March 14, 2017
To our physician colleagues and OMA representatives,
Much has changed in the two years since negotiations between the OMA and Government of Ontario fell through. Unilateral, non-evidence-based cuts to the physician’s services budget by the government, followed by the portrayal of physicians as solely self-interested, has served as a lightning rod for much of the burnout and frustration of working within an often constrained healthcare system.
It has been alarming that the government has continued these cuts when physicians are considered an essential service and yet have no recourse in negotiations such as binding arbitration. However, some of the escalating responses of physicians have been equally alarming. While it has been heartening to see physicians engaging in effective grassroots organizing, bullying tactics have sometimes been used to silence those with differing views. Many physicians have used social media to call for user fees for patients and argue for a two-tier healthcare system. Amid the recent OMA election, there have been calls for job action, and on March 6th an open letter to patients alerting them to this possibility was released by the OMA itself. While it may have been government policy and mishandling of negotiations that allowed for ideas such as user fees and job action to enter the mainstream discourse, continued movement towards these policies will only hurt doctors and patients.
Doctors for Responsible Healthcare stands against job action for many reasons: patients will be the ones to ultimately suffer; it will disproportionately affect vulnerable and marginalized populations; it will only erode public confidence in physicians and in our publicly funded system; and it will not actually work to change government policy. Job action will not have public support, just as the physician strike against extra billing in 1986 did not, and it will only provide the government with easy fodder with which to justify further unilateral action. We will be back to where we started, with the only outcome being erosion of public trust in our profession and of a publicly funded health system.
Some physicians have argued that they are willing to take to job action to “fix a health system in crisis”. As helpful as binding arbitration can be as a tool for fair negotiations, it will certainly not resolve chronic underfunding and fix our healthcare system. In the end, the only way governments at both federal and provincial levels will act to resolve the funding gaps in healthcare will be through public pressure; job action as a tactic will be counterproductive as it will direct the public’s attention away from the issue of funding and strengthening universal healthcare and will focus it on the issue of physician salaries and erode public confidence. Physicians and patients would be much better served if we took a leadership role and focused on the innovative, evidence-based, and cost-effective ways to improve the system in which we work hard every day, and on which our patients depend for their health.
We congratulate the newly elected OMA representatives, many of whom have worked tirelessly against the government cuts over the last two years. We hope that you will respectfully listen to those who do not share views supporting user fees or job action. Voter turnout for the recent election, by district, ranged from 9.2% to 25.5% of all eligible voters. That means at least 75% of physicians did not vote. In the Membership Satisfaction Survey, from which a presumed support of job action is being drawn, only 15.2% of OMA members responded. The recent survey around physician job action simply asked for job action ideas, and did not even consider opposition to job action as a possibility. To take such a drastic measure as job action, we would expect a much more comprehensive and thorough gauging of membership support. Every day in practice, we see physicians put patients first. Based on our interactions with colleagues who work through their lunches, their evenings, and even their maternity leaves, our bet is that most physicians not represented in the election or Membership Satisfaction Survey would stand opposed to actions that would threaten patient care or our publicly funded system. We trust that you will seek out the voices of all physicians and strive to represent them.
Doctors for Responsible Healthcare