Authour’s note: This opinion piece of mine was published in the Medical Post. However, many physicians are unable to access that as you need a dedicated account. I’ve reproduced it here.
The Canadian Medical Association (CMA) has been embroiled in controversy this past year. It first started with the announcement of “Vision 2020”, the new strategic plan for the CMA. What’s the first priority of the plan? “Consistently bring a patient perspective to the work of the CMA.” The second priority? “Engage in courageous, influential and collaborative dialogue and advocacy.”
This all sounds nice, and politically correct and oh so socially conscious. Except for one thing. The CMA is supposed to represent physicians and their needs. That’s the whole reason for its existence. Instead, physician representation is third on the priority list, and even there, it’s couched in phrasing like “based on empowering and caring for patients, promoting healthy populations and supporting a vibrant medical profession.”
From the perspective of the CMA’s leaders, I suppose the needs of the general membership don’t really matter. The recent sale of MD management to ScotiaBank has provided the CMA with a significant amount of revenue. So much so that they likely don’t even need members anymore. It’s worthwhile noting that the first $15 million from the sale has been earmarked for a building for health care innovation, as opposed to, you know, a program to look at the alarmingly high burnout rates of physicians. Certainly the changes made at CMA Governing Council (no more motions to direct the organization) prevent the CMA Board paying attention to silly little things, like the duly elected representatives of physicians across the country. (NB – it would be unfair of me not to acknowledge that at least the General Membership will be able vote on all the Board members for the CMA. However, I’m curious to see what the criteria are for becoming a candidate for CMA Board).
There is similar pressure to advocate for patients and health care policy, being placed on the Ontario Medical Association (OMA), particularly on social media. Recently the OMA has been asked by various physicians to:
– sign letters opposing the separation of children from parents of migrants
– condemn the changes to sexual education curriculum made by Premier Doug Ford’s government
– speak out against the pause to Vaping rules, also made by Doug Ford’s government
– express concerns about the health care for trans gender patients
– and a bunch more.
There are merits to all of those causes (the separation of children from parents is the one I feel strongest about – it’s just child abuse). There is also the argument that physician’s organizations should use their authority to advocate for social issues, as it increases our standing in the eyes of the public and makes us “leaders”. This enhanced standing will supposedly help us when we advocate for ourselves. The cynics, especially those of us burnt by the previous Ontario government will strongly disagree with this.
But here’s the thing, there are so many good causes out there to advocate for. And they will keep coming. How should the OMA, which unlike the CMA, continues to need broad member support, choose?
There is already disagreement about vaping rules/sex ed curriculums and so on. What happens when the OMA is presented with information about the poor health care Rohingyan women receive? Or the damage the contaminated water in Flint Michigan has caused? Or if you want controversy, how about the malnutrition and mental health issues suffered by Palestinian children? The OMA is supposed to represent 40,000 members with a diverse range of views, not just those who are motivated by one particular issue.
Many Provincial and Territorial Medical Associations (PTMAs) offer media training and advocacy courses. The OMA for example, has long been asking physicians to become advocates. Perhaps rather than criticizing on social media, those who feel passionately about various issues can receive the training to allow them to become leaders in their areas of interest. They can then directly get their message across to the public and work for whatever their cause is. They are still doctors, and they will still be seen in the public’s eye as doctors taking a lead on health care issues.
As for the PTMAs is it really too much to ask that they focus on membership advocacy first and foremost? There is absolutely nothing wrong with advocating for meaningful action on high burnout rates, fair contracts and improved working conditions with less interference from bureaucracy. It’s what these organizations are supposed to do. The simply reality is that you cannot have a high functioning health care system without happy, healthy and engaged physicians. Surely advocating for the same is not unreasonable.