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Dr Eric Cadesky becomes new President-Elect Doctors Of BC
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Dr Z. Essak, MD - Vancouver BC - July 26, 2017.

Congratulations to Dr Eric Cadesky on winning the election for President-Elect of the Doctors Of BC, the BC Medical Association.

It has been an interesting campaign with opportunities to get to know both candidates, Dr Eric Cadesky and Dr Jean-Noel Mahy, through not only their websites but also meeting them in person at the debate and for everyone to see them on the YouTube live stream and recorded video of the debate.

Seeing both candidates making such efforts to promote thought and discussion about health care in BC it is disappointing that only 16 percent of doctor members even voted.

With less than 2,000 of the 12,000 members voting and the winner with 58 percent of those that voted to describe the win as "a show of support for the association's current direction" may be less an analysis than a spin, overlooking that 84 percent of doctors are not engaged through the association's current path.

As the new President-Elect will oversee the next contract negotiations with the BC Government, hopefully a greater depth to understanding why doctor members are not engaged will be explored.

While the election may be over, the conversation that arose through the healthy debate of this election is still available for watching and further discussion.

Are doctors and patients having difficulty making the BC health care system work?

Watch the debate, hosted by the Vancouver Medical Association and the Westminster Medical Association, available on Youtube beginning with a moment of silence for the recent passing of Dr James Busser.

05:00 Moderator's opening remarks with introductions and opening remarks from each candidate. https://www.youtube.com/watch?v=894GAgTDxTE&t=05m00s

Followed by questions and answers which can be accessed individually:

15:50 Why haven't these things happened already? And what is the root cause of the apathy of members? https://www.youtube.com/watch?v=894GAgTDxTE&t=15m50s

18:40 Moderator's guidance and invitation for questions from audience. https://www.youtube.com/watch?v=894GAgTDxTE&t=18m40s

19:10 Richard Merchant, On the question of engagement, how are you going to engage individual specialties and every physician? https://www.youtube.com/watch?v=894GAgTDxTE&t=19m10s

23:15 Alan Ruddiman, How will each of you support reducing wait times and giving patients access to operative and consultation services in this province? https://www.youtube.com/watch?v=894GAgTDxTE&t=23m15s

27:50 Karen Dallas, How do you propose to work together with us at St Paul's with the new hospital initiative? https://www.youtube.com/watch?v=894GAgTDxTE&t=27m50s

34:25 Derryck Smith, The current crisis in BC with 143 forest fires, is there a role for the Doctors of BC to be more proactive in assisting our colleagues around the province in times of disaster? https://www.youtube.com/watch?v=894GAgTDxTE&t=34m25s

37:20 Zafar Essak, Is it too late, have doctors already given up independent professional thinking that patients expect? https://www.youtube.com/watch?v=894GAgTDxTE&t=37m20s

42:14 Raj Kalla, What are each of your positions on the Canada Health Act and private health care? https://www.youtube.com/watch?v=894GAgTDxTE&t=42m14s

46:35 Vincent Wong, As a new resident, the increasing cost of living and office overheads in metro Vancouver are prohibitive, how might you guide negotiations? https://www.youtube.com/watch?v=894GAgTDxTE&t=46m35s

58:00 Caroline Wang, The inability of British Columbians to find a family physician; for the last 5 or 6 years the Doctors of BC have worked with the Government on the GP for Me program, why has it failed? https://www.youtube.com/watch?v=894GAgTDxTE&t=58m00s

1:03:00 Robin Patel, Information Technology in our workplace is not well reflected, Alberta is way ahead of us in terms of integration throughout the province, what are some of your priorities for moving IT forward in health care? https://www.youtube.com/watch?v=894GAgTDxTE&t=1h03m00s

1:08:30 The Naniamo EMR issue, what can you do to simplify EMR within the province? https://www.youtube.com/watch?v=894GAgTDxTE&t=1h08m30s

1:17:25 How should community doctors involved in clinical teaching be compensated for their contributions, through fee for service or salary? https://www.youtube.com/watch?v=894GAgTDxTE&t=1h17m25s

