Quebec doctors demand a pay cut?

[Aconitase]

I am not sure if folks have seen this but it is now all over the US and even BBC about how doctors in Quebec have asked the government to take away their pay raise. 

 

https://www.washingtonpost.com/news/worldviews/wp/2018/03/07/hundreds-of-canadian-doctors-demand-lower-salaries/

 

any my thoughts on this? I’ve never seen anything like it 

[JohnGrisham]

There's always radicals

[Aconitase]

1 minute ago, JohnGrisham said:

There's always radicals

Lots of the American articles mention how this would only happen in Canada. 

 

Had not heard a lot about this around the hospitals in Ontario yet but seems very newsworthy!

[Snowmen]

A very small minority*

[Aconitase]

16 minutes ago, Snowmen said:

A very small minority*

Yeah although up to 800 docs now. Lots of residents and med students as well

[Hanmari]

I hesitate to write this off as the action of socialist radicals. Maybe it's just my bias but it is difficult for me to understand it as an act of pure idealism in the light of the already punitive atmosphere towards physician income in this country; if you want lower income, just let the status quo do its job. What do these physicians think they will gain from doing this? We are clearly in the spotlight often enough as a profession that the "any publicity is good publicity" argument doesn't work.

[la marzocco]

17 minutes ago, Hanmari said:

I hesitate to write this off as the action of socialist radicals. Maybe it's just my bias but it is difficult for me to understand it as an act of pure idealism in the light of the already punitive atmosphere towards physician income in this country; if you want lower income, just let the status quo do its job. What do these physicians think they will gain from doing this? We are clearly in the spotlight often enough as a profession that the "any publicity is good publicity" argument doesn't work.

Precisely. It is not so much about socialist radicals. It is more about political posturing. 

[#YOLO]

quebec is never happy.

[Aconitase]

20 minutes ago, #YOLO said:

quebec is never happy.

Yup. Even when they get a raise the complain!

[shikimate]

14 hours ago, la marzocco said:

Precisely. It is not so much about socialist radicals. It is more about political posturing. 

They already pocketed the monetary raises, so someone decided they wanna pocket some political raises too. You can eat your cake then pretend you meant to donate it to someone else, how brilliant is that?

[ralk]

It's not just Quebec. There is a wide swath of physicians in Canada who are angry, upset, or disappointed with how the profession has been treated by various actors - the government, other health care professions, even patients. These feelings have led to actions, taken by official groups, unofficial groups, and individuals in support of physicians' interests, particularly financial interest. Yet, this had led to a counter-movement among what still appears to be a minority of physicians, who believe these actions to advance physician standing are being driven by some combination of greed, arrogance, or indifference to more important problems affecting our healthcare system. This petition appears to be part of this counter-movement.

Now, Quebec physicians are lower-paid relative to other provinces, so physicians there likely deserve a raise. Yet, most recent data from CIHI indicates their income rose more sharply than in other provinces, easing what was once a rather significant disparity.

In any case, can't argue with this group's results. They've now got national and international attention on Quebec's overall healthcare funding.

[indefatigable]

21 hours ago, ralk said:

It's not just Quebec. There is a wide swath of physicians in Canada who are angry, upset, or disappointed with how the profession has been treated by various actors - the government, other health care professions, even patients. These feelings have led to actions, taken by official groups, unofficial groups, and individuals in support of physicians' interests, particularly financial interest. Yet, this had led to a counter-movement among what still appears to be a minority of physicians, who believe these actions to advance physician standing are being driven by some combination of greed, arrogance, or indifference to more important problems affecting our healthcare system. This petition appears to be part of this counter-movement.

Now, Quebec physicians are lower-paid relative to other provinces, so physicians there likely deserve a raise. Yet, most recent data from CIHI indicates their income rose more sharply than in other provinces, easing what was once a rather significant disparity.

In any case, can't argue with this group's results. They've now got national and international attention on Quebec's overall healthcare funding.

Just to add to the context - Québec's FP are actually less paid than ROC.  Specialists actually earn more than ROC on average.  But that's also because fields like psychiatry, peds and neurology are paid like other 5-year specialties.  In the ROC those disciplines are paid like FPs (or less).  My understanding is that it was especially the recent agreement between specialists and the government along with news about other health care workers (like nurses) that started this letter (there are two negotiating groups - the specialists and FPs).  

[Aconitase]

42 minutes ago, marrakech said:

Just to add to the context - Québec's FP are actually less paid than ROC.  Specialists actually earn more than ROC on average.  But that's also because fields like psychiatry, peds and neurology are paid like other 5-year specialties.  In the ROC those disciplines are paid like FPs (or less).  My understanding is that it was especially the recent agreement between specialists and the government along with news about other health care workers (like nurses) that started this whole movement (there are two negotiating groups - the specialists and FPs).  

I see - so basically a play to get more attention on the funding and try and divert money away from specialists to the FP?

 

otherwise made no sense why anyone would protest a pay raise 

[rmorelan]

People are looking for ulterior motives here.

But I do feel the need to point a lot of people in these movements and medicine really 100% believe that doctors are paid too much, and that their costs burden the health care system to the point that it harms patients as it cause the entire system to be under funded. It is a relatively small number for sure but it probably bigger than most people realize. 

