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September 13, 2009

I managed to get the Board of Directors spot I was running for. We had a record voter turnout, so to all of you who cast your ballots, even if they were against me, thank you! Hopefully we can build on this momentum and use your enthusiasm to put some “oomph” behind our message as we head into a challenging year.

It is especially great that we wound up with three Family Practice representatives in the group; it’ll give our field the voice it deserves and closer to proportional representation at the table. I’m a bit disappointed that the International Medical Graduates (IMG) didn’t get a spot, especially with such keeners amongst them, but they were at a disadvantage in the election not having done undergrad with the majority of the voters and not knowing the flavour of Canadian medical education politics. The availability bias – and the time I put into this blog – certainly did me a favour.

Regardless of our composition, we’ve got some uphill battles coming our way. We’ve got a crack negotiations team and a very clear message. I lack persuasive speaking and tactful charm, so I ought to be far away from the bargaining process, but behind the scenes I’ll be happy to do my part in the way of lobbying.

Our message is simple:
1. improve patient care by improving resident working conditions
2. retain and recruit the best of the country’s new doctors, using a competitive salary and good working conditions; parity with other provinces is the least we can do to ensure the brightest kids chose BC for their residency. It’s likewise with hours and resident well-being. There’s a reason our province’s Internal Medicine program did not fill up in the first round of matches

There are few big fights here.
While the majority of evidence is clear – residents work better when they have sleep and take care of themselves – sometimes the system doesn’t adapt to these changes; a constant argument by those resistant to easing the burden on Resident Physicians is that the shorter the shifts, the more frequent the handover, and the more details get lost, which leads to poor patient outcomes. See Kevin MD’s post about it.

We’re hoping that when residents get riled up about the new contract, they’ll get excited about other things too.

Federally and grossly on the political scheme of things, while the US moves to bolstering and universalizing their public system, here in Canada, some groups are looking at establishing rights for private sector health in our emerging two-tier system. This will be long in the courts, but for those of us intending on working for the next 40 years – and that’s about how long it will take me to pay off my student debt – we will certainly be affected by whatever precedent is set.

Never forget the power of a union. You pay your dues whether you are involved or not – better get the most out of it and use PAR-BC to fortify our voices! Did you know, we Resident Physicians have NOT been classified as “Essential Services?” That means we can take job action if and when it’s necessary. If we ever got to that stage, it would be an enormous wrench in the system. Can you imagine an academic hospital running CTU without residents? Or the general surgeon on call doing all the bogus consults in the middle of the night? Surgical specialists having to their own weekend rounds on 30+ patients? Or Family Doctors being called directly for Tylenol or sedation orders, or to assess a mild tachycardia at 2am? It would not be pretty.

2 Comments leave one →
  1. September 14, 2009 7:26 pm

    congratulations, and good luck.
    back in my day, at a city hospital family practice residency program, i routinely worked 80-120 hours per week. it was cruel to me and to patients, and approximated a kind of apprenticeship/slavery model of labor. I do have a new appreciation for my own stamina and ability to function without sleep, but at what cost to my health and the health of others?

    nice palin quote. if she lacked the high cheekbones i wonder if anyone would listen.

  2. September 15, 2009 8:11 am

    120 hours a week is pretty ridiculous. I’ve worked 100 on CTU (clinical teaching unit, an Internal Medicine thing) during clerkship, but that was in addition to studying for unit exams and getting oriented to the first hospital I’d ever worked in.

    Being busy and feeling some pressure (time, knowledge) can an be important part of a learner’s growth. However, behind pushed so far beyond your comfort zone that you can’t take care of yourself and can’t take care of your patients, well, that’s just not right. Trouble is, finding where that line is.

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