OMA Mid-Life Crisis

65 thoughts on “OMA Mid-Life Crisis”

1. Hi Shawn. You are so right! What organization would be so meek and mild that barely a word has been heard since the unilateral cutbacks. I am looking to see what the latest police contracts that are being recommended to its members. I bet there will not be a salary reduction ! OMA start giving direction and confront the present Wynne government ! Tim Nicholas

   1. Wow. You are fast off the mark, Tim! Thanks so much for commenting. I hope it didn’t sound too negative.

      We – the OMA – face a serious crisis and need to decide what we will stand for. I don’t think ‘getting back to the table’ is an end in itself. Frankly, I think the government won’t bother coming back for a few years.

      I worry that OMA will need to make some substantial changes on how it deals with government, or changes will be forced upon it.

      Thanks so much for taking time to read and comment!

      Best

      Shawn

      1. There is no agreement…hence there is no end. Negotiations, and the negotiation process, have been deemed OVER by the government until they see fit to change this.

         This further compromises the relevance of the OMA and, as a result, they had better adjust their priorities.

         It makes me ill that no one saw this coming with the 2012 ‘agreement’ where conciliation, facilitation, exclusive negotiating rights for the OMA and the short contract were sold as tradeoffs for a “one-time” $850 million cut. I remember asking at the 2012/13 sideshow (roadshow) what happens when conciliation and facilitation fail and I was chortled and guffawed at by the OMA prez of the time as well as OMA economics, legal and negotiating team members. It was sold as a ‘huge’ win.

         Only the OMA could turn a huge win into a catastrophic loss

         1. Great points all, Paul!

            I think you captured the feelings of many of us with, “It makes me ill that no one saw this coming with the 2012 ‘agreement’ where conciliation, facilitation, exclusive negotiating rights for the OMA and the short contract were sold as tradeoffs for a “one-time” $850 million cut.”

            I disagree with one point. I believe the OMA is all of us. It’s only as good, smart and strong as those of us who get involved. So while I share your frustration and agree with almost all of your comments, I don’t go quite as far in criticizing the ‘OMA’ as though it were something other than you and me. Bureaucracy aside, you and I make the OMA much of what it is; all 25,000 of us do.

            Again, thanks SO much for sharing your thoughts! I love it! We need passionate expression and discussion.

            Highest regards,

            Shawn

            1. “It makes me ill that no one saw this coming” I saw it coming. I think I convinced some in my section but like Cassandra of Greek mythology. My prophecy was correct but no one believed me

2. As a graduating family medicine resident, I must admit I feel somewhat betrayed by the OMA. My colleagues and I have not only seen our income decimated, but also have been told where we must practice and the type of practice were allowed to have. I do not know of another professional organization that would stand for this without significant action.

   Invariably government will renegotiate with us before the next election, but I think we are foolish as a group to allow that. I think we should make it clear to government that they either negotiate now, or wait until after the next election… That would likely bring them back to the table in a hurry.

   1. Great comments, Matthew!

      Our most vulnerable members have been attacked, and we don’t see any outrage. I got involved out of frustration a bit like you face now but on a much smaller scale. I feel sick that we aren’t mounting a massive sit-in, march or some major demonstration to show solidarity with you. Just sick. This is not right. History will not judge us kindly if we continue with the same response to date.

      Thanks so much for sharing your thoughts! Let me know if there’s anything you think we especially need to discuss.

      Best

      Shawn

   2. Matthew,

      The table has been set…there are no further negotiations until the government says there are.

      Negotiations before elections are better for doctors. Witness how a ‘strong’ (used facetiously) majority government has dealt with physicians with impunity.

      It is somewhat ironic, don’t ya think. The med students and residents in 2012/13 were sold that contract so heavily and voted well over 90% to support it. The seeds for disaster were sown in that agreement but how could you/they have possibly known.

