We all have something in our family that we never mention. Every family has skeletons. Yet, we work to promote our best family face.
We talk about our children’s accomplishments and awards. We want people to know the best about who we are. We cringe if someone asks about our struggles.
“All happy families are alike; each unhappy family is unhappy in its own way.”
― Leo Tolstoy, Anna Karenina.
Every doctor in Ontario has a family name. Our family name is the OMA. The Ontario Medical Association is only as smart and witty and compassionate as those of us who get involved.
If doctors want the OMA to look or behave differently, then doctors have to help to make that change.
It’s Your Family
If we hate how our family behaves, or what people think of our family, we work to change the impression. We spend time improving behaviour and reputation. We work with other people in our family to make things better. We never publicly criticize our family.
But that does not mean we fawn and gush over our family, either.
We courageously admit when things are hard. We accept when our family stumbles and disappoints, or even embarrasses us. But we never disown our family. We own our family’s failure just as we own its success.
Believe in the OMA
Doctors have tremendous power, tremendous opportunity, with the OMA. It is our organization, our family. Any doctor can stand for election and get ‘inside’ the political structure. Anyone can influence change from within.
The OMA stands unique in that it unites doctors around the one thing that doctors hold in common: caring for patients.
The founders of the OMA gave power to working doctors. They invested authority in a group of 250 working doctors at council. Council members direct the board to do the daily work of the OMA. They hold the board to account. If the board disappoints members, then members vote them out.
Over the years, many groups have tried to improve the OMA from the outside. The Coalition of Family Practice campaigned against the OMA in the 1990s. Eventually, they infiltrated and got 8 members elected to the board.
They overhauled how the OMA looked and behaved in the early days of primary care reform.
Today we have new groups: Ontario Doctors for Justice, Concerned Ontario Doctors, and others. These groups inject passion into the OMA.
They serve a valuable purpose. Members from grassroots organization run for office and transfuse enthusiasm and energy in a crisis. They work to renew and transform our organization.
Flawed, Like All of Us
The OMA is like any other human invention: flawed. But it is the best that doctors have. The OMA offers the best opportunity to create change in Ontario. It provides the most organized, funded, and powerful voice in medical politics.
If you want to be at the centre of medical politics, you MUST get involved in the OMA. There isn’t any better way.
A Personal Note
I started at OMA council because I was mad. I thought,
How dare they force me to pay dues! They do not care about my life, my work.
I got involved because I wanted change.
So I attended my first council meeting. I met scary smart people who had spent their lives – literally 30 years – trying to improve our healthcare system. They had made dents here and there, but they had not seen the transformation they hoped for. Still, they refused to give up. I realized that change in medical politics is hard, impossibly difficult.
Years later, I still want change.
If readers look through the comments on this blog, they will find many times when doctors attack the OMA. Many of my posts invite those attacks. I want people to say what they think. I want to wrestle with the issues beyond slogans and hyperbole.
I believe in the OMA enough to want to make it better. I work passionately to improve the OMA. I do not pretend it is perfect. I do not cover its faults. But I never stop believing that it is the very best way to drive change in healthcare.
When people care about something, they work to improve it. They do not ignore its failures, or pretend they do not exist.
If you take the time, you will find that every time someone attacks the OMA, I defend it. I admit where we could have done better. I share the struggles at the time. I invite ways to improve.
But I always defend our organization. I stand by the OMA.
I will quit, if I stop believing that.
After years of service, and countless hours of unpaid advocacy, I still believe the OMA offers Ontario’s doctors the best vehicle for change.
If doctors do not like what the OMA is doing, then they need to get involved and change it.
If doctors get involved, they see how the OMA’s job is almost impossible. Doctors who get involved see how hard it is to change things in Ontario. They get a peak at all the work that no one sees on the outside, which no one can talk about publicly.
I believe healthcare in Ontario needs major change. And I believe the Ontario Medical Association is the best vehicle to make it happen.
If you want to see change in Ontario healthcare, then you need to be involved in the OMA. Stand for election. Get inside. Help out. It’s your family name.
Lets guess who’s going to be thrown under the OMA MOH bus this time? In 2012, the OMA accepted a flawed agreement instead of starting the legal challenge then. It got exclusive representation rights and MDs took the hit. Mds found savings and had cuts imposed some of them as high as 50% to certain fee codes. We endured and continued to endure further humiliation and fee cuts.
This time on the hit parade will be the ophthalmologists, radiologists and cardiologists. All got hit the first time around in 2012 and again with the targeted cuts since that time. This will give the MOH and OMA the venerable scape goats for whom they are searching. When they cut them see where that money goes because I can bet you it will not be going to the other doctors.
