• Adam Kassam

The Ontario Medical Association doesn't need more chaos

Adam Kassam | October 14, 2018

Controversy seems to follow the Ontario Medical Association (OMA). After a period of transition, including the resignation of an unpopular board of directors and the installation of a raft of fresh new voices, the organization is now faced with another existential moment that may permanently alter its future.

An open letter was sent to members informing them that a group of doctors would be creating a parallel organization representing the interests of specialist physicians. This decision was borne out of their frustration with the OMA and its negotiation position on relativity - the concept of creating pay equity among doctors. It also builds on the longstanding criticism of the mandatory dues physicians must pay the OMA for representation. Many of them have resented this imposed structure because they believe the OMA has done little to advocate on their behalf.

This new movement is being spearheaded by Dr. David Jacobs, an outspoken radiologist who hopes to emulate the Quebec model where independent provincial bodies represent specialists and family doctors. These entities currently negotiate separately with the provincial government on a range of issues including remuneration.

It's not unreasonable for Ontario physicians to want the freedom to choose their own representation. In fact, a monolithic organization like the OMA is limited in being able to properly advocate for all the different doctors under its large umbrella. The vast majority of doctors represented by the OMA are family physicians based simply on their size, while minority specialty groups - like physiatrists - often struggle to be heard. A new institution aimed at advocating for these smaller groups may not be such a bad idea.

However, there is also no guarantee that this untested coalition - likely operating under a similar mandatory dues framework - will be any different. Larger and better resourced specialties like cardiology, opthalmology and radiology will continue to dictate priorities resulting in the same inequity that currently exists. It is also well known that physicians in the Quebec model have suffered from a divide and conquer strategy used by the government to neutralize their would-be collective leverage.

The motivation of this proposal is also curious given that it comes at a critical juncture of the negotiations between the OMA and the province. Despite the Ford government's election promise to work with doctors, it has used the same posture as previous administrations resulting in an impasse, thereby setting the stage for an unprecedented arbitration in the coming months. With the swirling uncertainty ahead, this ill-timed initiative has the potential to derail a process that is years in the making.

At a time when the profession is dealing with growing burnout, doctors need to focus on healing themselves and their patients. Research is clear that happier doctors make for healthier communities, and we need these professionals to be motivated to help develop solutions for our healthcare problems. What's clear is that we need a united OMA to end the five-year long struggle without a contact. More chaos is not the answer.


This article was first published in the Toronto Star.