Tag: UNION

OMA Does a Disservice to Members with Veiled Threats to Board Candidates

OMA Elections will soon be upon us. This year the possibility of significant change to the organization exists as half of all physician Board Director positions are up for grabs. A review of the OMAs election page shows that there are 58 (!) candidates running for 4 Board positions.

My three loyal readers know that I have long felt that the first and foremost responsibility of the OMA is member advocacy. Many have heard me say time and time again that you cannot have a high functioning health care system without happy, healthy and engaged physicians. The OMA needs to consistently and effectively promote physicians.

Unfortunately the government of the day continues to disrespect physicians by forcing us into a never ending arbitration process. It also, despite the correct warnings of the OMA, continues to expand the scope of practice of non-physicians. I therefore wanted to see which of the Board candidates would be willing to take a more aggressive approach to this issue. So on a bunch of Social Media forums, I posted a request for all Board Candidates to sign a pledge if elected.

What exactly was this “pledge”? Was it a demand to remove the compulsory dues that all physicians have to pay to the OMA? Was it to split the OMA into two organizations- one for specialists and one for family doctors like they have in Quebec? A demand to fire certain staff?

Nope. It was a pledge to get data on how much allied health care providers (in this case NPs) cost the health care system when they try to do the work of family physicians. See below:

Now, did I think the culture of the OMA, that has been put in place by and is overseen by the current Board, would be happy with this? Of course not. Despite what my kids tell me, I’m not that out of touch. I expected some sort of push back suggesting this was (in their view) inappropriate.

But I confess I was taken aback by not only the factual errors in their response, but what quite frankly can only reasonably be perceived to be a veiled threat to myself and Board candidates. Here’s a copy of what I got:

The first factual error is to conflate the governance transformation (which I supported, and still do) with the elections process. The governance transformation was about reducing the size of the Board, and making it electable by and therefore responsible to the membership as a whole. This is opposed to the mishmash of ways people got on the Board before. It was also about sunsetting OMA Council (which had long served it’s purpose) and putting in a better, more co-operative General Assembly system, along with a Priorities and Leadership group to advance the needs of the members.

I did, and continue to support all of that (trust me, the old system was much worse). BUT – that is completely separate from the elections process itself. The intense over regulation of what candidates can and cannot say or how they can act during elections is NOT governance transformation, it’s micromanagement.

The second error is to suggest that it is because of my previous role at the OMA that I am “viewed as a leader”. Apart from the obvious fact that I have a bunch of detractors, the blunt reality is that there are a whole lot of ex-OMA Presidents out there who would not have influence because of the title itself. They have influence because of who they are/what they advocate for/actions they take outside of any past title.

The email to OMA Board Director candidates was almost as bad:

The underlying message is quite clear. Sure you can run for Board Director. BUT, if in OUR opinion, you “campaign”, or take a position WE don’t like, or speak out of turn – WE disqualify you. Intentionally or not, it creates the impression that the organization only wants a certain kind of Board Director. Not a strong independent type who can think on their own, and, dare I say it, take a bold stance that perhaps requires come chutzpah (like signing the pledge would!) But rather a benign, meek, Board Director – who will simply rubber stamp what’s been presented to them.

Unacceptably, in my view, is the more subtle threat of damaging our careers. The comment that this is”not in keeping with OMA’s code of conduct and civility”can really only be viewed as a veiled threat. Charging someone under a code of conduct violation has the potential to be extremely damaging. Many physicians, when they apply for new positions have to answer questions like “are they now under investigation” for such and such, even if there has not been a ruling yet. Being charged with this would force them to answer yes and potentially damage career options.

To be clear, I actually support the code of conduct and civility. I saw in the aftermath of the miserable 2017 tPSA debacle some incredibly unprofessional comments made towards the OMA staff (and others). I also am aware of many instances since where staff have been verbally abused by members and that is completely unacceptable. The staff are a very hard working bunch – who follow the direction and the culture the Board puts in place. It’s the Board that should be – respectfully – held into account.

But to tell a potential Board Director candidate (and me) that stating an opinion that might be viewed as controversial and advocating for that as part of an election process might see them charged?? Especially when there was absolutely no foul/derogatory/demeaning language used in the posts? Sorry but that simply comes across as attempting to censor a view point that you don’t happen to like. And that’s just wrong. Worse, it gives credence to the many critics of the policy who feared it would be used to suppress discussion.

