elections – justanoldcountrydoctor

Why the OMA Annual General Meeting Matters This Year

I was thinking about what to say about this years OMA Annual General (AGM) meeting. As a die hard Star Trek fan, my thoughts went back to the excellent Next Generation episode, “The Drumhead“. After foiling the ambitions of a Federation official to twist things for her own benefit, Captain Jean Luc Picard reflects that “vigilance is the price we continually have to pay.”

It’s the same for the OMA. Things go off the rails IF members don’t pay attention. Given how big, complex and convoluted the OMA is, well, members do tend to ignore some of the goings on (I am just as guilty of this as other people).

The governance changes at the OMA are a great example. What started out as well intentioned (and badly needed) changes to modernize the organization, in the aftermath of the debacle of the mid-2010s, has been turned into something worse than what was intended. For a bunch of reasons, I personally continue to think that it is still better than the previous structure – but a course correction is needed. We’re now in a situation where the staff seemingly control everything, regardless of what members want. Because, let’s face it, as a whole, we physicians didn’t pay enough attention to the OMA. Thus, the organization was able to repeatedly put changes in place that benefited the organization, ahead of the rights of front line physicians.

It’s gotten so bad that two OMA Board members, Drs. Paul Conte and Paul Hacker, resigned their roles early. These are not just ordinary Board Members. Dr. Conte is a former Board Chair, and also Chaired the Governance and Nominations Committee of the Board. Dr Hacker Co-Chaired the Governance Transformation Committee when all of these changes were put in place . They are absolute experts in the field, and if they say something is wrong with what’s going on, well, you can bet it is.

This is why you should all virtually attend the OMA’s Annual General Meeting (AGM). Dr. Paul Conte has come up with four motions (which I am seconding) to present to try and get the organization back to where it should be. There is some wordy legal jargon in the full motions so I’m only going to list what each motion hopes to accomplish and why. The full motions should be in the meeting package you receive when you register.

Motion 1 and 2: Removal of references to non-physician members and increase physician directors to 10

Some background. I was the founding Chair of the Georgian Bay Family Health Team. When we put the team together we knew that there were some skill sets, information and knowledge that physicians just didn’t have. Finances, negotiations, business plans and so on. So we had non-physicians on the Board of the team to help provide those insights. But we also realized that you cannot have a situation where non-physicians governed physicians . As a result, those non-physicians were what we called ex-officio Board Members. They could contribute and offer suggestions at the Board level, but they were not able to directly make decisions.

When the OMA began the necessary governance transformation process, I begged the staff of the OMA and the consultants to do the same thing with non-physician directors. They refused. I was told “Board Members had to vote” under ONCA (Ontario Not for Profit Act). This is twisting things. If you really want a non-voting person on the Board you can create a separate category – say “Board Advisor”. But the staff and consultants just didn’t want to, regardless of what the duly elected representative of the profession said. Then Covid got in the way, and ……….

By passing these motions we will eliminate non-physicians from having voting authority at the Board Level. The OMA can still have them there as consultants if they want – but non-physicians will not have the ability to govern physicians anymore.

Motion 3: Removal of the Screening Process for Board Directors

This year’s election process was an absolute travesty. Not only did the OMA unilaterally screen and short list candidates for Board Director, and only allow members to vote for the candidates THEY felt appropriate, they impugned the reputation of one of the President Elect candidates, by putting up a subjective opinion of their social media posts. It’s up to each individual physician to judge a candidate, NOT the OMA.

By doing so, not only did they harm a reputation, they’ve bastardized the whole election process and by default have tainted the victory of Dr. Haroon Yousuf.

This motion will put a stop to this nonsense.

Motion 4: An end to the Nadia Alam Rule

When I was on the OMA Board, it was quite obvious to me that many of the Board Members were extremely jealous of the popularity of Dr. Nadia Alam, who pretty well skyrocketed to fame because she spoke up and inspired others (including a certain grumpy curmudgeon who was going to sit the dispute with the government out). As a result they forced the implementation of a rule that says that anyone who held the role of President can no longer run for Board, even if they have less than 6 years on the Board (the current term limit).

