Addicted to Medical Politics – Medicare Obsession Syndrome

Hello, my name is Shawn.

I have Medicare Obsession Syndrome (MOS).

When I told my wife, she laughed harder than expected.

Like most things, everyone knows your problems before you do.

I think other doctors may have the same obsession.

The 12th step says, “Having had a spiritual awakening…we tried to carry this message to [others].”

Medicare Obsession Syndrome

Medicare Obsession Syndrome is not burnout, but can lead to it.

Burnout is a “state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress”.

Burnout often comes in jobs where workers feel “overworked and undervalued” with little sense of control.

Dr. Pamela Wible says physicians are experiencing abuse, not burnout.

Medicare Obsession Syndrome is an unrelenting, all encompassing, life consuming, every-waking-minute addiction to thinking about medical politics.

You get involved in long, passionate debates on multiple Facebook pages at the same time…often tweeting in-between.

You inject medical politics into every conversation. You write scathing editorials.

You create memes on social media and YouTube videos.

You replay Eric Hoskins’ slander and Premier Justin Trudeau’s heckling over and over.

You have no time for hobbies because it takes time away from thinking about medical politics.

If you find this funny, you probably do not have MOS. If this causes irritation, please see your doctor.

Oppressed but not Obsessed?

Doctors have been abused in Ontario since 2012. Cuts, unilateral actions by government, slandering in the media and heckling in the legislature have left docs wondering how they can retire or change jobs.

Applications to train in family medicine have dropped to lows unseen since the 1990s.

The election in June gave many doctors in Ontario a break. Social media died down. People turned attention back to family and friends, or poured energy into activism on social issues. In both cases, social media posts and posters are a tiny fraction from before.

Our system needs major change. It was built 50 years ago when the average Canadian was in her 20s and is now in her 40s.

Doctors hunt for ways to work around dysfunction.

It takes time and effort better spent on care. It turns a beautiful thing, that should build one’s soul, into something draining and painful.

I used to believe thinking was not work. It was relaxation. I was just thinking. Or reading. It was a break.

But I have so many political books to get through…

And so little time.

I must read faster.

And…

Hello, my name is Shawn. I have Medicare Obsession Syndrome.

I now spend time forcing myself to imagine what normal people spend time thinking about.

It is hard but will get better when Medicare improves.

Can you help?

Photo credit: modified from www.glasbergen.com

28 thoughts on “Addicted to Medical Politics – Medicare Obsession Syndrome”

  1. Physicians need to give up the fight for more income. We need to address the “physician happiness deficit”. We will never have an excellent healthcare system until, and unless, physicians are happy. What do we need to do?

    1. Thanks Ted.

      Most docs would LOVE to never talk about fees again. After 6 years of cuts to fees for medical services, the situation is desperate.

      I assume from your email that you run a business? Regardless, how could you operate a business when your accounts arbitrarily cut the bills you submit for payment?

      Docs are fighting for no more cuts to patient care. We’ve been cut every year since 2012 and multiple times during the year. That level of uncertainty makes it impossible to innovate or expand services that patients need.

      We need to start with patients and what patients need. Then we need government to live up to its promise to fund medical care. It is impossible to provide great service when government pays $32 for an intermediate assessment (e.g. a visit for pneumonia). 40% of that goes to overhead.

      I agree, disgruntled docs cannot provide great patient care. We need to start with government working with docs to address patient care needs. We all have hope that the new government will take a new approach after 6 years of abuse from the Liberals…but we will see…

      Hoping for better days.

      Thanks for posting a comment!

      Cheers

  2. Hello, my name is Rob. I have Medicare Obsession Syndrome

    The last 6 years have taken their toll. We always understood the power imbalance with government and knew they could unilaterally do whatever they wanted. We just never thought they’d actually do that ! Compound this with the perception that our representatives did not hear us and had their own agenda different from the membership’s. We have been abused.

    After 20 years in medical politics, one is asked to step aside to have the next generation continue the fight. But the abuse continued.

    The only 2 options were to continue to take it or vote with our feet. We “have left docs wondering how they can retire or change jobs.” Personally I’ve had it, and I’m closing up in a few months. For the sake of myself and my family, I’ve got to extract myself from the toxic environment that has become family practice.

    It’s time for me spend some time imagining “what normal people spend time thinking about.”

    Shawn, I’ll see you at the next meeting,

    Thanks for sharing….

    1. Good luck, Rob.

      Major problems in Ontario medical politics started decades ago. I went on strike in 1986 so that I could tell my future colleagues that I had at least tried to prevent the mess that we are in now. I became burned out a long time ago but it was the Final Abuse of the unexpected September, 2015 fee cut imposed by the government that got me to finally quit. The best thing about retiring is having Time. If you have other interests then you will be fine, Rob.

    2. I have Social Media Addiction Syndrome, of which Medicare Obsession Syndrome is just a subset. 😉 Great article as usual, Shawn.

