This afternoon, a brave young medical student raised a concern about established doctors belittling younger OMA members for their inexperience. His gripe is perfectly legitimate: no matter what side of this debate you fall on, our goal should be to persuade each other, not berate others into submission. Some medical students have read the tPSA and supporting documentation, and have come to informed conclusions no less valuable than those of doctors. Meanwhile, there are both students and doctors who pretend to understand everything about the topic because they read a 1-page summary from a clearly-biased party (on either side). The reality is that this debate invokes major medical, legal, economic, social, and political issues, which very few of us (students or doctors) spend the time really analyzing. So to bemoan any group for being inherently unaware is both unfair and untrue. And we should strive to build each other up, not tear each other down. But what do I know? Apparently, I shouldn’t have gotten into medical school.
In a move which will surely encourage solidarity within the medical community, Deputy Health Minister Bob Bell assured PARO that they would do away with discrimination against new doctors if they ratified the tentative PSA. The OMA is likely to be delighted by the government’s unilateral promise to bring residents to the negotiating table: at least there are some medical professionals they’re willing to listen to. For residents, who have called for leveling the playing field since the government rigged it earlier in its term, this was quite a victory. The government agreed to remove restrictions on new graduates, which they had previously introduced to cut costs. But if the tentative PSA is ratified, the cost problem would be solved by simply paying everyone less. For its part, the government was happy to find a solution that guaranteed equality cheaply: instead of having to bring residents’ salaries up to the level of senior doctors, the government will simply bring everyone else down to the level of residents.
For two years now, the OMA Board has been begging, suing, and negotiating with the government for a new deal for Ontario’s doctors. So when they reached a tentative agreement with the government last month, they were all set to get it rubber-stamped by the 1% of doctors who sit on the OMA Council. They had successfully represented the interests of doctors, and all without having to waste their constituents’ time with silly formalities like voting.
Sadly, it would not be quite so easy. Unbeknownst to anyone, doctors apparently have the right to decide for themselves whether to accept their new employment contract. They’ll now be forced to actually read the 6-page document and show up on August 14 to debate its merits. Who has time for that? Thankfully, the Board has taken the time to simplify this task by summarizing the complex document in 8 short, surely-unbiased lines of text on their website. We should all be grateful for their diligence and transparency.
After hearing countless heart-wrenching stories of overworked ophthalmologists, radiologists, and cardiologists, the government decided it was time to break the cycle of wealthy physicians going to work every day to help patients. To that end, in negotiating the new Physician Services Agreement, they generously offered to simply stop paying these physicians after they had done too much work – that way, for the last few months of every fiscal year, these over-achieving physicians would be forced to take a break. To their surprise, the OMA didn’t immediately embrace this proposal. It seems that some of these physicians actually found helping patients rewarding, and so wanted to keep working. Government officials didn’t know how to react. Said one MPP, currently on vacation, “Their reluctance to leave work is baffling. MPPs are meant to work for 24 weeks this year – I don’t know how we could do that without 28 weeks off!”
This Tuesday, the OMA board triumphantly declared that they had forced the provincial government to accept a 2.5% annual “increase” in health-care costs. After 2 years of deadlocked negotiations, doctors were impressed at the dramatic turnaround. The government, for its part, was surprised at the simplicity of the solution. All it took was redefining what value they were increasing. The OMA was adamantly opposed to their initial proposal of a 9.5% real cut in doctor compensation per service provided (2.5% increase in pay – 3% increase in utilization – 2% inflation – 7% previous cuts). But then accountants on both sides had the brilliant idea of just ignoring the negative numbers. So utilization increases, inflation, and previous cuts were removed from the draft. The OMA could hardly refuse such a generous deal. As doctors – the most educated constituency in the country – we should be proud of finding such a clever solution.