1:20:48 Gurdeep Parhar, UBC values its relationship with clinical faculty and Doctors of BC, now there is no UBC representative on the Doctors of BC Board or the Representative Assembly. What will you as President do to reconnect with UBC? https://www.youtube.com/watch?v=894GAgTDxTE&t=1h20m48s

1:28:00 What are your thoughts on having IT benchmarks as a standard for all health authorities and vendors, to ensure they are answerable for the money put in? https://www.youtube.com/watch?v=894GAgTDxTE&t=1h28m00s

1:31:05 Summary and closing remarks from each candidate. https://www.youtube.com/watch?v=894GAgTDxTE&t=1h31m05s

 

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Thank you for your comments
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Thank you for your comments. The turnout of about 16% is consistent with the 12-18% seen in most Canadian professional elections. (A low bar, I know.) It may have been apathy or that colleagues were happy with the calls for change from both candidates and felt confident in either choice. Either way, I am interested to hear ideas on how we can improve future election turnout. For reference, the Governance reform vote had a 25% turnout and the run-off election between Drs. Alan Ruddiman and Brian Day had a 50% turnout. (In fact, membership jumped during that period as colleagues joined Doctors of BC just to be able to vote.)

And thank you for annotating the video: I hope that we can all agree that bringing Doctors of BC to members was a great success. I will continue advocating for more events like this to make the association accessible to all members. In-person town halls, video broadcasts, and social media are important ways to give all members the voice they deserve and that we need to hear.

Finally, there has been a call for nominations for the Doctors of BC board of directors and I encourage those interested to apply.

 

Is 12 to 18 or 25 per cent acceptable for professionals election
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I am curious if you can provide the source for the data that 12-18 per cent is the range for Canadian professionals elections? Is this just medical association elections or other professions?

With democracies feeling threatened by voter turnouts as low as 60 per cent considering compulsory voting, should not voting under 25 per cent in professional organizations be a major concern especially for organizations that engage in negotiations with government as representing the entire profession?

 

Voting turnout
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I completely agree. The results were from a survey of Canadian professional associations several years ago.

Previous ideas have included changing the dates so that members can pay for dues and vote at the same time. 

What other ideas do you have to improve voter turnout? 

Source(s) of data show average is 39 per cent for associations
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I was hoping to see what source(s) of data might be shared with us from your experience especially since you have been a member of the Board and the Executive of the BC Medical Association (DoBC) for the past several years and presumably this would be a matter of concern at the Board and Executive.

Nonetheless, with a quick online search I found a meta survey for a diversity of associations - https://www.electionsonline.com/blog/post.cfm/average-voter-turnout - "The average voter turnout for these elections was 39 percent."

The article also includes a link to another article with some tips on improving voter turnout.

However, even the recently completed election in which you were successful raises some other unanswered questions as to how level the playing field was.

As to what to do, first of all, there needs to be an independent audit of the voting process of http://www.everyonecounts.com/ This has not been done even once since the selection of that company soon after the arrival of Mr. Allan Seckel as CEO. There have been numerous concerns voiced but no independent analysis. They are not the only company providing such services; e.g. https://electionbuddy.com/ so why the secrecy?

Without good data analysis one cannot make reasonable recommendations or plans.

 

I am really disapointed as well.
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I am really disapointed as well. I am afraid that it reflects the BC doctors general sadness of the health care status, the absolutely unacceptable wait times for even emergency procedures and our lack of ability to influence anyone, inculding our own Regulating body to influence medical politics in this province for the serious public health problems. They are mandated to take care of the public. I have not seen any activity taken or published from their side.

 

Election Turnout
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Thank you all again for your interest in improving voter turnout for Doctors of BC elections. I agree that there are many possible reasons.

With the help of Doctors of BC staff I was able to source the turnout statistics to a draft of a background paper that was last revised September 12, 2014. So, while the numbers are a few years old, here are some statistics and facts that you may find helpful. I will respond to the 17 methods to improve turnout in a separate post. 