I know quite a number of doctors that feel that way and while that can seem bizarre ha often to some people (particularly on the forum) I think it is important to realize that they really don't have any other motive but to help their patients. They aren't playing politics for politics sake. They aren't seeking to pocket money and then put on some fake statement of support for others etc for some reason. They actually would accept a pay drop if (and only if) it supported other parts of the system, and if they could figure out a way to have it globally happen they would encourage it (before someone says they should just volunteer back a big chunk of their salary in isolation - that wouldn't achieve what they are looking for  ). Plus this is Quebec where they don't have large student loans and med school tuition is extremely cheap, which removes a classic argument for doctor high wages so it is an easier argument to make there.  

I mention this in part to say I don't think you cannot dismiss or ignore people like that or thinking they are not actually truthful in what they are saying (800 people that declared them selves probably meaning a bunch sympathetic haven't as well - There aren't that many doctors in Quebec ~20K I believe). Not everyone is medicine cares about making money (beyond a reasonable point, and right now medicine is well above that point). One of the interesting things in medicine is exactly how richly diverse the people are in their personal and political beliefs. 

  

  

[indefatigable]

20 hours ago, Aconitase said:

I see - so basically a play to get more attention on the funding and try and divert money away from specialists to the FP?

otherwise made no sense why anyone would protest a pay raise 

It's complicated - but it was the specialists' agreement that was the tipping point, combined with other factors.  For instance, there was a nurse reporting exhaustion in the media, and then the agreement came out which made the specialists essentially higher paid than in Ontario (albeit with the caveats mentioned above).  So it was essentially a solidarity statement with other health-care workers in part.

Earlier there was an agreement with the omnipracticiens (FPs) but there wasn't much outcry, since FPs do earn quite a bit less than Ontario for instance (the default comparator).  In fact the FP agreement contained more wage increases, but the gap (écart) with Ontario esp. was higher.

Unlike Ontario, where the OMA negotiates on behalf of all physicians, in Québec there's more of a difference between specialist and FP.  To be fair, the movement seems to contain FPs as well, although I think the thrust of the letter was really more on the specialist side (who had benefitted more from the provincial government).  It's odd, because FM is really a specialty - however in QC, it's considered more like GP (in contrast to specialist).  

[la marzocco]

On the NS front: 

http://www.cbc.ca/news/canada/nova-scotia/family-doctors-physicians-incentives-raise-fee-for-service-wage-health-1.4582542

[Aconitase]

On 2018-03-10 at 3:46 PM, rmorelan said:

People are looking for ulterior motives here.

But I do feel the need to point a lot of people in these movements and medicine really 100% believe that doctors are paid too much, and that their costs burden the health care system to the point that it harms patients as it cause the entire system to be under funded. It is a relatively small number for sure but it probably bigger than most people realize. 

I know quite a number of doctors that feel that way and while that can seem bizarre ha often to some people (particularly on the forum) I think it is important to realize that they really don't have any other motive but to help their patients. They aren't playing politics for politics sake. They aren't seeking to pocket money and then put on some fake statement of support for others etc for some reason. They actually would accept a pay drop if (and only if) it supported other parts of the system, and if they could figure out a way to have it globally happen they would encourage it (before someone says they should just volunteer back a big chunk of their salary in isolation - that wouldn't achieve what they are looking for  ). Plus this is Quebec where they don't have large student loans and med school tuition is extremely cheap, which removes a classic argument for doctor high wages so it is an easier argument to make there.  

I mention this in part to say I don't think you cannot dismiss or ignore people like that or thinking they are not actually truthful in what they are saying (800 people that declared them selves probably meaning a bunch sympathetic haven't as well - There aren't that many doctors in Quebec ~20K I believe). Not everyone is medicine cares about making money (beyond a reasonable point, and right now medicine is well above that point). One of the interesting things in medicine is exactly how richly diverse the people are in their personal and political beliefs. 

  

  

I just believe anyone would want to give back money. If that’s the case then why don’t they just take their salary and donate money back to the nurses or something. It makes no sense to give back money someone is giving you!

[rmorelan]

Just now, Aconitase said:

I just believe anyone would want to give back money. If that’s the case then why don’t they just take their salary and donate money back to the nurses or something. It makes no sense to give back money someone is giving you!

because if they make a political statement about it instead, and keep pushing then they can in theory have money from all the doctors redirected to other aspects of health care. Since they are a relatively small majority doing that would amplify their impact roughly 20x and do it every year forever. Then with a doctor's cut they can go to the hospital admin and shame them into doing something similar or blam back in the news (that already happened in Ontario in a few places). You could if you wanted spin it so if any other health care worker wants a raise  the move will reduce that as well (you want a raise? Even the doctors didn't get one) - all to drive more money into directly aiding patients. It would also give them a new moral authority to demand the government do certain things in health care they want to have done - easier sell if the are in the media as protectors of health care and already agreed to cuts of their own. 

Just because they are generous doesn't mean they are also not intelligent and willing to do whatever they have to in order to achieve their goals. That's my point and why some people might even consider them dangerous (if you disagree with them). What is all that compared to a silent donation in isolation in the dark?