“That’s the thing about trust. It’s like broken glass. You can put it back together, but the cracks are always visible–like scars that never fully heal.”
― Hope Collier
A fifteen year old comes to my office. She’s pregnant. She’s petrified because her mom and one of my staff are good friends, and her mother doesn’t know.
A thirty year old man, with a long history of mental illness finally admits he was sexually assaulted as a child. He didn’t tell me sooner as the abuser worked with the husband of one of my employees.
A couple is having marital problems. There are affairs and now sexually transmitted diseases involved. They’re trying to work it out, but were scared to seek help as one of my staff goes to the same Church.
I’ve seen all of this, and much more, practicing medicine in a smaller centre. I would not have been able to manage these tricky situations if it had not been for the trust that I have in my staff. Like all family physician’s staff, mine have access to a great deal of personal information. I cannot effectively do my job without implicitly trusting them to ensure that confidential information stays confidential. I rely on them to skillfully do tasks I assign them for patient care. But I also trust the judgement that they have about certain situations and certain patients (they have a wealth of social knowledge that is invaluable to me).
This implicit trust is the hallmark of a high functioning health care team. Each member of the team is valuable, and each carries out their duties, knowing the other member will carry out theirs. This does not mean that we always agree on everything. Healthy discourse is important. But it means that at the end of the day, we know we will act in a patient’s best interests.
Which brings me back to the miserable situations in Owen Sound and Thunder Bay. In Owen Sound, to try to make up for his failure as a leader, OPSEU President Warren “Smokey” Thomas wrote to the College of Physicians and Surgeons (CPSO) to complain about the alleged tactics used by the physicians in the dispute. Let’s be clear, when you complain to the CPSO, you are threatening a physician’s career. A complaint should only be made in an egregious situation (for example sexual assault) and not over a pay dispute. Smokey himself is a nurse. He should have known this.
The situation in Thunder Bay is worse. Last week, under the leadership of Unifor President Jerry Dias:
- One of the strikers allegedly assaulted a patient
- The Union erected a metal fence overnight around the clinic and blocked access to patients attending appointments to see the physicians
- Despite a court injunction, the Union left the metal fence up and prevented patients from being seen for a second day
- Somebody glued the door to the clinic shut over night, and cut power to the building in what can only be called a criminal activity
Ontario Medical Association President Dr. Nadia Alam, stated that over 1,000 appointments were cancelled. Many had travelled 100s of kilometres. Many had been waiting for months for their appointments due to the severe lack of specialists in the North. Cutting the power caused loss of vaccines and, as the only fertility clinic from Sudbury to Winnipeg, also a loss of sperm and egg samples.
Eventually, these disputes will end one way or another. But what will never, ever be the same, is the trust between physicians in these clinics and the staff. How are the doctors in Owen Sound going to trust employees who threatened to end their careers? We are not talking about large corporations that make widgets where workers on the line never meet their boss. We are talking about smaller, intimate offices where everybody knows everybody.
In Thunder Bay how exactly are the doctors there supposed to trust employees whose actions, however indirectly, led to alleged assaults, physical threats and intimidation and vandalism? Unifor is denying responsibility for the vandalism, and no doubt will disavow assault/harassment as a tactic, but the blunt reality is that without the fence, none of the other stuff would have happened. No wonder a number of physicians are considering leaving Thunder Bay.
Worse, what does this mean for the type of health care that is going to be provided in these areas? The patients of Ontario have a right to high quality health care. As mentioned, when there is no trust within a team, health care will suffer.
The stories of Owen Sound and Thunder Bay have gone viral in the medical community. Both areas are short of doctors. How they will now recruit new physicians in the current environment is beyond me. The reality is that physicians are fortunate to have multiple options when they choose an area to practice. Why would any sane person go to these toxic environments? How will Thunder Bay replace physicians who leave? The stench from these messes will take years to fix.
The biggest losers are the employees of these clinics. They made a legitimate request for raises and improved working conditions. Unfortunately, they put their faith in two Union men, who clearly didn’t have a clue about how health care offices work. They used tactics more suited for factories, not physicians offices. The tactics have failed miserably (four months and no contract yet). In Owen Sound, 40% of the employees have quit, recognizing Thomas’ inability to get the job done. In Thunder Bay, if physicians leave, there will be job losses amongst employees there as well. Worse, the employees will be blamed for worsening access to health care, if doctors do leave.
The employees of these clinics deserve strong, effective and appropriate representation. Sadly for them, they are not getting it from OPSEU and Unifor.