March 2018 – Celebrate, But with Restraint
Celebrate, But with Restraint
I know of no medical specialist who hasn't been unhappy with the media circus surrounding the renewal of our agreement. After four years of denigration, threats, and laws as restrictive as unnecessary, we finally have the hope of resuming our place in our hospitals that have lost their souls but that we have learned to love since the marriages forced upon us by Bill 10.
We can once again trust hospital administrations with our common goals, their goal no longer being to simply place us in a small budgetary drawer, without listening to our arguments which are based on reality and needs. Finally, we obtained the recognition of being able to negotiate our working conditions as well as our professional independence that allows us to defend the needs of our patients and denounce the ineptitudes of the system without being afraid of having to face a disciplinary committee. Finally, we have the capacity to remunerate our heads who are so devoted (you cannot guess at the number of years I have personally been fighting for this issue).
We learned this week that the reorganization is finished... which is a good thing, since we, the professionals in the network, are also finished! What a victory for us that protects our rights within the framework of a signed agreement which guarantees we will be heard and will take part in decision-making ! We will no longer need to claim the right to work via formal demands. This agreement will protect us against unilateral abuse of power. The age of cooperation is back, the doors to the MSSS will be opened to allow us to continue to identify problems and find solutions to overcome all the barriers to access to specialized care.
All the efforts we deployed over the last year to implement the CRDSs are starting to bear fruit. We will ensure the update is complete and that the tools are effective before we deploy the second and third phases in order to get results that will improve access for patients. The target for surgery is directly tied to access to operating rooms and, since nothing works in the network anymore... We will not lower this target, because the population expects to undergo surgeries within reasonable delays. Lowering our targets to look good would be an infringement on the rights of patients. Instead, we need to work with the MSSS to transplant the model of certain institutions that have, on their own, succeeded in reducing wait times to 6 months overall, and to 28 days for oncological surgeries, with the addition of resources to reduce waiting lists, establish realistic delays, and, finally, to share these successes.
All of these gains for medical specialists and patients, who will have better access to care, disappeared as rapidly as they were announced to make room for the media circus whose only aim is exclusivity at any cost with, as a consequence, disinformation. Forget the fact that we have re-opened our agreement for the third time, that we gave up the trailer clause and that we were investing $140 million in measures to increase access. In these times of being subject to the court of public opinion and of fake news, declaring that our remuneration is higher than parity with the rest of Canada, without any study to show it, becomes the truth even if we have countered it with figures to prove it. Following this agreement, we will also review certain bizarre discrepancies resulting from bad decisions : goodbye to the notorious isolation gown. This fee will be cancelled in order to invest it in case management visits as attending physicians. Each association will need to clean its own house... to ensure the optimal use of public funds.
Fair enough ! Let's put our energies on the positive and show our medical leadership which makes of us the foundations of the system. This hospital-centred system... not out of complacency, but because of real need, works because of physicians. If there are no physicians, there are no patients; no patients, no hospital. If we are all perfectly agreed that first-line medicine is not practised at the hospital, we are also all agreed that the multidisciplinary approach has a decisive effect and that it must be adopted at the hospital level. When illness strikes, all Quebeckers, no matter what their socio-economic level, have the right to receive the best cutting-edge treatments by the best medical specialists.
What is standard for us, is heresy for our neighbours to the South. It is difficult for those who have never been involved in the network to understand that, to keep the best, you need at least a minimum of happiness with the work and within teams. Mandatory overtime is illogical and the model of full-time positions needs to be reviewed and updated. That is our next objective : re-establish this climate at work which is not a passing fancy. With a burn-out rate of 30% on the horizon, it is time to drastically change directions and to bank on our human capital at all levels. We need to rebuild teams, listen to them, stop smothering all the good ideas that come from our base, involve our teams in establishing targets and allow them to find their own ways of reaching these targets. Our status as a committed partner has a better of chance of furthering success towards our common objectives... for the best interest of patients… at the risk of being taken for Mother Teresa !