Calm, thoughtful advocacy works with reasonable people. The Wynne Liberals are not reasonable.
In the face of Bill 210, the so-called Patients First Act, Ontario doctors must lead action. We need to lead a protest that the public can see.
Not a strike. Doctors cannot strike.
Bill 210 is not about income. Bill 210 fundamentally redefines the doctor-patient relationship. It goes far beyond anything ever seen in Canada before.
This is a bigger change than the start of Medicare. Patients will remember our response.
Doctors Must Lead
In Bill 210, the Ministry of Health creates its own standard of care and enforces it.
The MOH will determine the kinds of services doctors must provide.
Low level bureaucrats – “investigators” – will have power to enter “without a warrant”, search private doctors’ offices, and examine all personal health records.
In section 21.1 (6)(a), investigators will access doctors’ private:
- books of account,
- documents,
- bank accounts,
- vouchers,
- correspondence and payroll records,
- records of staff hours worked and records of personal health information;
Note: Even if investigators can only search the clinics in which doctors work, there is no difference between clinic and personal MD information for many doctors.
Doctors will be forced to report how they spend each hour of the day.
Doctors shall report holidays and schedule changes to local bureaucrats for approval.
Contracts with local LHIN handlers must be signed or enforced unilaterally.
Family Doctors will take orders from appointed, local government officials, not patients.
Doctors Must Lead
Bill 210 is not about money. Doctors own the moral high ground in attacking this legislation.
Doctors have many options to respond. As a non-expert, here are some ideas:
- Doctors need to inform their colleagues and patients ASAP.
- Docs should flood social media.
- We need a broad range of articles in major news outlets about government failures in healthcare. Things like:
- uncoordinated care
- lack of IT connectivity
- waste in PACS, repeated imaging
- waits for surgery
- lack of spine surgeons
- inadequate home care
- overcrowded hospitals
- overcrowded emergency departments
- high cost of NP led clinics
- Doctors should hire expert advisers to lead this activism (not Liberal-supporting ‘experts’).
- Consider renting buses for a few thousand doctors to demonstrate at Queen’s Park every lunch hour for 1 week. Different doctors could attend each day.
- Organize a week of picketing in front of local MPP offices. Keep the picket times short.
A few thousand doctors attending a short demonstration will not adversely impact patients.
Bill 210 needs action. Now.
Doctors must go out and fight. The Wynne Liberals are not reasonable. They ram bills through the legislature with impunity. Doctors must lead a fight, or fail trying.
Hate to say it but anything the OMA or mds have planned for the next month is quickly going to disappear in the media once the top 100 billers names get published in July. OMA has missed the opportunity. The rage and engagement has never been higher and unfortunately due to no leadership from our provincially mandated leaders its turning to demoralized burned out mds.
Good luck with trying to get mds engaged with the government when I’m sure we will be turning on each other once those names are spread across the papers. Any argument mds had against the government will be lost in the comments from mpps about those million dollar docs.
One message to the OMA : too little, too late
Brad
Powerful comments, Brad.
I sure hope your prediction does not turn out to be true….I worry about the same.
Brad, I hear your frustration but I don’t think it will play out that way, especially after the first week. There will be more “casualties” as more physicians’ practices and lives are changed by events.
I put the word “casualties” in quotation marks purposely. A few hours ago I was on a tour at Boston Harbour and threw some tea off a ship with my co-tourists. As much as doctors are furious at our treatment by government what we are risking is a lot less than the men who risked and lost their lives and limbs within miles of where I am comfortably resting in a hotel room. I just learned that the US War of Independence was basically fought over an unjust GST.
Ontario doctors have more power and less to risk for what appears to be a more important reason than American Patriots fought for…. Really
Great comments, Gerry! Where’s our fighting spirit for freedom and self-government?
I will be one of the first to congratulate my colleagues for working so hard to provide so many hours of service to reach the top 100 billers. Each service has a price. Each service has a patient attached. I will thank them for their outstanding service and commitment to patient care. It’s also a nice polite way to say fuddle-duddle you Wynne and Hoskins.
Dr. Oz
Brilliant comment, Ozzy!
We should hand out awards for the doctors who cared for the most patients, instead of threatening them with shame in the Toronto (Red) Star. Disgusting.
So you are telling that every single physician who reaches the TOP 100 billers were working hard and physicians who makes less are not working hard?