      OMA needed a yes vote and was only too thrilled to tout the 81% approval rate and the highest participation of docs in a vote ever…yikes…

3. Shawn, that is one of the best opinion pieces I have ever seen. And I have seen a lot. Your analysis is excellent.

   The problem with the OMA and the government is not a new thing though. It is just that different doctors are now starting to see the problem affecting themselves directly. Many Ontario physicians had already seen the impact of government edicts to their own patients and practices in the past.

   Demonstrations are counterproductive!! I saw them in 1986. The best way to deal with the government is to just point out how they have concealed the fact that they overpromised and underdelivered in healthcare. All physicians have to do is point out the numerous deficiencies in our healthcare system and how the current fee imposition has suddenly made the problem even worse.

   As you know, I have already heard of physicians retiring and looking to leave the province because of the imposed deal.

   Demonstrations are not necessary as soon more patients will suddenly see for themselves what has happened to their own lives. It is just up to us to point out examples of what already is happening because of the government’s actions. It is as simple as that. We just have to get the story out to more people. It should not be that difficult.

   It would be best that the resources of the OMA were brought to bear in the information campaign.The OMA has made many mistakes in the past. I have been furious at the OMA many times, nevertheless, I prefer that they change their modus operandi rather than become irrelevant.

   1. Wow, thanks so much, Gerry!

      I appreciate your thoughts on demonstrations. It seems everyone who participated vowed to never do it again. But I wonder, Is there a difference between a strike and a peaceful demonstration? Even if for no other reason that to support our new grads, shouldn’t we consider a protest lunch at Queen’s park hosted by the Doctors of Ontario? We could serve hotdogs and hand out flyers?

      I agree with your comments about patients soon feeling the pain. They might wish doctors had put up a louder protest. If we don’t say enough, patients will criticize us for not advocating for them when we had the chance.

      The first phase of the OMA campaign/response has ended, in my opinion. We need phase two, and it won’t be easy to decide how to do it.

      You need to share more! I know it takes time, but we all need to hear more from the doctors who personally experienced government interactions through the 80s and 90s.

      Highest regards,

      Shawn

      1. Hi Shawn The OMA needs to be seen and heard. It needs to start talking about the inadequacies of the system and how government inaction and interactions are making things worse!!!

         1. Thanks again!

            I agree but struggle to mount much credibility unless I can say ## of docs have said what they want. If it sounds like I’m just spouting off my own opinions, the board won’t be as receptive to the ideas. Sure appreciate you taking time to comment! It would help if others do too.

            Highest regards,

            Shawn

4. excellent post sean — very clear and concise. have read through the comments.

   i think the OMA is struggling with a PR campaign that isn’t as clear and concise as your blogs. their posters don’t make sense to the average person. vandan’s interviews are not working because he comes off as obtuse and wordy, and worse, he says the exact same thing each time. he won’t point out that hoskins is wrong; he just keeps trying to explain things. while it’s noble not to scrabble inthe dirt, he must call a spade a spade.

   what the government is doing is wrong and unfair. unfortunately, their PR campaign is working well. so not only are we facing a threat to our profession, our reputation is tarnished as well.

   i actually don’t think patients will feel the pain of what’s happening for many years to come. at heart, most docs go into medicine for altruistic reasons. we will end up sacrificing ourselves to provide good care in the face of austerity-type measures.

   i don’t think we should strike. and the egg-timer business — i don’t agree with hurting patients to lash back at the govt. but you’re right, we need to demonstrate in public ways that what the govt is doing is neither democratic nor just. we need to take the fight to them directly.

   1. Thanks Nadia!

      I think the comments are always the best part of the posts. The OMA campaign seemed like a calm, thoughtful, cautious place to start. Now that it’s run for a few months, it might be worth asking what’s next.

      I agree that no one wants to cause patients more pain. The government cuts have caused enough. But I wonder how we would approach this problem if the healthcare system was a real patient? If we had a fresh trauma patient, would we avoid causing any more pain because the patient had suffered enough already? Wouldn’t we do whatever was necessary to help the patient even if it the treatment caused more pain?

      I sure appreciate your thoughtful approach! Your comments over on the google group sound very balanced and thoughtful, too. Keep it up!