Dr. Nadia Alam

The stated rationale for this goes something like “we give our presidents all sorts of publicity and it’s an unfair advantage if they run.” This is, of course, a load of cow manure. There are a whole lot of Past-Presidents who got lauded by the OMA and would get exactly one vote if they ran for anything ever again. This rule assumes the membership is too stupid to recognize who can inspire them and who can’t – and really is telling the membership they aren’t smart enough to know who to vote for.

Furthermore, Ontario is THE ONLY Provincial Medical Association that has this rule. (For that matter, no other Provincial Association screens Board candidates like this or puts subjective comments on election packages.)

Time to end this rule as well.

What happens if members don’t show up and the Motions Fail?

As members, we have a choice. We can spend a couple of our hard earned hours investing in and attending the AGM, hearing arguments both pro and con, and voting in the best interests of physicians. Or we can sit passively by, in which case the motions will likely fail, and the OMA will be emboldened, and continue to make choices for us, rather than the other way around.

Since my friend Paul Conte prefers the other, far inferior space franchise, this will be akin to the end of Revenge of the Sith, where Padme Amidala realizes:

Let’s not let that happen

If you are an Ontario Physician, I urge you to register for the AGM here:

https://web.cvent.com/event/c17ccc6c-d186-4ab8-985f-2e48127b4ffb/summary?sfmc_id=7563168

Open Letter To Dr. Cathy Faulds and Ms. Kim Moran: Why Should Members Bother Voting?

To: Dr. Cathy Faulds, Board Chair, and Ms. Kimberly Moran, CEO, Ontario Medical Association

Dear Dr. Faulds and Ms. Moran,

I’m writing to express my extreme displeasure about how the OMA has handled the elections process. The past couple of years have seen more and more that the OMA, as an organization, has sought to limit the ability of front line members to choose their representatives. This has had the effect of further disenfranchising the hard working physicians whom you are supposed to serve.

In the past couple of years, the OMA as an organization has put in extremely restrictive rules on candidates, particularly for Board Director. Candidates were not allowed to “campaign”. Candidates for Board and President can only offer up a brief statement that answers certain questions, and not much else. Town Halls were controlled with Orwellian like micromanagement. All candidates could only submit a pre-approved list of skills. No one is allowed to let their personality show through.

Even asking candidates a question, like I did last year, is verboten. The penalty for daring to ask candidates to answer a difficult question was to have your career and livelihood threatened by a code of conduct complaint.

This year, the elections process is markedly worse. Instead of letting members choose who they wish, you shortlisted candidates. (NB – please spare me the nonsense about hiring an “independent” third party to review the candidates – we all know that “independent” consultants get guidance from the organization they are hired by. They just do the dirty work of the hiring organization).

I will NEVER criticize a candidate for running (I may criticize their position or views – but not for choosing to run). It takes a lot of guts to stand up and bear the slings and arrows that inevitably come your way. BUT, the blunt reality is that your “shortlisting” process is by default going to create an entirely bland, non-confrontational and non-outspoken Board. It will create a Board that will not provide appropriate oversight to the OMA.

For example, one of your approved Board candidates was asked on Social Media if elected they would commit to change the direction of the OMA so that it would stop speaking out against expanding the scope of practice for pharmacists and others. (The questioner has been very vocal that allied health care providers can do much more). Your approved candidate replied with a response (I’m paraphrasing):

“I will always be on TeamPatient. We need to follow the evidence where it leads.”

The questioner was quite happy and obviously didn’t realize that the exact same response could be given if someone had asked the candidate: “Will you get the OMA to be MORE forceful in preventing expansion of scope of practice to allied health care professionals.” It’s the type of bland, non-specific, non-controversial response that is often taught in various “Leadership” courses and “Director” courses. You know, the type that is designed first and foremost to not offend anyone, while making everyone on both sides think you agree with them in the hopes that this will somehow make you able to enact change.

