Once again, the Ontario Medical Association is proving to be far more, ahem, entertaining than a physicians' advocacy group should be. This time around, the entire OMA Executive Committee is facing removal by the rest of the OMA Council, citing a litany of objections to actions taken before, during, and after the tPSA debacle.
Since the tPSA was rejected by OMA members, the OMA itself has tried to do an about-face and has essentially been on the warpath against the Liberal government, after having spent the previous period of time aggressively selling the tPSA as an acceptable arrangement. It's been... an interesting transition. Don't get me wrong, the OMA was never exactly buddy-buddy with the provincial government, but the public releases went from relatively civil, responsive, boring politically-minded messaging towards something more reactionary and, at times, rather vitriolic.
Anyway, the OMA's Executive Committee is on the block now and may or may not be removed from their positions. It's up to the OMA Council. I'm not sure what a good outcome from here will look like. I think the OMA would have been best served if the Executive Committee had resigned after the tPSA and transitioned their responsibilities to individuals who could straddle the line between the "pro" and "con" side of the tPSA debate a bit better. That said, since the tPSA my feelings of the OMA's actions have been mixed, with some positives in with the negatives, so I do worry that forcefully throwing out the current Executive Committee will result in a less experienced and capable group that takes things too far the other way.
There is one issue in this recent debacle I do put a high emphasis on - the prospect of Job Action by physicians. The OMA, pursuant to the strategy recommended by the various legal and PR firms they've consulted, has put Job Action on the table to push the government for a better deal. This terrifies me. In an era where many people feel they don't earn enough for the work they do, physicians' six-figure incomes are an easy target. The most palatable argument against cutting those salaries, or at least restricting the cuts to the higher earners among us, is that physicians work their butts off for their patients to earn that high salary. The second physicians stop working and put patient care second to compensation demands, we've lost any chance at real public support. It didn't work well the last time it was tried in the 90's and I have no reason to think it would be any better this time.
Critically, any sort of Job Action would undoubtedly have a negative effect on patients. Regardless of what it might do to improve our negotiating position, putting ourselves first by putting patients second is a line that should not be crossed under any normal circumstances. Even with the unilateral cuts, physicians are still doing reasonably well from a financial standpoint and nothing the Ontario government has done comes close to justifying compromising patient care.
Worryingly, I have no idea what any new OMA Executive Committee would push for on this front. Of the many perceived faults detailed by those trying to remove the current Executive Committee, pushing for Job Action isn't one of them. It's a surprisingly popular idea by physicians, on both sides of the debate. It's far too easy for physicians of all stripes to overestimate how well they're liked and how much support we have in any fight over money. Job Action is a high-risk, high-reward approach that bets that the Ontario government would face more scrutiny than physicians, with little evidence that this would be the case.
Whatever the outcome of the OMA's internal power struggle, I'm hoping Job Action gets taken off the table permanently, both for our sake and for the sake of Ontario's patients.
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