By Stephen Skyvington
Stockholm syndrome: A psychological phenomenon in which hostages express empathy and sympathy and have positive feelings toward their captors, sometimes to the point of defending them. These feelings are generally considered irrational in light of the danger or risk endured by the victims, who essentially mistake a lack of abuse from their captors for an act of kindness. Stockholm syndrome can be seen as a form of traumatic bonding, which does not necessarily require a hostage scenario, but which describes “strong emotional ties that develop between two persons where one person intermittently harasses, beats, threatens, abuses, or intimidates the other.”
—from Wikipedia
Although no one can pinpoint for certain the exact date when Ontario's doctors were kidnapped and taken hostage by their own professional association, the seeds were most likely planted in 1991, with the introduction of Bill 135, the Ontario Medical Association Dues Act.
In the 20-plus years since this particular piece of legislation was passed into law by the Bob Rae NDP government, the OMA and its members have engaged in a love-hate relationship of the kind rarely seen in medical politics. And while no one could have predicted at the time just how significant an issue the Ontario Medical Association's ability to “Rand” its members would become, the very way Bill 135 came about should have given some clue as to where the association's future priorities would lay.
For those in need of a brief history lesson, the Rae government was in dire straits and about to go over a fiscal cliff of its own, shortly after taking power in the fall of 1990. Unable to afford any kind of increase to the fee schedule for Ontario's doctors, the government instead asked the OMA if it would support a new piece of legislation giving the association the power to Rand its members in lieu of a fee increase for doctors. The Ontario Medical Association said "Yes" and the hostage drama was on.
Year after year after year, the OMA collected money from Ontario's doctors—whether they wanted to be a member of the association or not. Any doctor who didn't pony up the required dues in December of each year would have the money taken out of his or her Remittance Advices later the following spring. Fifteen million, $20 million, $25 million. Each year, the dues went up and the Ontario Medical Association's pot of gold continued to grow. In 2013, the OMA will charge doctors $1,930 each, likely raising between $40 and $50 million.
Now, I don't mean to suggest there's anything fundamentally wrong with the Rand formula. Introduced by Justice Ivan Rand in 1946 as a way of solving a Ford strike in Windsor, the basic premise of Rand is that no member of a union should be able to benefit from whatever the union has managed to accomplish at the bargaining table without paying his or her dues. Fair enough. But in the OMA's case, while it has been very good at collecting doctors' dues, it hasn't done such a good job—especially in the last decade—representing its members at the bargaining table.
Take the last round of talks, for example. The Ontario Medical Association actually agreed to have its own members ration health-care services instead of leaving it up to the government to pick and choose what to cut. Small wonder that many doctors have come to take a dim view their own association. Although 81% of the 54% of doctors who bothered to cast a ballot last December voted in favour of the new Physician Services Agreement, most were disgusted by the way their representatives rolled over and played dead when Health Minister Deb Matthews threatened doctors with even more drastic cuts the previous spring.
Cue Dr. Douglas Mark and the Coalition of Family Physicians and Specialists. For the past decade and a half, Dr. Mark and his organization have been very vocal in their opposition to the policies and actions of the Ontario Medical Association. Like former Reform Party Leader Preston Manning before him, Dr. Mark has challenged his members to “think big.”
Vowing to blow up the Coalition in 2013 in order to form a new organization to take on the OMA, Dr. Mark is putting it all on the line so that doctors and their patients will finally have someone they can count on to stand up for them and speak out when services are threatened and our health-care system is in danger.
Unlike Manning, however, Dr. Mark will not be running for a leadership position with the soon-to-be constituted DoctorsOntario. He does plan on giving his all during the next few months until the new organization is up and running and fully functional, with a new president and board consisting of specialists and family doctors in place.
Hopefully, all those doctors suffering from Stockholm Syndrome are paying attention. After years of suffering at the hands of their captors, members of the Ontario Medical Association will no longer have to hang their heads in shame, saying things like: "We can't blame the OMA. They did their best. Maybe things will be better next time."
In typical fashion, the Ontario Medical Association is trying to ignore this latest threat to its sovereignty. OMA President Dr. Doug Weir recently told the Medical Post: "Whatever they are calling themselves, the Coalition has done nothing more than protest and naysay." He then went on to say that DoctorsOntario would be "a non-elected group who would confuse members." This from the leader of an organization that doesn't even allow its members to directly elect their own president.
If it succeeds in convincing 50%-plus-one of Ontario doctors to sign up and pay the voluntary $250 membership fee in 2013, DoctorsOntario hopes to be at the table next year, negotiating the next Physician Services Agreement with the Ontario government. The new organization also plans to take over the public relations and communications functions from the Ontario Medical Association, as well as supporting its members during any disciplinary procedures instituted against them by the College of Physicians and Surgeons of Ontario.
Will any of this come to pass? Hard to say, at this point, although the early response has been encouraging. But as Dr. Mark, who plans on leading a mass resignation from the OMA in the next month, says, "Like Dr. Martin Luther King, I too have a dream."
A dream which just might turn out to be the Ontario Medical Association's worst nightmare.
Stephen Skyvington is president of PoliTrain Inc. Twitter.com/@SSkyvington.
© 2013 Follow The Kingston Whig-Standard