      Highest regards,

      Shawn

   2. Hi Nadia. You are right on. My mother who is sharp as a tack and is 90 asks why do we never hear from the doctors about unilateral cuts from the government. When I point out to her about the full page adds from the OMA that ? won awards she doesnot see any connection or what they are about. Neither do I ! You have to make a point and make it simple ie NO MORE GRAVY TRAIN. That is how to win a campaign!!

      1. thanks tim. i actually feel better hearing about how confused your mom was about the adds. to be honest, i was too. i looked at the OMA posters and am embarrassed to say, it took me several minutes to get their point — or at least, what i thought was their point. i figured if i have trouble with it — with the inside knowledge that i have about medical care, politics and overhead — how could my patients possibly understand? and in fact, when i asked even my brightest, most well-educated patients, they too were just as stumped.

         like the commentators above said, i want the OMA to change with the times. i want them to continue educating the public (with better posters of course), but i want them to fully represent the docs. i want them to rally us together to have peaceful demonstrations asking the hard questions — why is the govt unwilling to even fund healthcare for a growing population? is it because they are giving up on universal health care? is universal health care a socialist pipe dream? is it time for a change? and if there is change, what sort of change do we want to see — change borne out of frank discussion with front line health care workers (docs and nurses alike), patients as well as politicians OR change that is unilaterally imposed by an apparently undemocratic govt?

         when i talk to my patients about what is going on, they don’t see me as a rich b**ch whiny doc. they see me as someone struggling with an unreasonable employer with my back against the wall but a doc still making the effort to provide good patient care. they see someone who is struggling to pay back loans, mortgage and provide for a family. they see someone struggling for the canadian dream — work hard, make money, live a comfortable life supporting my loved ones. i believe we can and should have demonstrations dispelling these myths of whiny fat cat docs that seem to have been perpetrated by the media and the govt. we need to tell them the true story and humanize ourselves.

         your blog helps shawn. a lot. i’ve reposted a lot of what you’ve written on facebook.

         but we all need to do our part. i’m going back to the google group and putting in my vote for demonstrations.

         1. The demonstrations must not be marching in the streets but through media. Physically going to Queens Park is a losing strategy. I did in 1986 and doctors got absolutely destroyed and badly beaten. I cannot emphasize enough: do not go physically to demonstrate. Do it verbally by citing examples of how the government has failed patients.

            This is what we need to say:

            The duly elected representatives of the patients created this health care system. Physicians are not responsible for it, but just doing the best we can.

            1. I love your input, Gerry! You speak from experience and years of political observation.

               I wonder, at what point would you support a peaceful public demonstration? Is it never acceptable no matter how heinous the crimes of government?

               There seems to be a time when talking and writing reach the limit of their effectiveness. Do you agree?

               Thanks again for commenting! Fantastic.

               Shawn

               1. A public demonstration for physicians will never be acceptable to me UNLESS we are prepared to go on STRIKE. I will never go on strike again and neither will most of Ontario Physicians. A public demonstration, even with patients present, will be counterproductive and never be acceptable to me.

                  1. I feel what you’re saying but fail to see the logic. It seems almost like you refuse to treat the patient at all unless they accept a leg amputation. Surely there might be reasonable treatments to offer our Ontario patient?

                     Again, I love discussing with you, Gerry! Really appreciate you taking time to share. Much nicer to see you develop a whole thought in more than 140 characters. 🙂

                     Highest regards,

                     Shawn

                     1. The analogy is not quite appropriate, Shawn. We are not telling the patient that they NEED an amputation but they have already LOST their leg and need to deal with that fact.

                        As a physician I have been in peaceful demonstrations and I have been on strike. I even saw physicians jumping over blockades They all make us look bad and hardens the voting public AGAINST not for doctors.

                        You will be hurting your cause. Don’t even consider it demonstrations. Instead talk to your patients or give them a handout you have written. Include the Health Minister’s fax, email and phone number. Ophthalmologists got the government back to the table in 2014 with these tactics. Unfortunately, the OMA bureaucracy abandoned the small high overhead, high billing specialties for their own benefit.