Members deserve a strong, independent thinking and bold OMA Board. An elections process that goes to these extremes to prevent candidates from taking a stand on issues, advertising to members their skills (or lack thereof!) and their philosophy does not serve the membership at all. It will only disenfranchise them and lead to more voter apathy. About the only thing members can do at this point is NOT vote for any incumbents for Board Director and hope that will trigger some changes to this process.

As for me, I will try to get through the elections material – and pick candidates who I think will work to change the organization for the better. I will let you know my thoughts in a later blog.

“Smokey” Thomas Fails His Members

Authour’s Note:  Once again, I would like to state that while I am President-Elect of the Ontario Medical Association (OMA), I have not spoken with any of the Family Doctors in Owen Sound about this situation.  I did email them to ask permission to write this.  All of my thoughts are strictly based on reports in the media, and news releases (all of which are hyperlinked).

Last week I had suggested that Ontario Public Services Employees Union (OPSEU) President Warren “Smokey” Thomas should change his approach on how he dealt with physicians in union disputes.  Sadly, Smokey has doubled down on his tactics.  In doing so, not only has he utterly and completely failed his members, but he risks endangering health care in Owen Sound.

In Owen Sound (population ~ 21,000) there are 22 family doctors who have organized themselves into a Family Health Organization (FHO).  The FHO is a fairly common payment model that consists essentially of a salary and performance bonuses.  Like all other payment models the FHO models experienced years of deep cuts to their budgets during the desultory tenure of Premier Kathleen Wynne.  Cuts to physician payments, mean cuts to patient services.  Hence, the FHO focused on controlling expenses as best it could.

The staff at the FHO chose to unionize (which is their right) but unfortunately chose to do so under OPSEU, and became Local 276.  OPSEU and Smokey have absolutely no experience in dealing with intimate small office settings, and the necessary collegiality that is essential to providing high quality front line care.  As a Family Doctor, you MUST trust everyone from the receptionist, to the nurse and even the cleaning staff.  While disagreements occur, and are often healthy, the trust cannot be compromised, or patient care will suffer.

Smokey and OPSEU’s lack of experience showed almost immediately. Their bargaining team agreed to a contract and recommended it for approval to the FHO staff in May.  That’s right folks, OPSEU actually reached an agreement.  But the agreement was rejected by the FHO staff, a clear repudiation of OSPEU’s leadership.

This appears to be when Smokey went off the rails.  He (and OPSEU) could have taken a hard look at themselves and asked a simple question – “How could we be so out of touch with the members we represent, to have endorsed a deal they rejected off hand?”. But they didn’t.  Instead, in what seems to be an effort to prove to their members that they really are relevant, they doubled down and started hurling insults and threats.   Doctors were “punch drunk with greed” they screamed.

The FHO staff then went on strike, and the results appear to be disastrous for them.  Firstly, OPSEU should have told them that doctors office are not factories that make sprockets and cogs.  They provide essential medical services and they cannot be shut down.  The physicians continued to work, with legally allowable replacement staff (albeit at reduced levels).  All a picket line would do is harass patients, and that won’t win you public support.

Reports of harassment and even a serious medical event involving a replacement worker appeared, although it’s unverified.  Again, instead of stopping to think “What exactly are we accomplishing here?” Smokey, doubled down, increased his insults to physicians, demanded that the Health Minister and Owen Sound Town Council get involved (he failed miserably).  He also made a ludicrous allegation that physicians were “private and for profit”. Has Smokey not read the Canada Health Act?  Physicians haven’t been private since 1984.

Apparently, ten of the 30 FHO staff got wise to what a lousy job Smokey and OPSEU were doing, and actually quit their jobs.  Yet another opportunity for OPSEU to reflect on their own failures as a bargaining agent.  But yet again, Smokey lashed out, this time by asking the College of Physicians and Surgeons of Ontario (CPSO) to get involved.

Let’s be clear, the letter written by OPSEU is a collection of hearsay without naming any one physician. As such, it cannot possibly be investigated by the CPSO.  If they were to do so, it would diminish the already poor standing the CPSO has in the eye of most physicians, and would send a pall over the entire profession. They would almost certainly faced increased calls from physicians to lose self-regulation if there was anything other than a cursory “thank you, but this is outside of our purview” type response.

But the reality also is that a letter to regulatory body like this takes you beyond any hope of restoring trust in your team.  It’s the one thing that has potential to destroy careers. It’s the one action that essentially screams “irreconcilable differences”.  By going down this road, in what seems to be a desperate attempt to prove his worth, Smokey has caused a toxic meltdown to the point where there is no hope of a resolution.

The members of OPSEU Local 276 would do well at this point to really ask themselves if this is the kind of leadership they signed up for.