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FMinterview

The Ontario Medical Association doesn’t need more chaos

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https://www.thestar.com/opinion/contributors/2018/10/14/the-ontario-medical-association-doesnt-need-more-chaos.html?fbclid=IwAR1BQyrZ_h3coyl8Woqb6yuDdb9yCSE1HxVCd7lDHm8Yb2OKw-QLY_zyFJY

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Controversy seems to follow the Ontario Medical Association (OMA). After a period of transition, including the resignation of an unpopular executive committee and the installation of a raft of fresh new voices, the organization is now faced with another existential moment that may permanently alter its future.

An open letter was sent to members informing them that a group of doctors are creating a parallel organization representing the interests of specialist physicians. This decision was borne out of their frustration with the OMA and its negotiation position on relativity — the concept of creating pay equity among doctors.

It also builds on the longstanding criticism of the mandatory dues physicians must pay the OMA for representation. Many have resented this imposed structure because they believe the OMA has done little to advocate on their behalf.

This new movement is being spearheaded by Dr. David Jacobs, an outspoken radiologist who hopes to emulate the Quebec model where independent provincial bodies represent specialists and family doctors. These entities currently negotiate separately with the province on a range of issues, including remuneration.

It’s not unreasonable for Ontario physicians to want the freedom to choose their own representation. In fact, a monolithic organization like the OMA is limited in being able to properly advocate for all the different doctors under its large umbrella. The vast majority of doctors represented by the OMA are family physicians, while minority speciality groups — like physiatrists — often struggle to be heard. A new institution aimed at advocating for these smaller groups may not be a bad idea.

However, there is also no guarantee that this untested coalition — likely operating under a similar mandatory dues framework — will be any different. Larger and better resourced specialities like cardiology, ophthalmology and radiology will continue to dictate priorities, resulting in the same inequity that currently exists. It is also well known that physicians in the Quebec model have suffered from a divide-and-conquer strategy used by the government to neutralize their would-be collective leverage.

The motivation of this proposal is also curious given that it comes at a critical juncture in negotiations between the OMA and the province. Despite the Ford government’s election promise to work with doctors, it has taken the same posture as previous administrations, resulting in an impasse and setting the stage for an unprecedented arbitration in the coming months. With the swirling uncertainty ahead, this ill-timed initiative has the potential to derail a process that is years in the making.

At a time when the profession is dealing with growing burnout, doctors need to focus on healing themselves and their patients. We need a united OMA to end the five-year long struggle without a contract. More chaos is not the answer.

 

 

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24 minutes ago, FMinterview said:

Well written piece. I was sort of leaning towards the independent specialist group, mostly because in the short time that I've been following the OMA it's really come off to me as fat cat bureaucracy that got too comfortable with their mandatory dues. My sense is that a lot of the younger med students/residents feel the same way.

BUT the author makes a good point...we're finally at arbitration, which I'm (naively?) hopeful will go our way. The government has been quite rough with doctors for the last decade, which should bode well for us with an arbitrator. Even for those who are fed up with OMA, it maybe giving arbitration a shot? It's also a little suspicious that the government is supporting the division now that they have to move into arbitration...after they pump faked us and played hard (dirty) ball like the liberals.

I'm happy to be corrected by someone who knows more about medical politics that I do :).

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5 hours ago, PhD2MD said:

BUT the author makes a good point...we're finally at arbitration, which I'm (naively?) hopeful will go our way. The government has been quite rough with doctors for the last decade, which should bode well for us with an arbitrator. Even for those who are fed up with OMA, it maybe giving arbitration a shot? It's also a little suspicious that the government is supporting the division now that they have to move into arbitration...after they pump faked us and played hard (dirty) ball like the liberals.

I most definitely agree with the author. Trying to separate is an incredibly short-sighted move that will benefit the government (both in the short term as we move towards arbitration and in the long run). There is a lot more power as one collective OMA since it forces the government's hand in many things and generally results in a better deal for us. I'm blaming this one on physicians who use logic in their decision-making rather than using the strategic decision-making that politicians use. You can't win the game if you're playing with differing rules.

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