        1. Thanks, John. I have bookmarked it. I will get to it when I have finished catching up on Twitter, Facebook and YouTube. 😉

      2. Ha! Too funny, Gerry. I think many of us share your Social Media Addiction Syndrome.

        Sure appreciate all your involvement in the discussions. You have the courage to gently push back on the strident voices. I sure appreciate that!

        Thanks again for reading and sharing a comment.

        Cheers

    3. Hey Rob

      I read your note with a mixture of sadness and jealousy. Sadness because I remember you well, from my first days at council, articulating positions that demanded response. And response was hard to offer! I also admit to a bit of jealousy, that you are able to move on to new adventures. There used to be a time when doctors found their jobs too good to be true and practiced for 40 years. You couldn’t drag them from the office. Those days are gone.

      I agree. We got hit from both sides. Government was obvious. A half-hearted response from the OMA hurt even more in some ways. A revolution was a long time coming. I think the OMA will never be the same again. Everyone remembers the nightmare of the failed 2016 tPSA. It failed for good reason. That it ever came to light has no good reason.

      Looking forward to seeing you at council. I assume it will be your last one? I hope you get up and say something memorable (as always)!

      Thanks so much for sharing a comment.

      Cheers

      1. It’s been a few years since I’ve been to Council. My 20 yrs were up around 2015/16. A lot of the older guard left around that time too and I feel the OMA lost much corporate memory and experience during that phase out. Restructuring disrupted our Branch Society and its representation at Council. It’s a different OMA now moving forward and only time will judge if the changes were or weren’t for the better…

        1. I thought so… When you said see you at a meeting, I wondered if I had it wrong.

          I agree. The changes were not all good, especially when we lose someone like you. On the other hand, there were some delegates who had more than 2x the number of years and didn’t even practice medicine anymore.

          You are right. Time will tell.

  3. Great article !! What are the early symptoms of Medicare Obsession Syndrome Shawn ?

    1. Great question, Bev!

      I suspect MOS starts out as a good thing, maybe like running. When it becomes the thing you think about most, it becomes a diagnosis.

      After nearly 2 decades in medical politics, the biggest hurdle I found was getting doctors to care about it. Apathy killed most attempts at change. Doctors knew that the government held all the cards. They just wanted to take care of patients.

      Over the last six years, a whole new generation of physicians have become attuned to ‘the system’. Their eyes have been opened. They see the Wizard of Oz behind the curtain. They know that the system could be something other than it is today. In essence, they are ruined. They can never just sit back and enjoy the show; they can never just see patients. This whole generation, of all ages, of abused but aware doctors will now pay attention to what goes on in medical politics. They will because they have to. They know that government can completely ruin our ability to care for patients.

      The trick in achieving a healthy approach is to figure out how to maintain a real, balanced thought life in the presence of a dysfunctional, invading virus. How do we live a ‘normal’ life when our medical world is occupied by a foreign, if you will permit me, infection? How can we care for patients with government/regulators/bureaucracy looking over our shoulders? Somehow, we need to find a way to be happy, healthy, caring physicians while still pointing to a better way, without becoming obsessed. I haven’t figured out that balance yet.

      Sorry for such a long answer to short question! Thanks so much for taking time to read and share a comment.

      Cheers

      1. Lots of wisdom in your thoughtful reply, like the expression “balanced thought life” . For sure, awareness is important and mindfulness is helpful.

    1. Thanks John(y)!

      Sure appreciate you reading, commenting and sharing a link, too!

  5. Hello, my name is Donna. Shawn…I’m supposed to tell my doctor? What the hell is my doctor gonna do for me? I’m pretty sure she’s got it too.

    1. You crack me up, Donna!

      I thought the same as I was writing this. There has to be someone, somewhere who is still sane, no?

      Thanks so much for reading and sharing a comment!

  6. Since we are ‘ fish’ that are forced by law to swim in a certain water it is understandable that the ‘fish’ be concerned, obsessed even, at the nature and purity of that water …of the garbage , pollutants and toxins that the powers that be throw so thoughtlessly into that Medicare pool even as they increase their demands of the ‘ fish’ and criticize their quality.

    1. What a brilliant analogy, Andris. I suppose if we wanted to be completely fair, some of the things thrown into the water were, ostensibly, thought to be for our good. Sort of like wrapping a child in bubble wrap to protect him before you tell him to ‘Go have fun!’

  7. My name is Ramunas,but I don’t have MOS.
    I dealt with the abuse over the years by extricating slowly from the system and finding non OHIP sources of income….fortunate that I could.I have become disengaged,dispassionate,and disinterested in the ‘system’ and clinically do only what I enjoy…..to prevent burnout.

    1. Ha!

      I should have known you figured out something, Ramunas. Your advice rings true. I might use the idea as a spark for another blog post. Unfortunately, lateral moves are harder for some docs than others. Not saying it wasn’t hard for you…but some specialties have more options than others.

      Great advice! Thanks so much for posting a comment!