As much as you defend the OMA I have yet to see them actually really represent the doctors rather than their own interest. Hopefully I will be surprised this time but I doubt it.
I hear you, Brad.
Many of your comments are fair. Especially looking back, it seems impossible to not ask whether we couldn’t have done better. I was there. I supported the decisions. I NEVER believed we would be dealing with such a tyrannical regime. This government ignores democratic principle.
I am not quite sure what you mean by naming the highest billers. As you know, family med got some of the biggest cuts in the last 2 years. Nuc Med got over 50% cuts in some cases. Are you defending the current state of relativity?
I’m just saying that we are the OMA. If we find a major problem with it, doctors have the power to come together and change our own organization. We need people like you working from the inside.
Thanks for taking time to share!
Highest regards,
Shawn
I want to believe in the OMA, too.
It is why I got involved in 2004 on the SGFP Executive. It is why I left it in 2010, disappointed.
I saw a top heavy organization that looked down with contempt and disdain upon those who dared question it’s ‘wisdom’. After 12 council meetings attended, I grew tired of seeing a Board that squelched debate whose every whim and wish was rubber stamped by Council. I cannot recall a single Board motion in that period that was not passed at Council.
I have attended all of the contract road-shows. IN 2005, because of the COFP, the OMA Board was not able to put out a recommendation for a very bad contract. The Board Executive and the negotiating team were all in favour of it and tried to sell it HARD, though. It was put to the membership and was defeated. As a result of that defeat, we got incorporation – quite possibly the greatest benefit ever attained in an OMA contract.
As for 2012, I have said more than enough on that debacle. That contract was built on a house of cards that got taken down by a cold winter breeze in 2015. Then the OMA had the gall to crow about 81% of the greatest percentage of voters ever saying it was OK for MD’s in Ontario to be cut. Those who questioned the OMA at the roadshow were laughed at…derisively dismissed and asked to leave the podium.
I hope that physicians in Ontario have learned. I hope that they have learned that the OMA can behave like the Pied Piper leading lemmings off of a cliff.
I hope that the OMA has learned. I hope that the OMA has learned not to take advantage of it’s membership to attain the ‘illusion’ of peace. I hope that the OMA has learned not to play physicians against each other in the hope of getting a contract passed. I hope that the OMA has learned that it is going to have to play dirty and get comfortable playing in the trenches with it’s opponent. I hope that the OMA now realizes that it is dealing with an opponent and not a partner.
The OMA has been given another ‘opportunity’ to show what it is made of. I wonder why this is. Was it because of the tepid boring uninspiring ads put forth from the guidance of Navigator? I doubt it. Was it because of the COD rally at Queen’s Park this past weekend? Maybe. Or…is this happening because of the MOH/Dr. Hoskins agenda for health care transformation. Perhaps they realize that they cannot control doctors as much as they want to without the OMA blessing of an approved contract. The ‘deadline’ of June 30 would seem to suggest that the latter is very much at play here.
Regardless, an opportunity is what it is. We shall see how the OMA handles this. Is the OMA now willing to play hardball? I hope so…
I want to believe in the OMA again. I really do…
Great response Paul. Couldn’t agree more. We all wait with baited breath as the OMA excitedly jumps at tge chance to sit down at the table to negotiate. The letter of invitation was that of preconditions and yet we seem to accept those preconditions on the pretense that the other side might give us binding arbitration. Not an auspicious start in my books but like Einstein said “the definition of insanity is doing the same thing over and over again expecting a different result”. Hopefully we aren’t insane.
Thanks for sharing such a thoughtful note, Paul.
You mention, a few times, how some people were dismissive, condescending, and arrogant. These are accusations I have heard from others, too. They are terrible and embarrassing. We need to do better. As I said in the post, the OMA takes on the character of those of us who get involved. It also changes depending on what council allows. If people think that council supports a bit of paternalism, then people will offer more of it. I have seen what you describe, but I have also seen leaders humbled. I have seen speakers tell council how much we need members’ help.
I cannot do justice to all the ideas you shared. Thank you SO much for taking time to share them. I know readers will look through them carefully.
Highest regards,
Shawn
Thank you Shawn for reminding us about our OMA family and perhaps bringing us down to Earth a bit.
It always hurts when you feel that those you trust or those who were supposed to look for you, have failed you. Or perhaps, just possibly, they have intentionally neglected to help you out of their own best interest.
In light of those feelings, it is difficult to stay calm and objective and maintain sufficient composure to follow the most logical path.
Perhaps it would help to mend this rift in the family if the other party would offer an olive branch.
In the end, I have to agree that the best way forward for us, is from within the OMA and not via sabotage.