                        The government cannot DELIVER healthcare they can only LEGISLATE it. Just show them and the public this fact.

                        1. Good points. I worry about demonstrations changing character, too. I like hearing about your experience in 2012 with grassroots mobilization. We definitely need to escalate our response; it’s just not clear how.

                           Your opinions definitely resonate with many of the wiser heads around. They say very similar things.

                           I think we need to increase our response at the same time as re-examining what we stand for as outlined in the original post.

                           Thanks for persisting in advocating for some other response than a public demonstration. I think your handout, email and fax approach offers an intermediate step. Perhaps, we could get patient signatures on forms handed out in our offices then fax them into MPPs etc.?

                           Thanks again!

                           Shawn

                           1. Faxing forms signed by patients was exactly what Ontario ophthalmologists did in 2012!

                              I had one lady phone the MOH and scream at them… I just kicked her out of my practice for screaming at my staff. 🙂

         2. I really like the questions you ask in your second paragraph, Nadia. We need courage to ask them!

            I’m also glad to see you mention that we all need to do something. The OMA cannot act without clear support. It’s power is directly proportional to the energy exuded from the front-lines.

            Thanks again!

            Shawn

5. A true test of the OMA and it’s willingness to change is what it does, or does not do, next.

   You are right, Shawn, phase 1 is done. In my view it was too tepid, mild and obtuse. It did not reach enough of the right people. The media yawned and government saw no need to pay attention. Hell, Doctors Ontario’s egg timer piece was in the news FAR more than the OMA’s meek response.

   Everyone has moved on…media, government and public at large.

   OMA challenge is how to bring this back to the front in a manner that gets the attention of the right people. It will involve the OMA thinking far outside of the small box that it keeps itself in.

   1. Great comment, Paul!

      I think many of us worried about the ‘what if’ scenarios in 2012. What if the government pretended to negotiate? What if they took us through the whole process and STILL legislated?

      While we hoped it would never happen, we agreed to cross that bridge if the government was ever so draconian. It happened. Now we need to fight, I think. It will be a long battle with escalations and retreat. I think it’s time for escalation.

      I loved what you said: “OMA challenge is how to bring this back to the front in a manner that gets the attention of the right people. It will involve the OMA thinking far outside of the small box that it keeps itself in.”

      Thanks for taking time to comment!

      Highest regards,

      Shawn

      1. I agree wit the above comments.
         I want to add; so much money and funds have been
         wasted by the government in scams and errors.We have to pay
         for their mistakes.
         What about other agencies who use medical services such as
         u/s(midwives);NPs are they going to be cut too?
         Although it is not the fault of physicians,
         I personally feel that the public is not in our favour;
         a good 80% of people cannot get same day appointments;
         there are long waits to see specialist.
         Any kind of industrial action will go against us.
         The OMA has a very difficult task too ;they have to get the
         government back to the table.
         There is going to be a lot of discontentment and friction for
         next few months.I cannot see OMA winning .
         Sad state of affairs.

         1. Thanks for sharing this, Shelly.

            It doesn’t seem fair when every other public servant around us seems to get raises and we get 5 years of cuts — massive cuts! Your comments about public support ring true too. We’ve been so panicked about losing public support, and when we really need it, it doesn’t seem to help. What good is an 80% approval rating if it allows the government to impose 25-30% cuts to net income?

            Thanks for taking time to read and comment!

            Best

            Shawn

      2. The fight should have been fought in 2012 when the most cut specialties worked their butts off mobilizing patients and getting into the media. This pressure on the government was what go government to come back to OMA. The government was on the ropes when the OMA and the larger specialists threw these fighting specialties under the bus.

         Now doctors should do what would have been better done in 2012. Many more doctors are now affected by cuts and so their mobilization should be easier. Unfortunately, lots of doctors are quitting now. Had the fight been fought in 2012 these drastic effects would not have happened. Nevertheless, the same strategies used by the vocal specialties of 2012 should be used by all groups and hopefully the OMA can be mobilized on the side of doctors.