What about the cardiologist who has sent patients to unnecessary exams to bill more? Is he a hard working physician?
This is NOT bashing against physicians.
What about physicians who see three times amount the patients so they can bill more and rushing through?
What about physicians who gloats about the number of the patients they see a day and how much money they make?
What about physicians who brag about their luxury mansion and luxury vacations to their residents who don’t know what their futures will be?
What about physicians who shows their MAs their supercars?
I am not jealous and I am not a physician but there should be a difference between a physician and a businessman. If you want to be rich and want luxury lifestyle at least be quiet and don’t rub it under other people’s nose because in that way the population thinks that every single doctor makes millions!
I hear you, but I am not really so sure that the OMA is to blame–i.e. “too little, too late.”
I have been practicing for 25 years now and I have never seen a willingness of physicians in Ontario to roll up their sleeves and commit to working effectively together to represent our profession. We complain, but we do not commit to constructive actions. We are all tired, busy and yes a bit dejected. What we need is to hire a seriously productive PR firm to represent us. We need to donate $1000 each to this cause, and we need to make ourselves available en mass to show up to rallies. Unless we do, well, we are to blame. Am I correct?
Can’t argue with that, Chris!
I suspect things may even need to get worse. It seems the idealistic doctors of 40 years ago have gone. We have multiple generation (me included) of MDs who’ve grown up inside a heavily regulated environment. We are not pioneers and idealists. We work hard, but keep our noses out of things mostly. If we all stood up together, things would change fast!
Thanks for writing!
Shawn
Chris, you are correct about the physicians being willing to roll up their sleeves. The OMA has been trying harder than I remember for a long time.
The money you suggest spending on a PR firm would be better spent on supporting Concerned Ontario Doctors, a group that was bankrolled by a few physicians who worked their butts off rebutting and fighting the government. They are run by a small group of dedicated physicians who have accomplished a lot without any support from OMA that I am aware of. COD has already got positive press coverage and affected one byelection.
Join their Facebook Group and get involved. Help them affect the next byelection.
Shawn, I hope you don’t mind the plug for COD. Maybe you can send me the bill for advertising on your blog.
Gerry, you know I LOVE hearing whatever people want to write in the comments! Plug away for whatever you like (as long as it’s not racist, untasteful, etc.).
Thanks so much for caring on the conversation without me! Awesome.
I will address each if the comments in turn.
Gerry, I respect your opinion but the war is not won amongst ourselves. The war is won in the public eye and if the lie is told often enough it becomes the truth. The public believes we are all fat cats and that we deserve to be knocked down a couple of pegs. They don’t understand in the long run it affects them but I think Shawn has already written about the politics of envy. As some one else commented already we need to stop trying to engage the public and affect them as they sympathy but don’t care unless it affects them.
The OMA had a chance to lead us. They could of took action in 2012 when the imposed contract could have caused a legal challenge about lack of negotiation etc. instead it took legal rep rights and sacrificed the profession by agreeing to flawed negotiation process and left us in the predicament we now find ourselves. Instead of now leading they are pussy footing around and not supporting the only group that’s trying to affect change (COD).
Why is that the radiologists have to engage their own radio ads to fight this government? Why is it that the ophthalmologists had to take out full page ads at their own expense in 2012? Why is it that concerned doctors ontario are looking for donations to continue their fight now? Sorry Chris groups have been trying but the OMA reaps the rewards of smaller groups hard work and financial investment. Too little, way too late by the OMA.
As for Dr Ozapplauding the hard working MDs who will make the list, I appreciate the sentiment but it is well known that the most of the OMA will relish the fact that high billers will be crucified in public. Again the politics of envy come into play. How many times have we seen our colleagues agree with the MOH regarding ophthalmologists needing to be cut? We see it in the comment sections all the time. If we reduced ALL ophthalmologists to ZERO dollars in billing it would cut 600 million off the physician services budget. That’s it!! MDs as a whole gave back almost a billion in 2012. Think about that. Do you really think the ministry is going to be happy if they save 200 million on the backs of ophthalmologists? That’s only where they will start.
Reminds me of the quote about the Nazi taking of people during WW2. “First they came for the communists and I did not speak out because I was not a communist. Then they came for the Jews and I did not speak out because I was not a Jew. They finally came for me and no one spoke as there was no one left to speak out.”
Next time think about applauding the MOH when they cut the ophthalmologist or cardiologist or radiologist as they are only the first ones to be cut. They’ll be coming for you too. It’s only a matter of when.
