Physician incomes at heart of dispute with province

TheStar.com – Opinion/Commentary – The public would take doctors a lot more seriously if, along with their demands for more money, they called for a redistribution of wealth in the form of far more robust social programs, which collectively influence health to the same degree than all medical interventions combined.
Feb. 10, 2017.   By PHILIP B. BERGER

In 1991, then Ontario Medical Association President Dr. Basil Johnston was the keynote speaker at the annual meeting of the Medical Reform Group, a left wing pro-medicare group of doctors who had long and publicly opposed the OMA (in 2014 after 35 years the MRG disbanded).

It was extraordinary that the president of the MRG’s nemesis would agree to address the group. During his speech Johnston, a soft-spoken Peterborough orthopedic surgeon, warned that the real threat to the OMA arose from the right, not the MRG on the left. Johnston was prescient.

Recently in these pages OMA council member Dr. Nadia Alam issued the manifesto predicted by Johnston 26 years ago. Alam is a former spokesperson for the ultraconservative Coalition of Ontario Doctors and led both the successful charge against the summer tentative Physicians Services Agreement (PSA) and the non-confidence vote in the OMA executive in late January.

In her commentary entitled “More proof our health care system is broken,” Alam catalogued the alleged evidence — or as she put it, the “terrible reality” — of the “consequences of poor government policy (which) are severe and intolerable.” It is scary reading and it is mostly untrue.

Alam believes hospitals with boards of directors, whose membership includes the most powerful and well-connected citizens of Ontario, are afraid to protest the so-called broken system, yet such board members routinely lobby government on behalf of their constituencies.

She invokes the frightening Orwellian proposition that nurses are fired if they protest, despite the nurses belonging to one of the strongest unions in Ontario and which regularly criticizes the government.

According to Alam, the doctors are “truly the last line” of defence. It is laughable — only the medical profession alone can protect the citizens from a democratically elected government.

Alam slams the government for not reinvesting savings accrued under Bill 41, the Patients First Act, into patient care and derides this as “poor policy.” Alam fails to mention that 50 per cent of a person’s health status is determined by conditions outside the domain of heath care, such as socioeconomic status, education and housing. It would be more beneficial to the public’s health to raise welfare rates, establish a basic guaranteed annual income or dramatically increase the budget for our public schools and legal aid system.

Alam has previously referred to the PSA’s 2.5 per cent annual increase (over four years) in the physicians services budget as “scraps.” The Coalition wants more money for doctors. That is understandable. Physicians by some estimates have seen a 7.5 per cent reduction of income over the past 3 years and nobody likes money being taken away. But a 2.5 per cent annual increase represents “scraps?”

In private, most doctors — even the severest of government critics — acknowledge they are privileged and live more secure and enriched lives than their fellow citizens. It brings the entire medical profession into disrepute to complain so bitterly about incomes.

Alam describes medicine as a calling and she recollects with flair the ailing patients she has saved and the tears she has shed “from overwhelming fatigue.” Alam’s resuscitation at midnight of a father of two and the “first premie (she) saved” are not special. It is what doctors do and are paid handsomely to do.

The public will not be fooled by such sanctimonious declarations and moral cover for what lies at the heart of the dispute between government and doctors — physician incomes. And higher wages for doctors will do nothing to remedy the flaws in our health care system.

The public would take doctors a lot more seriously if, along with their demands for more money, they called for a redistribution of wealth in the form of far more robust social programs, which collectively influence health to the same degree than all medical interventions combined.

Doctors should not be ashamed of their efforts to secure as best a bargain as possible and would fare better by being transparent instead of promoting tendentious arguments that lack in verisimilitude. They should be ashamed of threats to withdraw services and demanding, as Alam writes, that government “submit to the will of the people.”

Everyone knows the real expectation is that government submits to the will of the doctors.

Philip B. Berger is a founding member of the Medical Reform Group and a long time downtown Toronto family physician.

https://www.thestar.com/opinion/commentary/2017/02/10/physician-incomes-at-heart-of-dispute-with-province-opinion.html

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