Pick an analogy: a frog slowly boiling, a camel’s nose inside the tent, a slippery slope. Too often, we accept small changes and wake up with disaster, a camel in our tepee.
Canadians hate rigid thinking. We avoid fights and love compromise. This makes us pions to activist governments.
Medicine faces an existential threat in Ontario.
Do not listen to the wise, old doctors who say,
“Relax. The pendulum swings. Seven fat years followed by seven lean. Don’t get your knickers in a knot. All good things come to those who wait….”
People who spew such nonsense, in light of the current Ontario government, are, with great respect, deluded.
Premier Wynne is no pendulum; she’s a juggernaut.
The Wynne Liberals propose changes faster than anyone can respond. The Liberals want a revolution in healthcare; a completely different way for patients to access care.
And they want the government at the centre of their new world order.
The examples of this government’s abuse of power would run pages long. Consider just the following:
Bill 210 completely revolutionizes primary care. The government wrote this with no input from working physicians. Bill 210 turns doctors into civil servants beholden to local bureaucrats.
Doctors will be paid to do what bureaucrats tell them to do, not what patients want. Every schedule change, every hour of patient care, must be reported, and approved by, local bureaucrats.
The government will hire an army of bureaucrats to staff the new ‘sub-LHINs’ and manage all the doctors under their care.
Bill 119 gives government broad access to patient records. Defenders of this bill insist that the government always could come to a doctor’s office and look at charts, but this is not clear (or even true apparently).
Even so, in the days of paper charts, sensitive bits of data, for example, an HIV test, might not be handed to the bureaucrat demanding a chart. With electronic medical records, it’s all available to government with a mouse click.
As with Bill 210, the government ignored input from physicians.
On top of this, the Liberals have cut hospital funding 9 years in a row and have cut 1400 nursing positions despite a growing and aging population.
Will Medicine Survive?
The Ontario Liberal government is attacking medicine. They want voters to believe it’s all about doctor and nurse incomes, but it’s not about money.
It’s about control.
Of course money is involved. It always is.
But politicians and social reformers love power more than money. They want command: absolute jurisdiction over how and when doctors work.
They believe that they know best whether a doctor should stay late in the office, or go on a house call. They want to control when doctors take breaks and how they pay clinic staff.
Government wants to make doctors accountable to government. They want to force doctors to order fewer tests, and do more preventive care, in return for little bonuses.
Patients’ needs do not matter; government knows what patients need.
Honest Politicians
Coercive Utopians
Honest politicians believe that forming government means serving and listening to all the people.
But not the Wynne Liberals. They act like any other democratically elected dictatorship.
Premier Kathleen Wynne is not a centrist. She’s a woman on a mission with a long list of things she wants to get done. She does not believe that representative democracy carries the duty to represent all voters.
She thinks that a ‘majority’ gives her the right to trample on anyone who does not agree with her. She steamrolls her bills through parliament without any adjustments or feedback from others.
Fair and Reasonable
Doctors need to assess how ‘fair and reasonable’ is working with this government. They need to look beyond negotiations and consider what’s crumbling around them.
- Who should lead medicine?
- How should decisions be made?
- Have unilateral actions, sham ‘consultations’, and cowboy legislation ever worked well, outside of totalitarian regimes?
Canadian doctors hate fighting. I get it. I am Canadian. I thrive on diplomacy. But, how’s that working for you, doctors?
I’m at my wits end. I am tired of making excuses for doctors being ‘fair and reasonable’ in the face of tyranny.
Things will change irreversibly in Ontario, over the next 12 months. Doctors could make a difference. But I suspect they won’t.
Will medicine survive, as we know it, in Ontario? Will patients appreciate the doctors they find in their tent when Premier Wynne gets done with her revolution?
photo credit: bbc.com
I like the Shawn with the knotted knickers!
Several of your colleagues who are specialists continue to assist OHIP, as experts, in legal proceedings against residents of Ontario who are self-represented at the Health Services Appeal and Review Board and who are attempting to access health services outside Canada. It would appear that these specialists do not share your views about the Ontario Government or, at a minimum, they would refuse to assist OHIP. Query whether it is the substantial hourly fee plus expenses that they receive from OHIP to be experts.
Once again Shawn, thank you! It is unfortunate that the OMA won’t or cannot stand up to protect health care in Ontario!
The OMA has commenced legal proceedings against the Ontario Government. What else would you have the OMA do other than commencing legal proceedings?
The legal proceeding you refer to relates to acquiring binding arbitration when OMA & MOH negotiations fail. This will take years in the court system. In the meantime MDs income was cut twice in 2015, privacy laws will be breached & now Wynne is pushing through legislation that is all about bureaucratic bloat. If government starts dictating my hours, vacation, etc I will leave medicine. So I expect OMA to come out swinging against all of this. Media releases, press conferences, effective advertising & organized job action.
Job action. Would not effect emergency services but would throw the public in an uproar (obs stop accepting patients in first trimester, for example.)
Wow this is really frightening, glad I left Ontario when I did – if anyone wants to practice elsewhere I would say my experience in Alberta has been quite pleasant.
Please let us know how it all works out for you!
(secretly jealous 🙂 )
Isn’t honest politician an oxymoron?
🙂
Hi Shawn I like your tag line about challenging accepted thinking and you are great at it. I am also intrigued by what offering solutions looks like. After the failed tPSA there may be a window of opportunity for creative destruction but where is the vision for what would be better? If history repeats itself my concern is that only a more expensive status quo will result. A few physicians may feel victorious and satisfied for a couple of years. If one has not been a patient lately one’s view of what works may be incomplete.
Hello Nancy,
I love how you put patient experience at the centre of how we define what works. I expected, initially, that 63% of doctors voting against the tPSA would ignite ‘creative destruction’, as you say. Maybe it’s too early to say, but I am not sure it will happen. The most common move in politics is to let time pass and hope people forget.
Thanks so much for taking time to read and share a comment! You are the first person to mention the tag line in several thousand comments! 🙂
Great to hear from you.
Warm regards,
Shawn
PS Sorry for the delayed reply. End of summer and school starting….
We are quite literally up against the wall with the firing squad charging their weapons. Our OMA leadership is in disarray due to the PSA debacle.
Our choices for response to these devastating changes planned for physicians and the citizens of Ontario are limited. Certainly a massive ad campaign to share with Ontarians what is at stake. However, the only thing that will truly get the attention of the political tyrants and the citizenry is work slowdowns or stoppages. We all realize, or should, that if 1 billion was removed from teachers pay and therefore education in Ontario There would be riots in the streets and a complete shutdown of the education system. We need to decide when is enough, enough?! Hopefully before everything is totally effed up.
Great comment, Robert.
Doctors seem to favour passive aggressive action, like retiring or leaving, instead of coordinated work stoppages. We work until we cannot, and government knows it. Having said that, the last two rallies in Toronto got positive media coverage. Who knows? Maybe the times are changing and coordinated action would work?
Thanks for taking time to comment! Sorry for the delay in responding…
Shawn