Shawn Whatley published a recent blog post: Can Doctors Rebuild a Working Relationship with Government?
The photo from 2015 that originally accompanied this blog post was interesting. In 2015, North and South Korea almost came to open warfare after the deaths of two South Korean soldiers in the DMZ between the two. The two governments eventually sent high ranking insiders to negotiate a way out. BBC Korea, correspondent, Steve Evans, analyzed the situation:
Each side is represented by two members of the inner circle of the leaderships in Pyongyang and Seoul.
The difficulty is that they cannot even agree on the facts of the events which led to the current state of heightened tension.
It started when two South Korean soldiers were seriously injured by landmines in the so-called Demilitarized Zone between the two countries.
South Korea said North Korea planted the mines; North Korea said that was absurd.
Both sides say the other then fired the first shot in the artillery barrages.
The talks will not diminish the fierceness of the rhetoric between the two halves of Korea, but they may find a way for both sides to walk away safely from a dangerous situation before it explodes.
As a reaction to the August 4 landmines, South Korea resumed playing propaganda on loudspeakers near the border. In 2004 both sides had agreed to end their loudspeaker broadcasts at each other. North Korea threatened to attack those loudspeakers, and on August 20 North Korea fired a rocket and shells across the border into Yeoncheon County. South Korea responded by firing artillery shells back at the origin of the rocket. There were no reports of injuries on either side. Following threats of war from the North, and various troops movements by both North and South Korea and the United States, an agreement was reached on August 24 that North Korea would express sympathy for the landmine incident in return for South Korea deactivating the loudspeakers.
I don’t think I have to detail what has gone on in the short years since this photo was taken. Today’s headlines regarding North Korea/South Korea relations are as follows:
“South Korea proposes military talks with North Korea to ease tensions”
“Kim Jong-un may have more plutonium than anyone thought”
“There’s no chance of reunification for North and South Korea”
“America says it is prepared to use military force against North Korea”
Shawn’s blog asks the question: Can we forgive the Ontario Government? And when any commenter on Facebook says that this is difficult or unlikely, the author asks a straw-man question: “Given all that, is there ANY way you might consider working with them? What would it take? If they seriously changed direction, would you try to work with them?”
Shawn is asking if we are ready to forgive and I say most would say “no”. Simple, and understandable. Other than some vague assurance that Shawn gives that Premier Wynne wants peace with the doctors (how exactly has she “signalled that she wants to rebuild a relationship with doctors”), while somehow her Minister and Deputy Minister of Health do not, doctors have seen no indication that this government understands the damage it has caused to the relationship between doctors and government and the impact this has had on patient care. Lost opportunities to improve the delivery and quality of health care in Ontario caused by intransigence, disrespect and pursuit of what seems to be an anti-doctor (and pro-every other health care provider) agenda have burned any trust that doctors have that the current government wants to put care before ideology, and responsibility before self-aggrandizement.
It is not the “satisfying joylessness” of anger that sustains the current dispute between doctors and government. Doctors are not “refusing” to forgive the government. Doctors are not expecting “a tear stained face clutching hat in hand.”
Rather, it is the “joylessness” of our relationship with government that is pushing doctors away from engagement of any sort with government, that is pushing them to work as hard as necessary, but no more than that, that is making doctors feel helpless in the face of the overwhelming power of the government bureaucracy industry. Rather, it is the government that is “refusing” to forgive doctors for wanting to continue to practice for the benefit of their patients, rather than for the benefit of micromanagers and senseless meeting-goers in the LHINs, sub-LHINs and sub-committees of sub-LHINs. Rather, it is increasingly the voices and faces of doctors that are tear-stained with the frustration of seeing patients suffer and die due to government incompetence, and patients who we see “clutching hat in hand,” begging for better access to treatment.
So are we now seeing the Ontario Government “expressing sympathy for the landmines” they laid over the last 5 years, in exchange for the OMA “turning off the loudspeaker?”
If I am not mistaken, binding arbitration assures us that a PSA will be reached prior to the next election, either through negotiation alone or via mediation and possible arbitration. However this PSA is portrayed by the government, even if generous to doctors, we must continue to advance our advocacy for our patients and the system and we must insist on a system that is sustainable from a financial and workload perspective for physicians in order to ensure its viability. A PSA may ensure what and how we are remunerated, but it will not ensure that the government fund and organize health care effectively and efficiently. If the PSA gives a boost to the fee for a total joint replacement but the government reduces O.R. funding to hospitals, how would this help anyone?
So there is no reason not to applaud new funding and new programs to improve health care. But we must remain resolute in defending the existing programs from the ongoing erosion that has occurred. We must remain willing to ask the hard questions and make the difficult points such as the simple connection between underfunded home care, lack of LTC space, and hospital overcrowding leading to unsafe work conditions and less than ideal quality of care. When a major Ontario newspaper, the Ottawa Citizen, publishes article after article after article over a two week period relating the poor environment in many LTC homes, this is an gift for doctors to stand up and say “We care about LTC, we see its connection to the entire health care system, and fixing the problems there will yield benefits everywhere in the system. We are ready to assist and if the government will only listen, patients will benefit.” Instead, we have two infographics about wait-times, a blog about forgiveness, and not one single quote from one single doctor in page after page of health care reporting.
Shawn, a person or organization that truly regrets its actions behaves in certain ways. These include: acknowledging the action, acting in a way opposite to that action, understanding the magnitude of the action, correcting the action if possible, refraining from repeating the same action given the opportunity, among others. And these behaviors must be done willingly, not because they would be inevitable (like BA) or untenable (like further unilateral cuts).
I am willing to have my Association negotiate with the government. Just as the North and South Koreans sat down and negotiated. But I want my Association to understand who they are negotiating with. I want my Association to put in place the situation where the government can start to behave like a partner. Over the next PSA, the government of whatever party is in power has the opportunity to demonstrate its interest in being that partner or in building the next big missile to aim at doctors. And that government has the opportunity to understand that doctors will always stand up for our patients and our ability to provide the care they need. Ongoing positive messaging about the shortcomings in our system is not like offensive loudspeakers aimed at the government, it is advocating for the humanitarian work that we do every day as doctors. We must continue and intensify this while we observe the government’s behavior over the term of the next PSA.