It has been a difficult and emotional ride. So many others have worked so much harder and gone through so much more than I. I feel for them as well and I can understand why some have such feelings of rage, disappointment, abandonment and frustration.
Your article is timely and I hope more of us will see the path you are trying to light.
Well said, Ken, as always.
You make a very good point. Olive branches help. Trust is lost not only because outcomes disappoint. We lose trust in something, or someone, because of how they go about delivering an outcome, not simply because we did not like what they delivered.
We stand a better chance if everyone who has passion and energy gets inside the OMA and supports change from there.
I sure appreciate you taking time to share this!
Highest regards,
Shawn
I supported the OMA all my career. I always paid my dues even when it was voluntary. I worked on my section’s committee many years ago. I trusted the wisdom of the OMA. I remember as a very young physician, sitting next to then President of the OMA, Earl Myers at a meeting and sensing that this was a man who felt the same as I did about treating patients well but still protecting the rights of physicians.
On looking back, the OMA seems to have lost its way and become something different. When I think of the OMA today, I do not think of it as a group of individual councilors or board members. I think of the OMA now as an amorphous mass with inertia and a will of its own, a bureaucratic morass that is more powerful than the individuals who are elected to run it and certainly much more powerful than front line physicians who actually feed it with their hard-earned money.
The 2012 agreement confirmed my belief when the OMA seemed it put its own existence ahead of the interests of many of the members that it had a fiduciary interest to protect. The OMA seems to have forgotten that it needs to advocate for the interests of its own members above others because there is no one else to do it: the CPSO’s mandate is not to serve members but to protect the Public. For years and years I have hoped that the OMA would again push the interests of front line physicians strongly but it has failed miserably in negotiating our incomes and protecting the viability of many medical practices in Ontario.
It has also failed in protecting its members from being insulted and maligned by politicians and the media, rarely coming up with strong refutations of the slurs against our profession. I will never forget seeing the head of the American Medical Association on national TV years ago. It was a discussion about doctors’ incomes. One of the panelists made a comment about doctors’ not paying taxes on cash income. The AMA President nearly took this fellow’s head off, screaming how DARE you impugn the integrity of physicians in general! Now that is the kind of profession-protecting behaviour that I want to see from OMA spokespeople.
Many members gave up on the OMA in 2012. There are still doctors trying to push the OMA to take our side more aggressively in the fight with the government. Concerned Ontario Physicians have been doing what many of us believed we had been paying the OMA to do for all these years. The rumblings to get rid of the OMA have been getting louder and louder as physicians have been pushed downward on various level including health care policy as well as income. Shawn, you blogged about this not that long ago. If the OMA does not get aggressive about protecting physicians it will become irrelevant as a bargaining agent for physicians, possibly remaining as weak organization getting physicians discounts at hotels, retailers and insurance companies. I hope it doesn’t come to that but it may happen.
Ontario doctors have enough to do just practising medicine. We don’t really want to be on the streets fighting government health care cuts. Does the OMA actually believe that physicians want to be fighting against the OMA too? Just represent us the way we expect you to.
I REALLY like your note, Gerry.
I agree: the OMA must remember that it serves members first. No other organization organizes to speak for doctors’ interests. It needs to speak with courage and confidence.
You raise a point about the OMA having and inertia of its own. I worry about this, too. There are times when we all feel uncomfortable with the direction things are headed, but the parliamentary rules force us to keep going in a direction. It’s very hard to say ‘Stop!’ to any massive bureaucracy.
We need a strong OMA family. I still believe it offers the best hope of change. I see huge value in people speaking freely about how the OMA could do better. We need loud debate and challenge, something like the opposition parties offer in parliament.
Thanks for all you do and have done, Gerry. I am so impressed that you keep your passion and interest after decades of watching all this. We need to listen to more people like you: experienced docs who still hope for improvement.
As always, thank you SO much for taking time to share your comment!! You know the readers love them.
Warm regards,
Shawn
Some physicians continue to “assist” OHIP in disputes between OHIP and residents of Ontario at a time when physicians are in a dispute with OHIP. The most recent physician who “assisted” OHIP was Dr. Brent Graham, a recently retired orthopaedic and plastic surgeon at Toronto Western Hospital. That is a matter of public record. Query what would transpire if physicians, such as Dr. Graham, refused to “assist” OHIP.
Great question, Perry.
I do not have a good answer. Many doctors move very far away from supporting their colleagues after they retire or take non-clinical work. Not all, just many. Also, if he needs his income from assisting OHIP, we would be asking him to take a 100% pay cut on principle. How many other MDs would do the same?
Still, you raise a good question. Thank you!
Best regards,
Shawn