survive Online with Strong Opinions”

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Time to Rebuild the OMA

There are two kinds of homeowners. The first kind would never change faucets and doorknobs. They buy a house, tear it down and start over. 

Other people keep what they can tolerate. They cannot afford to be radical.

No matter the approach, everyone agrees: The point of renovation is to rebuild.

Like an old house, the OMA sprawls with additions, legacy rooms and dark closets unfit for visitors. It’s tired and dysfunctional. Most people finally admit it.

The OMA was never built to service 42,000 members. It was not designed to command a battle with an activist, majority government in the trenches of social media.

Crisis can bring out the best in people. It often brings out the worst in organizations. The OMA crisis exposed problems that no one talked about when times were good. Continue reading “Time to Rebuild the OMA”

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Political Vision Must Come Before Negotiation

The movie, It’s a Wonderful Life, is a political thriller, despite all the crying, hugging and cuteness.

At its core, the movie portrays a battle of political visions.

Will George Bailey accept Mr. Potter’s salary in exchange for Mr. Potter’s iron control of Bailey’s Savings and Loan?

Will George stand up for his own political vision, of small loans for his neighbours, or will he sacrifice his integrity for Mr. Potter’s vision of control and serfdom under Potter?

The movie pivots on George’s refusal to accept Potter’s vision of reality.

The following 2 minute, 30 second clip captures the struggle:

Selling Out

Once surrendered, integrity is almost impossible to regain. Some say doctors have surrendered too much already. We gave in years ago: Better to compromise and get a raise than lose a fight and suffer more fee cuts! Continue reading “Political Vision Must Come Before Negotiation”

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Governance Renewal – Ask Why Before How

Action expresses priorities – Ghandi

Every doctor has seen or done something horrible to an old, dying patient.

Armed with good intentions, we spot a gasping 95 year old and jump into action. We snap open a laryngoscope blade, hoist her jaw into the air and shove in a tube to relieve her “upper airway obstruction”.

Our technical prowess is matched only by our moral purity. But we accomplish something grotesque and wrong.

Doctors must learn to identify sick patients and how to resuscitate them. But these skills cause harm if doctors do not learn what comes between diagnosis and treatment.

Before treatment, we must ask: Why?  

Purpose Before Process

A governance expert entertained a large group of doctors in Toronto this weekend. He summarized a graduate textbook on board governance in 40 minutes, for a group who had very little board experience.

It was brilliant, funny and almost useless. Continue reading “Governance Renewal – Ask Why Before How”

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Fundamentalism in Medical Politics

Fundamentalism simplifies life. It turns a messy world, full of grey, into a crisp, clean existence of peace and clarity. Even dogs and colour-blind people can see black and white.

Fundamentalism uses publicists to guide true believers.

Some news columnists, ersatz journalists, make their living as publicists. They sell words that paint the same, stark plot: Everyone is good or bad, oppressed or oppressor.

Stylites in the Main Stream Media chant their sermons, while the choir nods in unison.

Doctors are oppressors, arrogant and powerful.

Liberal members of parliament are warriors for social justice.

Not even Odysseus could sail between the publicists and warriors unscathed. Black and white makes life so simple.

Most people expect news-papers to report the news, not create it.

Now, many newspapers only write about events that support their narrative. Continue reading “Fundamentalism in Medical Politics”

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Doctor Patient Magic

All great stories include magic. Characters dance around rules or constructs that define their world.

For example:

Guess my name and you may keep your child.

Find love before the last pedal falls or remain a Beast forever.

Never say the name of he-who-must-not-be-named, or Death Eaters will find us.

Magic applies to non-fiction, too. We buy books about real, faulty people who win despite their flaws.

We want stories about people struggling and limited in the same way that gravity limits us. Limits and faults make real life and fairy tales come alive. Gravity is magic by another name; no one knows what it is.

Doctor Patient Magic

Medicine has its own magic, the doctor patient relationship, that defines and controls medicine every bit as much as gravity rules us. Continue reading “Doctor Patient Magic”

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How to Energize Your Career or Change It Completely

A colleague one town over died recently. After 50 years, he had a huge practice.

His patients say that he often called them on Sundays with results. He loved medicine.

He saw 40 patients one day and died the next.

Doctors used to work until they got too blind or dull to carry on. Seeing more patients was the best way to shake off malaise and stay energized. It gave instant rewards, decent pay and didn’t feel like work most of the time.

Today, old docs say that young docs don’t want to work. The old-timers are partly right, but for the wrong reasons.

Very few doctors can survive old-time clinical medicine: 60 hours a week for 50 years. Modern clinical medicine has too little medicine left in it. Continue reading “How to Energize Your Career or Change It Completely”

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Doctor Derangement Syndrome

Some people hate cows.

Cow haters often have good reasons for feeling so.

Perhaps they had a bad experience with a scary cow. Now they tell everyone that cows are smelly and bad for your health.

Occasionally, cow haters pretend to support the dairy industry, but only if it leads to increased regulation of cows in general:

Cows are such a precious resource that we need government to control them.

Other people love cows above all else and put them centre stage at every state fair. They push for more pasture, just for cattle. They re-write food guides to support the dairy industry.


Some people hate doctors.

No doubt, doctor-haters have deep reasons for feeling so. Perhaps they had a bad experience with a scary doctor.

Now, they write nasty columns in the Toronto Star about doctors.  All the inspiration they need is a tweet, by a famously unpopular Premier from the 1990s. Continue reading “Doctor Derangement Syndrome”

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