Can Doctors Rebuild a Working Relationship with Government?

Can a broken relationship be mended? When one party has done something really wrong, and the other has lashed back, can they reconcile?

Doctors in Ontario have been heckled in the legislature, slandered in the media and ignored for multiple pieces of legislation. Unexpected rounds of unilateral cuts have caused festering wounds. It makes caring for sicker patients with longer wait times almost unbearable.

Some doctors are so sick of feeling abused, they only want to mock the other side. A few prefer mutually assured destruction.

But most doctors just want to care for patients. Doctors want to be left alone to care for patients without worrying about the next crisis.

Can doctors find a way to rebuild a new relationship with government?

How to Rebuild a Working Relationship

In conflict, emotion trumps logic. Desire for peace leads one party to make a move, a concession. A rebellious teen reforms. A wayward spouse repents and begs forgiveness.

Concession is hard. But waiting for a response from the other party is harder. Relationships do not mend overnight.

The reformed teen must endure weeks, perhaps months, of disbelief to earn a new reputation. Teachers are cautious, old friends wary. The teen lives through a wasteland of being a new person inside but being treated like their old selves.

Forgiveness is the Janus face of concession. Injured parties must choose to forgive.

Resentment and hate act like chains. We give others power over us when we refuse to forgive them, a jail of our own victimhood.

A satisfying joylessness accompanies our right to be angry. We hold it tightly with a jealous love.

What makes us forgive? Do people suddenly change their minds and decide that wayward spouses or rebellious teens aren’t that bad after all?

Not usually. Forgiveness does not mean denial. Restitution does not forget malfeasance.

Forgiveness comes when the wounded party realizes that they have more to gain from restitution. They decide that they do not want to live in a jail of spite.

They decide to forgive for their own sake.

They forgive because they want to build something better, something they value more. They forgive with intention.

Doctors have been abused. They have every right to feel frustrated, outraged and desperate. Now we face a choice:

Can we see a bigger reason to forgive or will we fight to the death?

Is there some reason to try to rebuild a working relationship?

We cannot expect a public apology. We cannot expect contrition. A reversal of opinion equals contrition in politics.

Funding hospitals after years of cuts equals contrition. Funding for mental health services, tweaking clunky legislation and many other little things signal a change in attitude, too.

True, it does not give us the satisfaction of someone begging forgiveness, with a tear stained face clutching hat in hand. But we cannot overlook big policy changes.

Senior bureaucrats said that they could never imagine binding arbitration for doctors, even a few years ago. Yet government changed its mind. Adults do not change their philosophy without enormous sacrifice.

Doctors fought hard for BA, but we cannot forget that BA also had to be given. Government agreed to it. This is big.

Reasons to Rebuild

What do doctors want? What might we hope to gain from restitution?

Doctors want a working relationship with government based on equity and respect. We want to be respected as professionals, as independent contractors.

We need control over our practice environment. We cannot care for patients when government calls all the shots without consulting us on anything.

We want a working relationship, but what are we willing to change to get it?

I do not have a complete answer. Watching patients, I believe that reconciliation starts with something very simple: a smile. Wounded parties find something to like about the other side.

Can we find a reason to smile?

Maybe new funding for mental health?

Or a new cardiac surgery program in Thunder Bay?

BA should make us smile, shouldn’t it? We asked for it for decades.

To be clear, we must still advocate for change at the same time as we rebuild with government. Healthcare does not need another sycophant, but continual war does not help either.

Our fight is not against the Liberals, or any other political party. We fight ideas: authoritarianism, unilateral action, command and control.  We want equity and respect, freedom and true constitutional democracy, not mob rule.

Our patients offer the biggest reason for us to rebuild a working relationship with government. Our patients need care. We cannot provide care unless we work with government.

Premier Wynne has signalled that she wants to rebuild a relationship with doctors. It will take time. Doctors and government will not become best friends overnight.

But after all that has happened, can we see a place to start peace talks? If government signals a willingness to change, are we willing to rebuild?

PS. I changed the photo….didn’t realize the first one was from N and S Korea military talks.

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27 Replies to “Can Doctors Rebuild a Working Relationship with Government?”

    1. That just about sums it all up, Gerry. Thanks!

      We need respect, but we also need to show that we can be reasonable.

      1. Could it be that our profession and its leadership have been and still are too reasonable?

        As GBS put it ” The reasonable man adapts himself to the world, the unreasonable persists in trying to adapt the world to himself.
        Therefore all progress depends on the unreasonable man”.

        The unions did not get their generous incomes, vacations, benefits and pensions by being reasonable .