Brad
Brad, I agree with almost everything you have said. The only disagreement we have is the outcome of the current fight with government in 2016. The OMA blew it 2012 and even if OMA blows it again, the rank and file will rebel and keep the fight going.
Brad and Shawn – The points I hear you both making are solid ones, and with merit. However, I think that all Ontario Concerned Doctors – there are almost 11,000 of us, need to make the commitment to take the high road within the profession. We had the opportunity to try to change and did not – water under the bridge. Or if you prefer the vernacular, let’s all stop “p-ing into the wind”. Anybody who is a high biller is working long hours, employing many staff and leasing extraordinarily expensive equipment. I’m not one of them. But I also suspect they subsidize their office with their NON-OHIP billings. So, if they are able to subside the public Healthcare by being entrepreneurial in private Heathcare, then more power to them. I may envy them from time to time, but I don’t wish hardship on them either when they can no longer sell the $5M mansion in the divorce.
So take the high road, stay out of the muck, and keep focus on our objective. It’s no small coincidence that this bill came out at the same time PAD/MAID came out. Clearly to bury the impact on the last page, as people will focus on how THEY feel about PAD, not how WE feel about medical “reform”. Unless there is some way to tie them all together. Shawn, I’ll leave that in yours and others capable hands. I’ve just planted a seed.
Great points, Connie (and Brad and Gerry and Andris!).
All of these major changes did not come together by chance. It’s much easier to attack on all fronts at the same time. It’s a Blitz. The Wynne government is dismantling years of work in a few months…wild!
The goose is , I suspect, cooked….the Ontario medical profession has sleepwalked into enslavement and the OMA played a vital role in the stupefaction and widgetization of its members that allowed the process to occur.
Ontario’s medical widgets will soon fall under the full control of the government and its collectivist central planners who will soon be moving them about the Ontario health care chess board at their will.
Leadership is a combination of courage and judgement….the OMA has not demonstrated such leadership and there is no sign of any such leadership emanating from the ranks…there might well be minor eruptions here and there which the government will crush….of course, I would love to see a real rebellion against the chains that are being applied as we speak by our slave masters, a rebellion against their tyranny…I would love to see the medical profession producing its own Declaration of Professiinal Independence….unfortunately , at present, we resemble an army of sheep led by sheep….will a lion appear to lead and save this medical flock ?Or will the flock walk docilely into the abattoir as the government anticipates?
Solid comments, Andris.
I hear your call for a rebellion against the chains. Most people do not even see them, or they scoff at those to draw attention to them!
I’ve been watching with interest from out here in BC. I think it’s a shame that as a profession we are being attacked, led by the media, and now the government is being responsive to the media. One thing I’ve learned throughout the years is to diversify. I diversified before med school (I studied something non-science related and could translate my skills to finance or tech should medicine not work out). I diversified after med school (did two residencies). Now, I have several jobs-my private practice in family med, working in academia, and working for Workers Comp. Finally, I manage my own investments and have enough assets generating enough income for me to just up and quit before age 40. I’m so sick of the government blaming us for everything.
Wow. Thanks for this note, BC doc. I wish I had been as wise as you. I hope other early-career docs get a chance to read your note. Inspiring.
I think the balance has tipped with Bill 210. Any medical student that pays attention will avoid family practice. Any doctor with options to work in a different industry will move. I think it’s the only thing that will force politicians/voters to wake up.
Thanks again,
Shawn
As a concerned citizen of Ontario, I would like to help the doctors of Ontario fight Bill 210. I have written everyone I know, and then some, and asked them to write their MPP and Eric Holkins to tell them that Ontarians are not in favour of Bill 210.
I have also written the OMA and Concerned Doctors of Ontario but have not heard anything back.
Would a petition be an effective way to get this quashed? We could call it KILL BILL 210.
I WANT TO HELP THE DOCTORS OF ONTARIO AND SAVE OUR HEALTH CARE SYSTEM? Just tell me what to do.
Wow! What a fantastic note, Donna!
People often ask me what they should do as activists. I think that you should do what you enjoy, what comes naturally. Some people like to write, other enjoy meeting with MPPs and other people can make creative videos or host meetings in their home. Do whatever comes naturally for you.
Thank you so much for taking time to share! I am sorry that I didn’t reply sooner….I’ve been away.
Best regards,
Shawn