Orphans make great fiction. Harry Potter leads a long list with Tom Sawyer, Anne of Green Gables and Oliver Twist.
Children need someone to trust. They cannot be children and fight the world at the same time. Abandonment is held with universal disdain.
Doctors feel abandoned. Over 61% voted No to a tentative deal that promised cuts and underfunding for 4 years.
The Wynne government has squandered money for medical services, by gambling on windmills and pension plans. Health Minister Hoskins makes a point of belittling doctors for working hard in the system his government created, while every other public union gets contracts, with raises.
Doctors feel abandoned by government.
Many doctors feel the same about the Ontario Medical Association (OMA).
No one can accuse the OMA of bargaining in bad faith. The OMA was determined to promote the 2016 Tentative Physician Services Agreement and spared no expense in advertising.
Robocalls, personal phone contact on the weekends, slick campaign ads by email, video interviews, dozens of roadshows, tele-townhalls, local medical meetings, letters to the editor and a massive social media campaign pushed doctors to vote Yes.
No one knows, but people guess it cost between $1 million to $3 million. This ignores hours of OMA staff time, as other work got put on hold.
The OMA has never tried so hard to convince their members to ratify a contract.
And that’s the problem.
The board endorsed the New Deal. It was wise to share it with members. But endorsement morphed into promotion and desperate advocacy.
Desperation creates blindness and drives odd behaviour. Superior Court Justice Perell ruled that the OMA Board’s Executive Committee had “abused the authority provided to it” and created an “unhelpful, unclear, unbalanced, and unfair” voting process.
Perell called the Exec “sneaky”.
Addendum: One physician leader insisted that Perell called the “OMA” sneaky. Legal opinion did not back up that statement, although it is not 100% clear. Regardless, whether Purell referred to the Exec, the whole Board or the OMA writ large, his comments are damning. We must get on and face the fact that the comments exist and stop blaming people for drawing attention to them.
We must not judge too quickly. Passionate beliefs make people double down and pour in more energy, precisely when they should step back. Double or nothing seems logical at the worst time.
A wise friend said that, People with weak arguments hold the bitterest resentment for those who do not support them. People with strong arguments do not need endorsement. Their case stands on its own merit.
The OMA bet everything on promoting a Yes vote and lost doctors’ trust in the process. Many of us might have made the same mistake.
Crisis of Trust
Warren Buffett said, “It takes 20 years to build a reputation, and 5 minutes to ruin it.” It takes years of effort, sacrifice and principled behaviour to earn the trust that creates lasting change.
Doctors need someone to watch their back, so that they can focus on patients. Doctors cannot provide care with one hand on their sword.
Many believe that the massive No vote is a vote of non-confidence in the OMA.
How to Rebuild Trust
Healing starts with taking other people’s beliefs seriously, regardless of our opinions about those beliefs. Denying a crisis of trust guarantees more failure.
For leaders, staff opinion must trump leadership ‘facts’. When staff members firmly believe that leadership betrayed them, leaders cannot fix it by proving their staff has no right to feel that way. Leaders win trust with behaviours and outcomes, not arguments and facts.
Doctors know this. When grieving parents attack us, it does not help to debate the best way to resuscitate a dying toddler. We want to run away when lawyers show up, but that is exactly the time to engage with compassion.
Leaders must deal with beliefs and emotions before process and projects. We must take the accusations of our most passionate critics with utmost seriousness.
If government is a reckless, absent parent, then the OMA must be the dependable one. The OMA must win the right to be trusted. It can be done. But it will be costly, in many ways. We need the courage and humility to start.
The OMA must prove to doctors that it values its members before anything else; that it will never abandon them. That might require painful sacrifice. But it’s essential. Orphaned doctors do not provide great care.
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