        Our profession certainly got itself into its present sad plight by being , over the decades, ever reasonable, by playing it safe, by refusing to break new boundaries and setting new records.

        It’s not reasonable to stand up when knocked down by a bigger opponent…but it is by standing up and fighting back that one wins.

        1. Great comments, Andris. We need to stay standing. We need to be tough.

          Can we be tough and talk at the same time? I think so. Just wanted to see what members thought about the concept.

        2. Agree w. Shawn: great comment Andris, we need to agree on a long-term plan HOW TO BE TOUGH first, to start implementing it without delays (even with our half-tied hands), & only then any negotiations can bring the result.
          And as you’ve nailed it, we don’t need to invent a bicycle here: the Unions have mastered it decades ago.
          So we’ll see if the new-OMA will lead us there, or the strike-breakers will prevail again..

  1. Thanks for the piece Shawn. A lot to think about.

    Not sure I understand the MAD reference. In any case, I have no trust or respect for this government. After being at the controls for 15 years and wasting billions, scandalous behaviour, villifying and robbing physicians and patients of needed frontline funding, redirecting federal healthcare transfer payments to non healthcare programmes, we are to move forward because the government is now gearing up for a re-election? It’s obvious why these announcements are being made now.

    These programmes you mention have been needed for a very long time.

    BA, has yet to play out, but in the short term, it is certain that the government is getting exactly what it wanted–silence and peace with doctors. Now that we can’t have organized public protests the government is happy. With any PSA surely going to arbitration, there will be radio silence from the OMA during this period, a period which could very well coincide with the heat of an election race.

    The issue with this government has always been trust and respect. I have neither for them and they have neither for us.

    It’s time for a change in Ontario and break the cycle of corruption and bad decisions. We ALL deserve better.

    1. Thanks Deron

      We CAN have public protests. Perhaps, your comment was a typo when you said that we cannot. BA specifically allows for protests of any kind.

      “Trust and respect” Well said. Both sides have none…is there any chance of rebuilding it?

      I don’t think silence will work. I think we still need to speak up, but we need to show that we will reason with reasonable people. If Premier Wynne has decided that she wants to be reasonable, then we should see where that takes us. This is about working relationships, not personal relationships.

      Thanks for taking time to write!

      1. Thanks Shawn. I would suggest that the OMA organize MD protests in front of MPP offices to test the limits of both the BA and how in tune the new OMA is with membership.

        This isn’t just about Wynne. Her entire cadre is anti MD INCULDING her MOH

  2. I am at best skeptical of BA. I’m not sure that we didn’t give up more already in BA than what we stand to gain. No offense Dr. Whatley, but placing the OMA in charge of bargaining in perpetuity makes me concerned when it has been a lapdog of the liberal government. Have you ever in your life heard of essential public servants like policemen or teachers agreeing to a pay cut unilaterally inflicted by a government ???? In 57 years I have not. And, as I understand in this “opt-in” theft is not even up for arbitration. Why do we have the representatives from 6 and 11 resigning? Is it because the OMA is so democratic??? Dr. Whatley… you have a lot to prove and we are already running out of patience.

    1. Thanks Brian, I hear you.

      We cannot be the lapdog of any party. We need to be tough and fair. We have often been sluggish and obsequious. This needs to change. Organizational culture takes time to shift. We are moving. I hope by fall council you will notice some substantive differences as our new strategy rolls out.

      The perpetuity of OMA as a bargaining agent came out of the 2013 agreement (rep rights agreement). I’ve commented on the district resignations elsewhere.

      I appreciate the reminder that docs are watching. Docs want change. They’ve had enough. I get that. Thanks for taking a moment to make that clear!

      Best,

  3. Looking forwards to the Ontario Minister of Health publishing an article “Can government rebuild a working relationship with the medical profession”.

    The onus is on the victimizer to rebuild the relationship with its victim.

    The victim may , in certain situations, forgive the abuser….but never forget.

    Medical doctors are not sick of “feeling” being abused….they HAVE been abused and still are..

    The abusing spouse , in this case, has not repented and is certainly not begging for forgiveness….the battered spouse syndrome is real, a form of PTSD and the hyperarousal and hype vigilance of the grass roots membership to the government’s actions ( as per its Bills) is real and understandable.

    The medical profession is NOT at fault for the government’s abusive behaviour..

    The onus is for the abuser, the government, to mend the fences …new funding for mental health will not do; a new cardiac surgery program in Thunder Bay will not do; Binding Arbitration ( binding on the profession, not on the government if inconvenient) will not do.

    The cycle of corruption and bad decisions on the part of the Ontario government must end…2018 offers a beacon of hope.

