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Last chance to save BC's crumbling health care system may rest with the silent majority of physicians defeating the PMA

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Dr Z. Essak, MD - Vancouver, BC - November 27, 2022.

The BC health care system continues to show larger cracks as it crumbles. Are patients and doctors to believe that the BC NDP Government and the Association of the Doctors of BC have a plan to fix it? You better think again. There is nothing in the Physician Master Agreement (PMA) that is going to fix our health care system. It is not going to restore longitudinal care. It doesn't even pretend to offer a GP for everyone, or even access to timely specialist care or surgery.

While patients are confused as to what will save health care, are doctors blinded by the glitter thrown in their faces? The only hope in sight is if the silent majority of physicians, the seventy percent who don't usually vote, decide this week to cast their vote against the PMA, to Vote "NO" to the PMA, and send a strong message to Government and their own leaders this is not a good fix.

The health care bureaucracy is way overgrown, expensive, and ineffective and the bureaucracy at the Association of Doctors Of BC with it's GPSC, SSPC and Divisions is the same. It is so large no one even knows the numbers involved. The Doctors Of BC, itself, has grown to 419 employees according to their own LinkedIn page. The staff tell the elite leadership this is what government wants and the leaders, while they may be well meaning, are misguided. They haven't even read the whole 445 page agreement. They tell doctors, "sure there are problems" and we'll fix them next time without saying a word about what the problems are.

After having the same CEO for more than 10 years a change was due and the Board could not even handle that without incurring untold legal costs and severance, hiding behind a guise of privacy rather than admitting the costs were in the ballpark of $4 million. With no accountability, they think the membership should accept their ability to select the next CEO.

The big problem is our health care system. Something we all depend on. It is not the toy of government and elite leaders to tinker with. Back in the early 1990's the BC NDP began to dismantle our health care system with local hospital Boards who would advocate for our communities needs and volunteer their time and efforts to ensure care was available. The Government replaced the local hospital boards with Regional Health Boards and we saw the emergence of health care administration and management as the fastest growing segment of health care costs, exceeding the costs of all physicians services combined.

This spring as our health care system descended into further chaos, the BC NDP brought out the matriarch of the early reforms, Elizabeth Cull, to declare, "these are unexpected consequences." Really? Or were they "foreseeable outcomes"? Concerns about increased costs of health bureaucracy and reductions in physician and community input were voiced loud and clear and ignored.

If all you need is someone to give you immunizations, treat your acne, allergies and hair loss you may be happy with Nurse Practitioners who are paid as much as Family Physicians and don't have the depth of knowledge or the overhead of paying their staff and running their own office. We might even do just as well with pharmacists, Amazon Health and Dr Google for a fraction the cost.

But, if you need someone who can ensure the headache you have isn't something more serious, like an intracranial bleed, you better hope you have access to a Family Physician. And if you need someone who can truly advocate for you and ensure you get the investigations and care you need, you will need true longitudinal family doctors, ones who don't just work in clinics but make sure you get the hospital care you need.

Doctors who can truly advocate for patients are not employees of the Government. They are independent practitioners that are not afraid to identify themselves as owners of a medical practice and to speak up for what patients need. But, they can no longer be undermined by Fee-For-Service (FFS) payments that don't keep up with the cost of doing business and inflation combined with PR rhetoric from their own association undermining the virtues of FFS.

And if that's not enough to silence physicians, the BC NDP now has "Bill 36 - Health Professions and Occupations Act" giving cabinet the power to change regulations pertaining to the licensing of doctors and other health professionals.

This may truly be the last chance we all have to see our BC health care system saved, but it will take the silent majority of doctors throughout BC to stand up to their own association and vote "NO" to the PMA despite all the President's Letters and tweets.

There are only a few days left to vote, ending on December 5, 2022. It's now or never.

Web Links

PMA Voting Information & links

Doctors of BC Linkedin page

Attached is a pdf of this article you can download and share with colleagues and others.

Last chance to save BC crumbling health care system.pdf49.67 KB

Preaching to the choir?

At our age and state of retirement the import of this is relatively little. Within a year or two I'll be pushing up the daisies.

What disturbs me is that neither our younger colleagues nor the general public seem to have grasped the gravity of the situation. They are the ones who should be up in arms about it. In time, as the writing on the wall becomes clearer to them the younger physicians and surgeons will simply uproot and leave Canada. With their skills and education they can move to any location in the world. Then the great Canadian public will ask "Why did they all leave?" Alternatively the bright young minds in high school will look at the state of medicine and say to themselves, "I'll be better off in any career other than medicine". They're not stupid.

The impact of over-reach by government is now being seen in many western nations. In Britain, once a cradle of socialized medicine, one third of specialists in the National Health Service have announced their intent to retire or change their location of practise next year. The average Brit has private health care as part of their union negotiated work agreement. The public health service is in crisis there as anywhere.

And it's NOT about money. It's about bloody bureaucrats and politicians who think they can tell everyone how and when to do their jobs. Even totalitarian states like Russia are not so coercive. 

If I were a young high school graduate in Canada today and wanting to give my life to the service of medicine, the first thing I'd do would be to look around and see where I might be appreciated and valued the most.


Every time you look the Doctors Of BC have more staff

Today, January 28, 2023, when you look at the Doctors Of BC LinkedIn page, you see the number of employees has gone up to 436 from the previous 419 in November 2022. A rate of increase of 24 percent per year!

Doctors Of BC staff keep increasing, now show 467 on Linkedin

The number of employees at the DoBC keeps on going up. Today according to Linkedin it's now at 467 (see attached image). Maybe not everyone updates Linkedin. But, can doctors get an answer to how many staff are currently employed and also a graph of the numbers of employees over the last 2 decades from 1993-2023 to show the growth?

Cease fire banner, you don't speak for the people.