         1. You touch a critical point here. We lost some credibility by not supporting members enough in 2012 when they were attacked. Having said that, it’s never too late to do the right thing.

            For me even if there was zero cut, I find it egregious that government can outlaw alternative places for doctors to work caring for patients AND legislate fees. That’s totalitarianism by any definition.

            Thanks again!

            Shawn

6. I’ve been asking myself the questions in your article a lot lately, and I too have been underwhelmed by the response from the OMA. No emotion, no strength. The province has latched on to the ‘public purse’ mantra and our message is… Well I’m not sure what it is. I strongly believe what we have is a major image problem in Family Medicine/ primary care. If we had a stronger profile, if the public truly understood what we do and believed in us, that there would be no way that the province would dare cut us. This isn’t something that we can reverse easily or quickly, and I have no fabulous ideas on how to fix the ‘pickle’ we’re in. But we need to start making ourselves valued and stop assuming the public, our patients, specialists, and the rest of the health care community know what goes on behind the scenes. We deliver top-quality patient-centred care. We manage multimorbidity day-in and day-out. And do it (even before the cuts) at stunningly affordable hourly rates. So why aren’t we selling ourselves?

   1. Great comments, Katherine!

      We need to admit that in our system stakeholders must fight for their share or get eaten by the others. Partnership and calm thoughtfulness works when there’s enough for everyone. When there’s not enough food on the table, the siblings must fight or starve.

      I hope the profession wakes up to this reality soon. If we wait until it starts to hurt patients and try to blame government then, it will be too late.

      I sure appreciate you taking time to share. The comments are definitely the highlight of any post!

      Highest regards,

      Shawn

   2. Katherine,

      The inherent problem, regarding ‘making ourselves valued’, is that the public values what they pay for. Often, when they come to see you, there is no money that changes hands. I know that this may be uncomfortable for some but there is an utter disconnect between what you make and what the public thinks you make.

      Patients wax poetic about their naturopaths/midwives /massage therapists/homeopaths/acupuncturists because they get all the time they want AND pay out of pocket for services AND products…

      The thinking goes something like this: you, doctor, make a lot of money…because you are a doctor. I have no idea what you make but you make a lot, too much…simply and only because you are a doctor.

      The patients who are most grateful for what I do are those who buy their doctor’s notes, pay for their forms and pay for their non OHIP full physicals. These services pay much more than I get for the patient who holds nothing but contempt for me because I won’t address all five of their issues in one visit.

      I have it posted EVERYWHERE in my clinic what I get paid GROSS for services provided by OHIP. What is posted is pre 2012/13 contract and after 2015 imposition. The responses to this have been favourable the vast majority of the time and patients have been very sympathetic.

      We need to stop thinking that discussing fees is beneath us. Because of our profession’s reluctance to do so, now the fees ARE way below us…

      1. Right on, Shawn.

         For various reasons physicians are afraid or unwilling to discuss payment for services rendered. Most of us have never billed a patient for anything. For the first 10 years of my practice (1976-1986) I billed my patients and submitted the bill to their insurance company (OHIP). My collection rate was 97%.

         I know that there are parts of the province where billing patients is almost impossible but there is little can be done about that unless the feds bring in a guaranteed minimum income. That won’t happen for now so forget that. The truly poor will have to be dealt with but there is a difference between can’t pay and won’t pay.

         I am sure many, if not most, Ontario physicians are petrified of billing their patients for anything. That is another topic.

         Even if you won’t bill patients directly, the fact that we can is a strong lever against government to keep physician fees reasonable.

         1. You touch on another huge issue with our current system: patient and provider insulation from costs. Even with 1st dollar coverage in the system you describe between ’76-’86, everyone still understood that services involved transfer of funds.

            Winkler’s ‘collision course’ will force physicians to confront uncomfortable change. If we only advocate for more power and higher fees, we will not avert the impending collision.

            Keep sharing your thoughts! Many read through the comments. It changes thinking in places you’d never have guessed.