    1. Good point, Andris: “The onus is on the victimizer to rebuild the relationship with its victim.”

      Thanks for sharing your comments!

    2. VAE VICTIS.. Woe to the Defeated..
      We have been abused.. and we will be abused..
      As long as there’s no unity, self-respect, activism and a genuine passion to change it, not just for our own individual benefit, but for the long-term success of the industry, which will eventually be the success for the patients & society as a whole..
      Otherwise, the scabs will prevail again & help the government to run it to the complete disaster.

  4. Although I understand the analogy of forgiveness as you have expressed it, you are ascribing emotional attributes to government when it is more analogous to a machine. Government infrastructure ie MOH is an unthinking and uncaring machine – a computer that attempts various alternative pathways to achieve a numerical outcome i.e. a budget. When a pathway fails, it simply tries another pathway without the guidance of a concept of right or wrong. Like all of her other attempts to buy the next election with things like; (falsely) reduced Hydro rates or an increase in minimum wage or guaranteed minimum income, Wynne’s appearance of conciliation is illusory. We cannot and must not soften our stance. We have an opportunity now to influence the pathway the government machine chooses, we must not waste it with thoughts of compromise before we even get to the bench of the Arbitrator. Relentless and reflexive bashing of OMA is not helpful certainly, but keeping the focus on producing the changes we need is necessary. I am concerned by the relative silence on developing our negotiations stance. The thought lounge survey recently done was a hangover from a past where we as an organization sacrificed our own interests in favor of the healthcare system. We need input from all the sections on re-writing the SOB as our bargaining position. Time is wasting.

    1. Great comments, Ernest.

      Paraphrase: Government is a machine. We must stay focussed on change. Time is wasting.

      Agree. We need to stay vigilant and strong. I wanted to spark conversation around whether or not docs were feeling that there was room to discuss. So far, most docs seem to be saying, “Sure, we will talk. But don’t think we are now best friends forever. We need to build trust.”

      Thanks so much for taking time to share!

  5. Pingback: Dr. Paul Hacker
    1. Thanks Paul!

      PS I changed the photo….didn’t think long enough to realize it was a picture of N and S Korea! Yikes. I just wanted a picture of some smiling people in peace talks.

  6. This article got me thinking at many levels. I believe in the philosophy of working together, forgiveness and giving people a second chance. Your question is a very valid one. And if I were to be perfectly honest with my self I would be able to work with this government, forgive them and give them a second chance if it was just me they had hurt. But I strongly disagree to to work, forgive or give a second chance to a government whose policy has hurt my patients. Thats the line in the sand for this physician.

    1. Great comment, Plabon. It’s not just about us. We must keep advocating for our patients, as you say.

      At some point, our patients need us to figure out how to fix big problems, for our patients, by talking with government, no? How do we talk with government and still stay tough and strong for our patients?

      Thanks for sharing a comment!

  7. Shawn, you were elected to change the way Oma does business . We are waiting for you to go for the jugular. I want my money back. The money that was agreed upon by the moh for the work I performed. Do not be blinded by their friendly ovatures, they will pull you in, lie to your face and steal our money forever. Do not give in to them befor the election. The only power we have is to make their despicable behaviour an election issue.

    1. You nailed it Sam!
      Let Shawn lead us to the victory of justice & common sense,
      iron fist in a velvet glove!

  8. And why beholdest thou the mote that is in thy brother’s eye, but considerest not the beam that is in thine own eye?

    Or for those who would prefer a non-religious analogy from Scot Robert Burns:

    Oh, wad some Power the giftie gie us,
    To see ourselves as others see us!

    Healthcare is a team sport, and some are saying the team won’t survive without the star doctor – it will.

  9. Hello everyone,

    For the first time, I deleted 10 comments (including 2 of my own). A few of us had started down a tangent that had veered off the main discussion and was not building fruitful, positive ideas (in my opinion).

    Thanks so much to all of you for reading and taking time to share!

    Highest regards,

    Shawn

  10. Shawn, I have read your update today re: corporations. Websites and petitions are a joke to this government. In your heart of hearts, you must know this is simply intentional antagonism. I would have doubts about any physician’s judgment who doesn’t understand that. It is time to get serious. I strongly urge you to go on the offensive. We need to go on strike for all services other than to CTAS 1 or 2 patients. Nothing elective. No hangnails. No snivels nor sprained ankles. Enough poking physicians in the eye. Don’t give me that we agreed not to strike. The government violated the agreement with unilateral pay cuts. No more OMA rolling over playing games. If the OMA won’t take action on behalf of physicians, disband and return us our dues.

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