The choice that awaits us
As many of you are aware, we are having a binding referendum on Aug 14th at the Allstream Centre to decide whether or not to ratify the tPSA. My personal opinion from talking to colleagues and reading the social media chatter is that we are pretty divided on whether to approve or reject the agreement. It is unclear what direction the members will vote on Aug 14th.
Some of you may have read the article in the globe by Andre Picard on his thoughts of the infighting between doctors and the way some physicians have been opposing the tentative agreement. He has referred to this as “Trumpism” - the idea of blaming and attacking everyone (fire the negotiators, OMA council resign, MOH lying etc) as a strategy to persuade the general membership of the righteousness of their position to reject any agreement.
I believe Mr. Picard has made a valid observation - which has earned him the ire of the many physicians who resent being lumped in with Mr. Trump. I too have alluded to the similarities between the resistance by some physicians to the agreement and the movement to have the UK leave the EU (Brexit).
The root cause I think is a widespread populist anger by physicians…. against who they perceive are “elites” in “positions of power” making unwise decisions about healthcare.
But why are physicians so angry?
In spite of a modest raise in their incomes over the past 15 years, many physicians feel burned out, many are extremely stressed with the volumes of patients, administrative work, and new responsibilities being downloaded to them. Couple this with a health care system that is falling apart at the seams, struggling to maintain the same quality of care that Ontarians are used to. The healthcare budget is growing fast (approx 3.1% per year) faster than the provincial budget. And with an aging population, there doesn’t appear to be any respite in sight. On top of this, physicians are being asked to shoulder (through shared decision making) some of that added system responsibility of using resources wisely and efficiently. No wonder many are angry and upset!
Physicians can continue to direct their anger towards the MOH and the OMA hoping for a magic fix to the structural issues that are stressing our society. A rejection of today’s tentative agreement will result in “business as usual” with more unilateral cuts as the government struggles to keep the budget intact. Some physicians will hope that it will force the government to come back to the bargaining table with more money (raises with no hard cap). How realistic is this goal based on the reality of today? It will only delay the inevitable conversation that is urgently needed to overhaul the system to ensure it becomes sustainable for our children.
Physicians can take up the challenge and vote to accept the agreement (however imperfect it is), and begin in earnest the conversation, ask the difficult questions and listen to our patients about what they want - a health system that works now and in the future.
I for one am hoping we choose YES on Aug 14th and get down to the urgent work at hand - for our patients.
Wise Elephant Family Health Team
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