(I’m not naming the candidate because truth be told, overall I actually like the person and if it wasn’t for the shenanigans that the OMA has been doing, would likely have voted for them – It was just too good an example to illustrate my point to pass up).

What’s worse is how you have treated the current list of candidates for President Elect. While I absolutely would agree with doing a social media search (along with other reasonable background searches for a position of such importance) – the decision should simply have been one of if a candidate is appropriate or not. And if not – they should not be allowed to run, and the OMA should deal with the consequences.

Instead, the OMA, under your leadership, has chosen to promote a document that characterizes one of the P/E candidates in a negative manner. (Yes this was the third party view – but you already know what I think of third party views). This negative characterization can, and should, open you up to legal action (whose defence will be paid for by my dues – which I find even more objectionable). Attaching subjective comments to the profiles of eligible candidates is outside of established governance norms.

ALL of these actions smack of the OMA as an organization self selecting candidates that the OMA finds suitable (not the members). It reeks of the organization wanting a complacent Board, a Board that simply rubber stamps what “experts” bring in front of it, rather than a Board that provides true oversight. True oversight demands that the Board ask hard, uncompromising and uncomfortable questions of the staff when appropriate. I can’t see a thing in your Board vetting process that would suggest you let candidates with these skills through.

You are undoubtedly aware that as a result of the actions of your current leadership, both Dr. Paul Hacker and Dr. Paul Conte have publicly resigned as Board Directors. Historically, the last Board Director that resigned under similar tumult was Dr. Shawn Whatley in 2016 . That was the same time as the disastrous tPSA fiasco. He was one of 25 (ish) physicians, or 4% of the physician Board Directors. You’ve lost two of 8 physicians – or 25%. That’s a critical blow. (Dr. Alam resigned a month early as well – but that was with much less fanfare).

What’s worse is the calibre of Directors that resigned. Dr. Hacker co-chaired the Governance Transformation committee of the OMA. Dr. Conte not only chaired the Governance and Nominating Committee, but was Board Chair. Having worked with them, I can tell you that both members have extremely high levels of integrity and both are extremely well versed in governance. They are absolute titans of good governance principles. They KNOW when governance is going off the rails, and for them to take this steps speaks volumes about your leadership.

In summary then, it appears the OMA, as an organization, has taken well meaning attempts to reform it, and make it more member responsive, and instead turned it into a way to only allow certain, pre approved members to be in charge. Outspoken, critical voices are not allowed. Strong opinions (however well stated) are unwelcome. Independent thought must give way to complacent behaviour.

All of which is my long way of asking, given that you have undemocratically preselected candidates, and impugned those you find wanting, why should any member bother to vote?

Yours truly,

A very very annoyed Old Country Doctor.

OMA Board Betrays Members By Latest Action and This Changes My Vote

OMA Elections period has opened. A chance for members to have a say in how the organization is run and what strategic direction it should take .

After my last couple of missives on OMA Elections, I was going to leave this alone and see what transpired. However, when I went to vote, I noticed a curious thing. None of the non-physician Board candidates were up for re-election. This sent up a red flag. There are three non-physician Board Directors – and every year, as members we have to vote for either one or two of them (the terms are staggered).

If one looks at the OMA website, this little nugget is hidden away in the depths of the Elections FAQ page, a page that I suspect extremely few members would access, much less be aware of:

“…In the case where the director holds a non-physician position and is interested in serving an additional term, the director would be presented to the membership as a re-appointed director…”

There are some conditions the sitting non-Physician Board Directors have to meet, but the blunt reality is that the OMA has taken away the right and ability of Members to vote for these 3 positions if those Directors want another term. This represents 27% of the Board (11 positions total) – which is frankly a large block of votes and can sway a close vote at the Board.

