I have a relative who loves to give unsolicited advice. As you might imagine, he is not popular. So knowing the risks involved and knowing that I may remind many of their cranky old uncle, I’d like to give doctors in Ontario some advice about social media during our dispute with the Government.
Please don’t let the Government set the agenda.
They love to talk about doctor ‘income’. Do you know why? It works. Don’t take them on about income. They will win.
I have to pay my staff every 2 weeks and I cut a rent cheque every month. I know the difference between revenue and income. But most people aren’t that careful with their language. Reflexively responding to government statements about income is not effective. Explaining about overhead and the lack of benefits, paid vacations and pensions will get a great response in a meeting of doctors but the general public’s eyes glaze over when that is the response.
People love their own doctor. They respect other doctors. They trust us more than they trust politicians by such a wider margin that it’s laughable. There is one exception. When doctors start to talk about fees, our credibility walks out the door. We are regarded as well paid.
I know that plumbers get paid a lot more for a house-call than I do. I know that the payment for an office visit to family physicians is just north of $30. I know how little a surgeon gets paid for doing an appendectomy and I know that it’s almost always done at night with little compensation for the evening, night or weekend work. I also know that no one except doctors cares about any of that.
Do talk about patient care.
That is our area of expertise. People trust us when we talk about care. It is especially credible when we relate stories about how changes affect our patients. Be specific. Talk about how care was improved or harmed to Mrs X by a change in policy. It means a heck of a lot more than speculating how a change might harm ten thousand patients 5 years from now.
Talking about patient care is honest and genuine. Between 2004 and 2014 I had the honour to talk with thousands of doctors in this province. I did hear concerns about net income, but usually in the context of equity between physician groups. Don’t get me wrong, I heard from plenty of colleagues who wanted more, but by far the most common concern I heard about was about making care better for our patients.
Be respectful to colleagues with whom you disagree, especially the Minister.
The Honourable Eric William Hoskins got his MD from McMaster University in 1985. He is a classmate of my mentor Dr Stewart Kennedy and graduated in the same year as I did, although I attended another (and better) University 50 miles to the east.
That makes him our colleague. He deserves our respect. Give it to him.
The World Medical Association’s code of ethics advises that a “physician shall behave towards a colleague as he/she would have them behave towards him/her”. I doesn’t roll of the tongue like Shakespeare but it’s pretty clear.
I think that we have all seen examples where this standard has not been met. I may disagree with Dr Hoskins about the high-handed manner he has made cuts and his eagerness to abandon what should be a fruitful relationship with the Ontario Medical Association but that’s what it is, a disagreement. He is not evil or incompetent.
His public service does not diminish him as a physician. He is doing what he sees as advocacy work for the people of Ontario. And he is not without supporters within our profession.
Write about your disagreements with the Minister but do not insult him.
Focus on one opponent at a time.
Does anyone really believe that the relentless criticism of the OMA is helpful? It may be satisfying at some level but it won’t help us get a negotiated agreement and it won’t help us get binding arbitration.
Imagine the glee in the Premier’s office and the Minister’s office every time a doctor directs anger toward the OMA. It’s fair to be angry but save your powder and express your opinion during the OMA election process. Go to a member’s meeting and yell at the President. Send a message to a Past-President telling him that it’s all his fault. That’s fair. But don’t take pot shots behind the semi-anonymous wall of Twitter and Facebook.
That’s it. That’s my unsolicited advice.
Talk about patient care, not about fees. Be respectful to the other side. Don’t air our dirty laundry in public. State things in a positive way. Avoid negatives.
Take the high road. In politics it is certainly the road less travelled.
Scott Douglas Wooder, MD