            Shawn

7. Seeing our hefty OMA fees wasted on a year of “negotiations”, and an arguably worthless PR campaign, is hard to take. Ultimately membership needs to see some difference between MOH and OMA. The OMA will need to become more of a Union and less of a “partner”. The “partner”thing is a noble goal in theory…but it just hasn’t worked out (Obviously).

   1. Good thoughts, John.

      When times are good, the OMA gains much by pursuing partnership. When money runs out, we have to be ready to change direction. Partnership hasn’t worked so well for the last few years, in my opinion.

      Thanks for taking time to read and comment!

      Shawn

8. Part of the big problem with the OMA mid-life crisis, and I was there from 2004-2010 on the SGFP executive, is the lack of vision and innovation from the non-physician governance/bureaucracy at the OMA as well as the legal and economics departments.

   At Council, SGFP meetings and Roadshow sideshows that they were required to speak and present , they came across far too often as sympathizing with the view of the opponents (MOH, CPSO). Patronizing responses to questions from many show me that they do not see themselves as working for the physicians of Ontario but for the OMA corporation itself.

   Too much laughter, eye rolling and expressions like “That will never happen” (well guess what, it did) show me departments of the OMA that are far too comfortable and unwilling or unable to innovate in their approaches and think outside the box.

   Those who have never been inside the OMA do not know. I am not saying that these are bad people. In fact, they are good and very reasonable people.

   The OMA, from the Board to the CEO to the various departments, needs people who are unreasonable who are willing to get down in the trenches and fight where the battles are happening in order to respond effectively to unreasonable opponents.

   1. I especially like what you said here: “The OMA, from the Board to the CEO to the various departments, needs people who are unreasonable who are willing to get down in the trenches and fight where the battles are happening in order to respond effectively to unreasonable opponents.”

      No doubt, there’s a time for pursuing a ‘just war’. I wonder if we’ve arrived at that time?

      Thanks again for sharing your comments, experience and advice!

      Best

      Shawn

   2. Paul, thank for that. I have been a outsider but have suspected exactly what you said about the bureaucracy at OMA for years to no avail.

      We may have to work around them and not with them but we must try to get OMA onside first. I have noted someone who was very high up in OMA now being a bit more publicly aggressive with government. Maybe there is a little hope. Those of us who can should be in touch with those at OMA who may be willing to help.

9. What can the OMA do? As George Costanza said” I have no hand”.
   Some will remember 1986 and the doctor’s strike, a public relations disaster; the OMA would not likely suggest another strike.The public will never be sympathetic to doctor’s income issues.Family medicine was enhanced in a big way because politicians grew tired of constituents calling their offices complaining that they could not find a family doctor.A small reduction in income will not effect access or care.Perhaps the OMA should resume dialogue with the government about reducing utilization that provides no benefit, not an easy task but hash tagging “care not cuts” is worn out by now.
   Keep up the great posts.

   1. Thanks for taking time to comment, Fred!

      Many share your thoughts, for sure. We don’t know what to do or say anymore. When all legal options have been tried and failed, what can citizens do in the face of obvious oppression? Thankfully, we can still mount a peaceful public demonstration. We might have to ‘stoop’ to all sorts of silly antics just to try anything and everything to correct this.

      I agree, a strike cannot happen. But our fear of strike – and of the CPSO – must not stop us from speaking truth to power, from doing what is right.

      The next year will require great courage and stamina from us all.

      Thanks again for taking time to read and comment!

      Best

      Shawn

10. Shawn for OMA President!

    1. Too funny!

       That’s an incredibly hard, thankless job for sure. I worry I might get kicked out, not elected. 🙂

       “Rick for President!”

       Thanks so much for taking time to read and comment, Rick! See you on Wednesday.

       Warm regards,

       Shawn

11. The OMA has more money and salaried bureaucrats to get our message out. We should be trying to get OMA to being the work that most of us clinicians don’t have the time, skill or stomach to do. That’s why I think we should try to work with OMA too. If they don’t work with us then the OMA will be irrelevant as Shawn said in his opinion piece.

