Are doctors selfless healthcare heroes?
Why did it take a freedom of information request for DoctorsNS to discuss the deal that paid docs up to 23,000 dollars biweekly for being off work?
I was a little hesitant to talk about this, because as you can imagine there are strong views on both sides. Well here goes, this shouldn’t be controversial or anything…
Andrew Rankin is one of the few true journalists left out there who is turning over rocks, presenting controversial views, and asking tough questions. (Imagine the nerve - asking Dr. Strang tough questions! NS premier Tim Houston himself said: “..to crticize and question Dr. Strang and public health… is just wrong.”) Check out Andrew’s articles at Saltwire. (As an aside, a shoutout to Linda Pannozzo, who is another journalist with integrity. You can check her out at lindapanozzo.substack.com)
Anyway, Andrew has several articles worth checking out during this pandemic, outlining concerns about vaccine adverse event reporting and other important issues.
His latest article is here. To summarize, and in case the paywall doesn’t allow you to access it, the article exposes a deal that DoctorsNS made quietly and privately with the NS government during the pandemic.
For those of you unfamiliar with NS medical bureaucracy and politics, DoctorsNS is not officially a union, but they serve as one in practice. Ostensibly they are “the voice of doctors” in NS, although many physicians would disagree with that. Membership is mandatory (as are dues!), but involvement with them is minimal. A recent “engagement tour” for instance, saw a whopping 1.5% of the membership show up to give feedback, and yet DNS was happy to come up with a report based on “what they heard from physicians on their tour”.
The deal that Andrew exposed paid out 65 million dollars to docs whose work was curtailed by the pandemic. Most docs aren’t on salary, so unlike direct government employees, when they stopped working, they stopped getting paid. (Mind you, “virtual visits” were very quickly OK’ed, so that docs could start billing again for phoning or teleconferencing with patients.)
There were docs behind the scenes who argued against this deal. They felt the fact that docs could apply for up to $23,000 EVERY 2 WEEKS in relief, while the peasants had to settle for their $2000 per 4 weeks on CERB, at best appeared greedy and self-serving, and at worst was greedy and self-serving. What end of that spectrum you choose to believe is a matter of personal opinion.
DoctorsNS is an extremely well funded bureaucracy, so immediately in the aftermath of Rankin’s article they went into “reputation damage control mode” and crafted a response. It was published in the Herald and available on Saltwire here.
To me, the response was defensive and doesn’t address concerns that the public might have. Here are some thoughts:
First, why was this deal not announced publicly when first reached? It took a freedom of information request to unearth it. If it was necessary and defensible, why did DNS only address it once forced to? This is public money being spent, and the public has a right to know about it.
Secondly, DNS states that doctors “had to continue to support their families and to pay office staff and overhead expenses such as rent and utilities”. My understanding is that their office staff were eligible for CERB if laid off. As to supporting family, rent and utilities, how are physicians any different from someone who runs a restaurant, or retail shop, or a gym (besides being, on average, far more wealthy). I have talked to several small business owners, who confirmed that the government relief available to them was not NEARLY as generous.
Thirdly, DNS defends the deal by stating how docs were still “working” early in the pandemic: that work being training and preparing for the pandemic. I can say that this was true of some, as I was still the head of ER at that point and I was indeed VERY busy for a time. But as are all docs who have official supervisory/chief positions in NS, I was paid an annual salary for my position. What I can also tell you is that most docs WEREN’T extremely busy making pandemic preparations. I think it’s - to use a polite word - ‘inaccurate’ to suggest that an average doc who works in the trenches was involved in pandemic preparations. In fact, many of our family docs who work part time ER were able to take on extra (well paid) ER work in the early pandemic when their office work was decreased.
And as an aside, ER volumes decreased incredibly for the first months of the pandemic. Some critics have (?rightly) pointed out that one wouldn’t expect docs and nurses to be making TikTok videos of themselves dancing in the midst of “the worst pandemic since the Spanish Flu”. A colleague said the early pandemic felt like being on the ramparts of a castle waiting for the barbarian invasion. We had our armour donned, the boiling oil ready, weapons sharpened. The only thing missing was the barbarian hordes.
In my opinion, a fair system pays us for what we do, and doesn’t pay us for things we don’t do. Sure, docs would have lost money for a few months, but given that a backlog of patient visits and procedures - which is what we make money for doing - was building up, we could have caught up later, as we gave patients the care that had been delayed.
Many other countries with different medical payment systems were faster getting medical care back online. Maybe I’m being too harsh, but one has to wonder: if we had not been paid to be off, would doctors have been fighting harder behind the scenes to re-open hospitals and clinics and get back to the work of seeing patients? Would we have been more focused on the hardships patients were suffering rather than being content to sit back and wait until the powers-that-be decreed it was “safe” to provide medical care?
I’ve noticed a stark split during the pandemic. Those of us in the “laptop class” could keep working, or at least keep getting paid when the world shut down. We have big houses with enough space to not drive our family members nuts. We were fine with lockdown. On the other hand, there were the poor. Those with marginal salaries to whom even a brief decrease in income is a potential disaster. Or small businesspeople who have poured their life effort and money into their own business, many of whom have been driven to or over the edge of insolvency. The pandemic has caused the greatest historical transfer of wealth from poor to rich ever. Wal-Mart and Amazon have seen profits soar, thank-you-very-much.
Through it’s largess to physicians, the deal negotiated by DoctorsNS exacerbated the inequity between rich and poor at a time when we were supposed to be “all in this together”. To many in the public, this deal tarnishes the shiny halos we “healthcare heroes” were bestowed in the early pandemic.
I’m a pharmacist. The number of doctors (family docs) UNAVAILABLE to their patients during the pandemic for was absolutely pathetic. Some family docs still won’t see people in person. How often say, are their patients BPs being monitored if it isn’t being done in office etc etc? Just absolutely pathetic to see some could have made this wage while I got absolutely nothing, had to deal with their unavailability by taking over prescribing for their patients, checking their blood pressure, providing dose adjustments, refills etc, which the govt pays us $12 for. Pathetic.
Thank you for your honest and frank articles. Very grounded, truthful and courageous. With deep appreciation, the truth will set us free and open eyes better than anything else.