  8. My name is Paul and I do not enjoy medical politics…and I am a current member of the OMA Board. But…please let me explain…

    I was on the SGFP Executive from 2004-2010. Wow…those were, for the most part, good days! More money, more models for family docs. Lots of celebrating! But absolutely no foresight into the risks inherent in divide and conquer of FP’s and the downstream costs associated with that ‘more money’. There were few dissenting voices at the SGFP at that time. Good times! Let’s all celebrate!! No one wants to listen to anyone raining on the parade, do they?!?! So…I left the SGFP Exec.

    And then 2012 came. The party was over. But the OMA either didn’t know it was, thought it was just temporarily over and/or deliberately deceived it’s membership. The OMA advised us to accept ‘temporary’ cuts AND a clause that said the government could do whatever they wanted in the event of future impasses. It should not have taken a rocket scientist to see what was going to come next. I stood at the mic at the local meeting to sell the deal and begged those in attendance to vote no…that these cuts would be permanent and in the next round of negotiations, the government would absolutely kill us with unilateral actions. The OMA Board Executive rep rolled his eyes at me and smirked as he said “Quite frankly, we don’t believe that is going to happen”. The OMA Senior Staff table were chortling and guffawing. 81% of voting doctors were hoodwinked and voted yes to accept cuts and the possibility of unilateral action…

    And then…came the hammers and cudgels of 2015. Twice…
    Who could have known??…
    The OMA and the membership were caught unaware and flat footed.

    Next…came the fall of 2016. A hastily conceived ‘agreement’ was hastily approved by the OMA Board. A hard sell was put onto the membership by members of the OMA Board in videos and on a roadshow. The OMA even hired the PR firm that they had previously hired for an ad campaign to sell the deal to the membership. Fool me once, shame on me etc.

    It was clear to me that the OMA had egregiously lost it’s way and was clueless and/or disingenuous in no longer looking after the interests of the membership. I knew that the OMA NEEDED to be fixed and ASAP. I believed that I had the tools and skill set to roll up my sleeves and work to fix the OMA. But I also believed that one had to get on the OMA Board to (1) learn what is actually really wrong with the OMA and (2) to be able to effect the necessary changes to fix the OMA. Fortunately, many physicians with the same mind set were elected to the OMA Board in 2017.

    So that is why I am grudgingly involved in medical politics. But I do not like it and I do not enjoy it. It is a dirty job to fix all that is wrong with the OMA. It took 30+ years for the OMA to get this bad and it is not going to get fixed overnight. However, I am very much heightened and heartened by what we have been able to achieve in only one year. Of course, the pace of change will seem glacial…it will take 2-4 more year to recognize the benefits of the changes of the past year. But momentum is an easy thing to lose and takes a shitload of work to maintain. I am going to work tirelessly to maintain the momentum of positive change at the OMA because the membership and, yes, our patients need the OMA to be the best it can possibly be. Someone’s gotta do this…

    1. Brilliant post, Paul!

      You captured what so many people felt. I might add that I think many on the board during the 2012-2016 confinement got bamboozled. Many of them were good people who lost sight of why the OMA exists: to take care of doctors so that doctors can take care of patients.

      You are a rare, fearless voice of sanity. I sure appreciate the sacrifices you have made over the years to make things better! Most people have no idea how much work you did last summer as Chair of the Governance Task Force. THANK YOU!

      And thanks for reading and posting a comment. Always excellent.

  9. Thank god for the likes of you, Paul Conte, and Shawn, Nadia and all our confreres (and conseres) who are sadly addicted as well. No, it’s definitely not enjoyable, but as you say, someone’s gotta do it, and you do it well! Thank you!!

    1. Thanks Donna…and YOU do it well, too!

      Looking forward to seeing you on the Board soon. 😉

  10. Definitely can relate to medical politics addiction sytem. I used to pay no attention and then became shocked by some of what was going on. So felt I needed to keep abreast.

    For myself as a psychiatrist in Alberta it has been very rewarding becoming involved in advocacy that not only involves other physicians, but also other members of health care team, and concerned public. I’m involved in Alberta Mental Health Advocacy Coalition and we are currently addressing 1) gaps in healthcare management and leadership, and 2) decreasing quality of public funded addiction and mental healthcare.
    Have had communications with Health Minister and Office of President and CEO of Alberta Health Services (AHS). Remains to be seen what happens with addressing our concerns, but just the profound appreciation of so many people for this advocacy work has been deeply moving.

    1. Hello Tammy,

      Thanks so much for your work in Alberta! One of your biggest jobs in you role is to find a clone to fill your spot when you move on to another position. Some doctors truly enjoy system work, but most MDs just want to see patients. This is a good thing, but it makes it harder for us to convince our colleagues of the need to spend some time helping to make things better. If we all spent a few years in meetings, Medicare would have a harder time ignoring medical thought from the bedside.

      Thanks so much for taking time to read and share a comment in the dead of summer! I hope you are finding time to relax and reset before the craziness of September starts.

      Cheers

      Shawn

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