    Family doctors and specialists must get the message out about the effect of the cuts in their own fields of work. We can also show the effects on delivery of care in other fields of medicine if we know about them.

    “Care not Cuts” may or may not be worn out but it is the message we should get out there with EXAMPLES that we know about of Cuts. That is why I use that #hashtag

    1. I support your approach. It’s definitely the high road. I also agree that we need to work with, support and influence our own organization; it’s the best way to get change in Ontario right now.

       1. I am happy to let the OMA to take the high road and look gentlemanly. The front line needs to give the OMA the data as well as tell their local media.

          If the OMA doesn’t cooperate with us then they will be irrelevant as Shawn has said.

          1. Well said! I can’t wait to see the 25,000 MDs of Ontario speak up.

12. I also feel this was a well-written post summarized by you Shawn.

    I more so feel that the OMA is suffering an identity crisis, not necessarily a mid-life crisis. I went to the president’s tour a few weeks ago, and it was rather lame. I felt that Dr. Vandan didn’t have enough balls over this matter. He said “don’t shoot the messenger” and other similarly meaningless statements. I felt like I was the only one there that was as mad as Heck at the OMA itself for failing to show proper leadership over this matter…I myself didn’t stand as much to lose as a salaried doctor, but I was really there in solidarity for my close MD friends who stand to lose a lot. I was really quite angry about the lack of anger on this “Dr. Vandan roadshow” to be honest–perhaps as professionals, most were trying to be cordial and polite. At that meeting in southern Ontario, however, I did meet quite a number of other MDs and for the first time in a long time felt a real sense of camaraderie and solidarity between the specialties. Overall however, I direct my anger at the OMA and not the government, although both are losers!

    The only thing I did like that Vandan said was that Doctors must not start a massive demonstration or protest or it is likely to backfire by public perception ie. the court of public opinion is fierce and unforgiving–Apparently this very thing happened in the 1980s. Other than that quite frankly I don’t know why I continue to pay dues to that silly organization who doesn’t have the cajones to stand up to the government (Wynne herself is an embarrassment to the province–before this I was traditionally liberal–not anymore!).

    Moreover, I might add, we weren’t just betrayed by the OMA, we were betrayed by Dr. Hoskins, himself an MD! This was inexcusable and irreconcilable as far as I’m concerned. He’s become an ivory tower doctor who has no real understanding of our collective struggle.

13. Thanks for commenting, Ken!

    I wonder whether we confuse physician politeness for lack of passion?

    In fairness to the President, he receives his speaking points with consultation from media experts. He can’t stray too far with personal editorial. I would attack his message and ask for it to change versus questioning his courage. If anything, I see your message as a call for all of us to have more courage.

    You voice what I’ve heard many others asking. “Why are we paying dues?” All dues need to be earned out of respect for those who finance them.

    Thanks again for commenting!!

    Shawn

    1. Speaking points?? Media advisors???

       Sheesh…is it these ‘speaking points’ which did not allow Dr. Tandan to obliterate the government head of negotiations on “The Agenda”. Time to guide the media advisors in a different direction or hire new media advisors.

       When a golden opportunity is provided to you in a debate or live media you have to take advantage of it to get your point and the truth across. I watch that show once a week when I need to do a slow burn…language is important…how can one dress up a clawback to make it look pretty? Dr. Tandan had him…and let him go. Because of these ‘speaking points’?

       1. 🙂 I hear you!

          Having said that, I can only imagine how tough a debate with an unfriendly might be on national TV. I’ve only been interviewed on TV once or twice and found it tough! No excuse for avoiding the jugular though.

          Perhaps, we’ll get a chance to talk frankly at council in May? I’d love to hear your comments off the record and share the ones I would never put in writing, too!

          Thanks again for reading and commenting!!

          Best

          Shawn

14. I went to the 2012 Road Show at the Family Medicine meeting. The A007 had recently been reduced by $1 while negotiations were underway. The OMA was announcing the offer of the 0.5% across the board cut. I asked the question about “what about the $1 cut to the bread and butter A007”. He just answered that it would stay in place (didn’t offer that spontaneously). I tried to stick to that point and explore it more but nobody else in the crowd seemed to care (this was a crowd of Fam Docs for pete’s sake), and they just moved on to the next question. I think I lost hope right then and there.