Worse is the vagueness of what is written for IF there was a vacancy. There are a number of requirements for running for the Board for these candidates – all of which are appropriate – however the very last sentence simply states:

“Shortlisted candidates will go through detailed vetting by Promeus Inc., including reference checks, police record checks and social media checks.”

Nowhere does it clearly state that in the event of a vacancy – there would be an election for the non-physician Board Directors. Perhaps this is still the case – however not mentioning it definitively in writing suggests the possibility that this may change.

I was on the OMA board when the governance changes took effect. I supported the overall thrust of them (still do). One of the issues when discussing non-Physician Board Directors was a concern expressed that the type of candidates that might help the OMA out would not want to run in an election. Apparently, these candidates would be “used” to being recruited and simply expected to be given a job.

I personally thought that was silly. If you’re a strong person, have a sense of self-worth, and are confident in yourself, you should be willing to run in an election. You might lose but that’s life (I’ve lost elections). But the personal integrity to run is essential. If the OMA is to represent members, then the members must have the right to vote for all Board Directors. Up until now, that’s what was happening.

Perhaps some non-Physician Directors are thinking “if I was on another board, they’d simply appoint me, and I wouldn’t have to take a chance on losing and ruining my precious resume.” But those are NOT Boards of representative organizations like the OMA

As far as I’m concerned, worrying about offending the egos of some candidates is not enough reason to take away the rights of members to choose ALL of their Board Directors. How much longer will it be before these 3 non-Physician Board candidates will simply be chosen by a process set up by the OMA without any input from the part of members? In case you think it unlikely, that is actually what was initially proposed by the governance consultants in 2019, until we shot it down.

Worse this change was made without an open discussion with the membership. The OMA should have presented arguments for this change to the members in an open, transparent manner. By hiding it in a FAQ without informing members is a betrayal of the principles of giving members power over the OMA. That was the main thrust of the governance changes in the first place.

What can members do? I mentioned in my previous blog that I personally won’t vote for incumbents. It seems that there’s only one incumbent up for re-election, current Board Chair Dr. Cathy Faulds. I have a lot of respect for Dr. Faulds (really). She’s accomplished much in her career (her resume is incredible) with work in health systems transformation/patient care advocacy and bilateral work with governments.

I was considering voting for her based on the fact that a good Board does need to hear all view points (even those that differ from mine) but I so fundamentally disagree with this move, and the current culture the Board has overseen that I personally can’t vote for her now. Whether other members see it that way is up to them.

A glance at the other candidates for Board show that there are 11 candidates who couldn’t be bothered to do a video statement to advertise themselves. Sorry – but as much as I disagree with the current elections process – if you are going to run for the top position at the OMA, and you can’t even find the time to put a video together to advertise yourself – well that is concerning.

My few loyal readers will know that I strongly supported Dr. Ramsey Hijazi last year – and continue to do so this year. He has consistently stood up for members – most recently by setting up a petition demanding that the government stop tormenting Dr. Elaine Ma for running a Covid Vaccination clinic. He’s also been strong in the press. He will get my first vote (which in the weird way the OMA weighs votes is the most important).

After that, there are a number of candidates that caught my eye – in alphabetical order – Dr. Khaled Azzam, Dr. Douglas Belton, Dr. Joy Hately, Dr. Pamela Liao, Dr. Afsheen Mazhar, Dr. Shawn Mondoux, Dr. Sameena Uddin, Dr. Darija Vusovejic. To be clear, members should review all the candidates themselves and vote, but I am going to vote for them after Dr. Hijazi.

As a family doctor, I also have a vote for my SGFP representative. Lots of great candidates running there. It will again, not surprise any of my followers that I will strongly endorse Dr. Nadia Alam for SGFP Vice-Chair. She’s an excellent leader and a dear friend. She took a well deserved break from medical politics for a bit. But it’s good to see her getting involved again and our profession will better for it. I leave the rest of the voting to your good judgement.

Dr. Nadia Alam, Candidate For SGFP Vice-Chair

Disclaimer: NONE of the candidates listed asked me to endorse them.