Dear Alberta Ophthalmologist,
I don’t practice in Alberta, and I certainly don’t know all the ins and outs of the Alberta Medical Association (AMA). But I, like every other physician in Canada, am horrified by what’s going on in your province. Your government has torn up a previously agreed to Master Agreement, and despite the attempts by the AMA to fairly negotiate with the government, your association has been ignored, insulted and treated with the most disrespect I have ever seen from a government, and I lived through the Eric Hoskins/Bob Bell years in Ontario!! That physicians are leaving work in your province is absolutely no surprise, and that patients will be the inevitable losers in all this, is entirely predictable.
However, I read with extreme concern when I read about the Eye Physicians and Surgeons Association of Alberta (EPSAA) offering to separate from the AMA and negotiate separately with the government. Sadly, I believe that whatever the internal political reasons behind this may be (let me take a stab in the dark and suggest it has to do with fee relativity and how you feel you are represented on that front), EPSAA is going to find itself played by the government, and you will all suffer after.
You see all of this mirrors exactly what Ontario went through a couple of years ago. We ourselves had something similar happen with the Ontario Specialists Association (OSA). They felt frustrated with the Ontario Medical Association (OMA) for reasons that are likely similar to yours. They thought, as EPSAA clearly does, that they would be better off negotiating separately with the government.
I warned the specialists that they were being played. In my blog, you’ll see I pointed out that in dealing with any militant government, they will use a split in the profession to divide and conquer, and that all physicians would lose out if they tried this.
The response from the Chair of the OSA, Dr. David Jacobs was to suggest that I was wrong in my concerns, particularly about our own Binding Arbitration Framework:
Full disclosure, I happen to like Dr. Jacobs. He’s passionate, smart, opinionated and when push came to shove, really helped the profession more than people give him credit for by publicly exposing the flawed 2016 Tentative Physician Services Agreement.
Despite my warning, he and the OSA persevered on their path however, and held a poll at the end of November, 2018 that suggested that up to 8 specialties wanted to separate from the OMA. And what was the first thing the government did in response to this? They of course, took away the Binding Arbitration Framework for EVERY PHYSICIAN in Ontario. It didn’t even take them two weeks to do that.
Now I would like to think I have a reputation for being very pro physician’s rights. Frankly, I hope to build on that more and convince those of you who may not feel that way that I am pro physician. But to be honest, I didn’t actually blame the Ontario government for trying to take away Arbitration. The reality is that when you are in a tough, difficult negotiation, you always look for weakness in the other side. The government sensed weakness, and so acted on it. Just like the Alberta government will on this move.
Thankfully however, the broader OMA as a whole immediately started a massive advocacy campaign that did result in the government realizing that the profession was maybe not as divided as they had hoped, and arbitration was returned. But the whole mess delayed the hearings that were in progress by a couple of months, and the effects of the delay were clearly felt in the shortened timelines for implementing the eventual Arbitration award.
I also need to point out that your current health minister, Tyler Shandro, is a……..um…….interesting piece of work. I seriously believed that I would never see a health minister as bad as Eric Hoskins from Ontario, ever. But while Hoskins was all kinds of awful and incompetent, at least he never went to a physicians house to berate them, causing that physician to fear for his families safety. Nor did Hoskins ever use his authority to access confidential information on physicians to call them.
Do you really think that Shandro will deal fairly with ophthalmologists, just because you propose to separate from the AMA?
I understand that you are unhappy with the AMA. I certainly spoke to many specialists (and family physicians!) who were unhappy with the OMA. But I guarantee you right now, that if you take this step, and fail to learn from the lessons in Ontario, you will be worse off than before.
The best way to fight a militant, un-co-operative government that seeks to vilify you is to stick together with your colleagues. You may not like what some of them say or do, but I guarantee you that you will be better off with them, rather than trying to do it against politicians and health care bureaucrats who have shown they don’t really care about you. To those politicians and bureaucrats, you are not partners (no matter what they say), you are simply tools and pawns to be used to promote an overall agenda.
I hope you don’t learn that lesson the hard way, like we did in Ontario.
An Old Country Doctor…….
4 thoughts on “Open Letter to Alberta Ophthalmologists”
TY Sohail. A lot of wisdom jammed in here. I learned a lot when you were President, and keep learning.
May the Force be with you.
Thanks for the kind words Darren! While some of the EPSAA crew, and perhaps some specialists in Ontario, might be mad at me for writing this, I’m genuinely trying to help them as I’m very very concerned they are taking the wrong approach to dealing with a difficult government…..
This is one sided.
Those who wished to leave the OMA probably had just cause – they wanted to leave because the OMA had voted to throw them under the bus and would support redistribution. When physicians are forced to pay dues to the OMA (RANDED), and their own organization then votes to take money away from them, why would they stay. The AMA is now about to learn the same lesson.
Hey, thanks for this important comment. As mentioned, I wasn’t sure what the exact reason was for EPSAA wanting to separate from the AMA but I suspected it had to do with fee relativity. You seem to confirm this. However, the reality is that as much as this caused the OMA grief (and it did) splitting up only hurt every doctor more. Keep in mind the Ontario government’s official arbitration position was to cut fees to the so called “big three” but up to 15%. In my opinion, there is no chance splitting the profession would have benefited them, and in fact, I’m certain they would be much worse off on their own. (This does NOT mean the OMA shouldn’t continue to try to advocate fairly for all their members, including the big 3, nor does it mean the big 3 don’t have legitimate concerns about the OMA – just that they are better to work together as opposed to splitting up).