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From 2012-2014 Doctors of BC members were asked to vote nine times (2 elections for 5 positions, 1 PMA and 6 bylaw amendments).  This is more than any other association in Canada over the same period. Voter fatigue is a recognized factor in lower turnout.   Turnout fo the president and officer elections was 24% in 2002, 10% in 2014 (and about 16% in 2017)   In the 2014 election, Peace River and East Kootanays voted most (24% and 37% turnout respectively)    -the least were upper Vancouver Island (8%), Okanagan and Surrey/White Rock (9%) The bylaw amendment on term limits had an 8% turnout in the fall of 2014 The 2007 PMA had a turnout of 18%   OTHER PROVINCES -Ontario has paper or e-voting and a consistent 15-17% turnout -Alberta has their representative forum elect board members, the president, and other officers. General members do not have a vote.  -Nova Scotia offers e-vote or paper. Turnout was 26% in 2012 and down to to 17% in 2014   CPSBC -about a 10% voter turnout    Chartered General Accountants of BC -6-10% turnout   BCNU

-e-voting. About 17% turnout for their presidential vote at the time of this analysis.

So, there is a lot of fluctuation and variability. These numbers help us appreciate the 50% turnout for the 2015 election between Drs. Alan Ruddiman and Brian Day and the 25% turnout for the 2017 governance referendum.

 

As always, I look forward to your thoughts. 

Ways to improve voter turnout
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Further ideas on how to improve voter turnout, here is my quick analysis using the link that he thoughtfully provided (https://www.electionsonline.com/blog/post.cfm/18-tips-to-increase-voter-...):

 

  1. Announce the election by email. There are usually several emails for candidates and voting in advance of and during the campaign
  2. Employ social media. Doctors of BC is recognized as one of the stronger social media presences among Canadian medical associations 
  3. Ensure the ballot’s accessible. I will ask what has been been done to ensure this
  4. Ensure mobile friendliness. The preferential balloting can be difficult on a mobile device but I know several colleagues that were able to do it.
  5. Place a prominent announcement about the election on your own web site. Done 
  6. Place an article about it in any monthly publications you produce (BCMJ.)
  7. Use social media: again, the Doctors of BC social media presence has been strong.
  8. Use email signatures to link to the ballot by having everyone in your organization include a link to the ballot in your email signatures while the election is underway. This is an interesting idea.
  9. Piggyback off of dues. If you're an organization with a dues season in progress at the same time as the election, include a link to the ballot on the online dues payment receipt. This has been discussed. It would involve a big change and either a very long or very short term for the transitional governors. What are your thoughts? 
  10. Consider single sign-on. We use a third-party system,
  11. Send email reminders. This is done every week or so during the elections
  12. Perform data hygiene. Information is taken from members' own self-inputted profiles 
  13. Shorten the election. The concern over the last election was that due to the governance changes it took place over the summer and a longer voting period was needed.
  14. Create a sense of community. Voter participation rates are higher for smaller organizations where the voters and candidates are more familiar with each other. I hope that my platform of unity and ongoing efforts such as townhalls improve the sense of community.
  15. Ask yourself why should a voter care. Again, this gets to the question of why turnout is low. What will change? Are people not voting because they are happy with either candidate? Or because of apathy?  
  16. Display the ballot count on your own website. Since a third party (Everyone Counts Canada) is used, I am not sure if this is possible

 

Social media may not be best for elections
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Thank you for the detailed response building on the ideas in the post from the link.

The use of social media for elections got me wondering how it may not be the best approach. This could be the subject of a separate thread on use of social media for professional organizations.

Reliance and prominent use of social media may have some downfalls.

First, it heavily favours those individuals who are already using social media including those physicians who have been involved in medical politics for a longer time over new candidates.

Social media tends to focus more on who rather than what is being discussed. It can be more of a celebrity platform than a discussion platform with "me too" tweets and name recognition with numbers of "followers", "friends" and "connections".

Social media may lead to a more shallow discourse. Similar to what was observed when Medline searches became more available back in the 1970's and 80's - there was a great reliance and propagation of ideas based on abstracts only. Many physicians and residents, in studies that were conducted, had not read the full article(s). Abstracts by themselves can be misunderstood and not be sufficent for decision-making.

I think further discussion on this is better suited to a new post where we might discuss more broadly the advantages and disadvantages of social media for professional discourse. There is no doubt that social media offers some good opportunities and raises questions on how best to utilize it. I'm not sure who will kick that off with a new post.