What the OMA needs to do now

The last nine months have been a stressful time for Ontario physicians, and has reached a boil over the past week with the announcement of further cuts by the Liberal government. Physicians have been active both in print and on social media in record numbers, and we are finally seeing the physician engagement on this issue that we have desperately needed for months.

As part of the vented frustration, the OMA has come under fire by many for a perceived lack of leadership in this crisis. The negotiating team from 2012 certainly deserves fair criticism for agreeing to a Representation Rights Agreement that allowed negotiations in 2015 to end with unilateral action. But I think we need to realize that in the short-term, the organizational muscle behind the OMA may still be our best bet to try and salvage something from this debacle. The OMA is a representation of the will of physicians. If enough physicians stand up and demand certain action from the OMA, they will have to act. With the number of splinter physician groups that are forming out of frustration with the system, the OMA is in a position where they must listen to membership, or risk becoming irrelevant.

One of the positives of this past week’s social media explosion has been the number of great ideas that have been put forward by physicians. Part of the downside of social media is that great ideas often drown under the wave of the next post by the next person, so here’s my summary of what the OMA needs to do immediately.

1) At the OMA Spring Council, Council agreed unanimously that “The Ontario Medical Association demand the Representation Rights Agreement be amended to add a binding dispute resolution mechanism”. The general understanding was that the window was three months for a response, and the details provided to membership by the OMA on this has been very disappointing. The OMA must provide both membership and the government with a clear timeline for when responses and resolution on this issue are expected, and need to follow through with legal action should expected deadlines from the government not be met. At this point, the government cannot be trusted as a reasonable partner, and they will stretch this out as long as possible. The OMA cannot allow this, and must use the immediate threat of legal action to create some urgency. Membership must be provided with very detailed and timely updates as to this process, perhaps even weekly.

2) Job action has been discussed by many physicians. Some ideas have been reasonable, others not so. The OMA must urgently provide its members with a “menu of options”, a list of detailed forms of job action that the OMA endorses. There has been great debate as to what the focus of these actions should be. Should they drive up non-physician expenditures to inconvenience the ministry? Should they be intended to inconvenience patients? Should they reduce non-urgent access for patients? (For the record, I think all three of those will hurt us in the long-run.). I know the OMA has been criticized for its reluctance to support any sort of job action, but this is an opportunity for it to provide membership with a list of approved actions to provide us with a united front. Rogue doctors reducing care will only disrupt their own physician-patient relationships, and will have very little impact on government policy.

3) The OMA must urgently create a publicly available database of physicians who have stopped working in Ontario since January 2015. The public will take notice of this growing list, and government will gradually feel the heat. I am tired of hearing the government boast about adding 700 doctors this year. Counter that with this list of the departed. Publicize the hell out of this list.

4) Along the same lines, many physicians have expressed interest in the leaving the province. The OMA should provide a form letter to its members, where physicians can sign a “Letter of Intent”, with the province or country they have inquired about moving to. This will not have any binding terms, but will provide the OMA with quantifiable data of the number of physicians who are considering moving. Again, putting numbers to this will make this situation very real for the ministry. Publicize the hell out of these numbers.

5) The OMA must urgently meet with family physicians in the Niagara, Guelph, and North York regions. They must inform those physicians that with the primary care reform being implemented by the ministry, obstructing that implementation temporarily is one of our few bargaining chips to push the government to binding arbitration. For those physicians who have yet to sign any contracts, the OMA must ask those physicians to refrain from doing so as a gesture of support for the rest of Ontario physicians.

6) Do not spend another dime on the #Carenotcuts campaign. It was a sensible campaign, but has failed to move the needle. Save that money for publicizing the threat of physicians leaving the province.

So there it is, OMA. There’s your blueprint. Please don’t wait for “physician consultation” and “road shows” to gauge physician sentiment. The last week has made things very clear. Physicians want action. Now.

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8 thoughts on “What the OMA needs to do now

  1. valron2015

    I was happy to see that OMA is finally posting what the real situation is on Facebook rather than saying what doctors do and providing some statistics. The new posts are much clearer about what is actually happening and what this will mean to patients as well as doctors. So hopefully the new leadership is willing to take a more aggressive approach. I have noticed a lot more doctors posting on Twitter and it is becoming obvious that they are reaching the end of their rope. The ON libs are quintessential bullies and standing up to them is essential. I think doctors must be very concerned with what the gov’t will “hit” them with next.

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  2. gerrybuddy

    I was wondering that too. We will be described by media as money grubbing unprincipled physicians who have violated the Hippocratic Oath. Sticks and stones etc… Let the words of those angry flow off your back. Before and during the 1986 strike, I took the nasty comments about physicians personally. It nearly destroyed me. It took me 10 years to get over it and enjoy working again. Do not take it personally. Look at the facts and make logical decisions.

    I hate anyone being angry at me but getting people angry at us is not a down side.

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    1. supermarioelia Post author

      “It nearly destroyed me”…but you’re encouraging us to go down the same path. And your advice is for us not to take it personally? C’mon now. We have other options for the time being that don’t involve taking a blow torch to our relationships with our patients.

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  3. valron2015

    No matter what you do, there will be those who play the “hater” game. Seems to be an insidious trend these days. All you can do is what you believe to be the right thing. Just as there will always be the naysayers, there will be those who support your decisions and actions.

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  4. gerrybuddy

    It almost destroyed me Spiritually. I am sorry not to have explained it better, but it was not what I did that destroyed me. It was the nasty words about physicians in general that I took personally. The media and government attacked us even BEFORE we took action. Other doctors handled it better than I did. They explained that it was only about money and not an attack about our integrity. I hope you understand me better.

    We lost that strike BECAUSE we wouldn’t do nasty things. OHIP billings went UP during the so-called strike.

    I am trying to protect my younger colleagues from what I went through.

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  5. Matt Henschke

    I think #3 and #4 are critical. Someone in PARO apparently made a list of residents who left the province due to the cuts – I consented to having my name on there. Might be worth reaching out to PARO to see how big the list is. If physicians actually leave the province I suspect Hoskins et al. will change their tune rather quickly.

    At the moment the government is relying on physicians good nature and desire to help people. It’s critical to show the government some teeth; whether through legal action or through a mass exodus elsewhere.

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  6. Alicia Schreader

    Thank you Mario for your efforts and excellent analysis. As a former student of political economy and history I have a somewhat different take on things. The OMA functions in a similar fashion to a medieval guild, a type of organization that at one time wielded great social influence and authority. Those days are past. In modern times only unions have legal standing and legally cannot be ignored. That is why we are the only public sector workers facing cuts to income, ie. Because they can. DoctorsOntario or some other “splinter group” needs to contact a professional Union and begin signing us up. Workers cannot be denied the right to unionize: it is enshrined in law. In Canada there are “piece workers” (FFS) like us who are unionized. I don’t see any other way forward for those who chose to stay in the province. Sadly, the OMA is a historical anachronism.

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