Sunday, July 10, 2016

An Ontario Doctors' Strike Won't Work

Don't do it. Don't even consider it.

Many of Ontario's doctors are, as they say in the Maritime provinces, right some pissed. Not that you can blame them. Their fees have been unilaterally slashed by the provincial government, with protests and far-off court challenges not being terribly effective. Even clinic closures have yet to convince the government to reverse course and return to the bargaining table. To make matters worse, doctors are feeling the squeeze on their professional autonomy thanks to a labyrinthine bureaucrat-led plan to reform primary care.

They're being publicly shamed in the press, and soon will see their gross earnings - without due consideration of overhead costs - published for all to see. Their medical association, the OMA, has been wholly ineffectual in improving matters, despite taking in tens of millions each year in membership dues.

The doctors are feeling understandably trapped and disrespected, which is why the more restive among them have been raising the spectre of job action or even a full-on doctors' strike.

It's a terrible idea. A terrible, horrible, no good, very bad idea. Why? Because it's an idea being bandied about without seriously addressing first-order questions.

Not First Order questions, but first-order questions, such as:

1. Doctors have gone on strike twice before, and emerged both times with nothing to show for it but damage to the profession's reputation. What would make this strike likely to succeed?

2. Even if a strike vote could get through the OMA and pass, many doctors (those in sparsely-served areas, or working with the critically ill) would be in violation of College policies by going on strike. Moreover, many doctors simply wouldn't strike because they don't want to. Without solidarity, would a strike cause enough of a public inconvenience to get the government back to the table? Think of the striking public sector unions that do see results: garbage collectors, teachers, airport workers, city services. We're talking major inconveniences to pretty much everybody. Are we to seriously believe that, say, 30% of doctors closing their offices, when the ER is still up and running, is going to cause a massive outcry? If it does, how can you be sure government will be the target of that outcry?

3. Unions generally amass some kind of strike fund as a buffer for members during a stoppage, because the bills don't stop even if the paycheque does. Staff can be laid off, but the office rent is due whether a doc is working or not. Where's the money to cover overhead during a strike, never mind personal debts and bills?

4. What is the objective of the proposed strike? The province getting back to the table? An offer of binding arbitration (for which there is no guaranteed outcome)? Repeal of Bill 210? Reversal of the 2014-16 cuts? What does a successful outcome look like?

5. Doctors do not have the solidarity of a real union. An individual city worker or teacher can always deflect criticism to the union as an entity in and of itself. Whether a strike is successful or not (however you define success), some doctors are going to be responsible for the outcome and some are not. What does that do to relations within the profession, strained as they are already? With the patients?

There are many, many ways to arrive at the right course of action in a given situation. It's possible that right now, the most reasonable course of action for Ontario's doctors is no action at all. But a doctors' strike is the wrong idea, in the wrong place, at the wrong time. Put it out of your head.


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