    1. I used to be shy and afraid to ask questions at meetings. It doesn’t mean they agree with OMA position. They might but not necessarily. No one likes fee cuts.

       1. I am shy too. But the people weren’t afraid to ask questions, they only wanted to hammer away at whether the 0.5% was worth accepting…and nobody seemed to blink that the $1 cut already represented about 3%. OMA was certainly glad to not talk about it. General practice really got burned already…but we still only hear about the 0.5% and the 2.65%….not that other 3% additionally.

15. A very simple solution is to stage a one day work stoppage every few months as needed to keep ourselves within the global budget for physician services. We are doing our part and it is the government that is refusing to cover the growth in needed services and fund additional doctors. A rally at Queens park (sticking to this message) would get the needed attention. The OMA must take the lead on this because doing nothing is not an option if they wish to become relevant again. All ER’s will remain open.

    1. Better way would be for Oma to calculate how much to slow down to stay within govt budget then just tell us how much we have to decrease our work to accomplish. But I believe the OMA won’t do it.

       At minimum the OMA could just publicize,even without condoning it, what doctors are doing on their own.

       Demonstrations will only detract from our message. We were angry enough to go to queens park to tell people their legislation would hurt healthcare not physicians but the headlines were and will be today: “doctors fighting with govt to protect their incomes””doctors demonstrate for more money”.

       The Star wrote a 2 page article in 1985 making two close colleagues look like slime balls. These guys were among most altruistic patient-centred doctors I know.

       The star changed a letter to editor I wrote and 3 people called my office, yelled at my staff and then canceled appointments.

       The media will crucify us if we demonstrate. Sorry for the blasphemous allusion

       Gerry

       1. Great comments Gerry and Matt!

          While I agree with your words of caution, we must balance them with the need to speak up with courage. I hope we can find a way to escalate without having to get too public with out demonstrations.

          Sure appreciate you taking time to share!!

16. Great thought, doc!

    Many would support a work ‘furlough’ or stoppage as you suggest. A peaceful rally could be part of the mix. Bottom line, most docs who care want to see something more than just newspaper ads.

    Thanks for taking time to read and comment!

17. As one of the least experienced among us, I find all of your comments incredibly rich and informative.

    I think to this point we are losing in the court of public opinion (as many have correctly stated already).

    I wonder about two strategies:

    1: a more simple message connecting cuts with the frustrations of most of our patients (wait times, poor access, ED wait times etc)

    2: imagine if we could convince a patient advocacy group to partner with us on protesting the government cuts with a highly publicized protest. It would provide a large platform for the advocacy group. For us, it would add legitimacy to our cause that would hopefully shift public opinion away from the status quo of greedy doctors who want more taxpayer money. To me it could be a win-win for both groups.

    1. Exactly, Matthew.

18. Time to get the OMA to become a union, not an association that beds with the needs of the current ruling party. Leave the patients’ interests to the CPSO, as they always have been, and stop the waste of money by the OMA toward patient education etc. that should be the role of the MOHLTC. The supreme court recent land mark decision is that ALL Canadians have the right to strike, regardless of essential service designation (with caveats of course). I’m rather tired of 27 years of begging. I closed my family practice after 13 years for the reasons you mention. The repair to the system must not be destroyed again!

    1. Hello Nick! Great to see you commenting here again!

       You held no punches in your note. I sure hope others read through to see it. Powerful! We need to survey the docs and figure out a way to highlight comments from folks who are truly engaged with what’s going on.

       Thanks for taking time to read and comment!

       1. Hi Shawn. Fantastic blog. Thank you.
          I agree. Rick for president! From what I remember, he’s never had a problem telling it like it is!
          Can you tell me the google group that Nadia is talking about?

          1. Thanks for reading and commenting, Andrew!

             I’ll send your contact info along to the group, for sure.

             Thanks again!

             Shawn

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