Before the voting began, the BC Medical Association (Doctors of BC) board of directors was presented with the eight-page highlights of the agreement - not the 239-page agreement and directors were asked to adopt a recommendation that doctors accept the new agreement. They were not given advanced information prior to the discussion and were not allowed to take documents with them for further consideration if needed. Following the discussion, a vote was taken and apparently passed unanimously.

Is it proper for directors to not have the full 239-page agreement when asked to make a recommendation?

The directors only received access to the full 239-page agreement at the same time as all doctors eligible to vote as members of the BCMA when voting opened. Some directors have said that they subsequently voted against the new agreement.

A survey of doctors midway through the voting showed 49 per cent did not know if it was a good agreement for doctors, 11 per cent answered yes it was good for doctors and 40 per cent said no that it was not.

On the question of is it good for health care, 54 per cent answered they don’t know, 11 per cent yes it is good for health care, and 34 per cent answered no - it is not good for health care.

Less than 20 per cent of doctors had read any of the full 239-page agreement and most had only seen the BCMA president’s letter and eight-page highlights document circulated with it.

More than 75 per cent found the agreement a little or very difficult to understand.

Some doctors said even the 0.5 per cent increase which sounds simple to understand really isn't because of all the targeted channels for the spending so doctors don't know if they will actually get anything.

Many doctors didn’t realize that the existing 2012 Physician Master Agreement has not expired and will continue in effect until March 31, 2016.

Some doctors asked, what was really gained by this re-opener in the middle of the life of the 2012 agreement. All that was needed was limited negotiations on specific items including financial matters.

Instead, through belief in the view that it would become contentious, a new agreement was developed that runs until 2019.

Why would it be contentious? Because government was going to threaten doctors with clawbacks?

And what? Doctors weren't prepared to stand up to government to ensure their ability to deliver patient care and keep up with the rising costs of medical practice, paying staff, office rent and rising professional and insurance dues?

Instead, doctors were urged to commit to a whole new PMA that goes on to 2019, through another election and possibly the retirement of senior staff with benefits doctors never see.

Who really benefits?

Does it benefit politicians gaining peace in the next election?

Does it benefit senior staff and all involved in the negotiations to ride high on the wave of it passing and spend the next five years working on the details?

Doctors don’t know if it will help them meet their expenses.

Hundreds of millions of dollars will be channeled through joint committees into a growing administrative bureaucracy.

Is this really going to help our health care system?

As one doctor said: "For years I have been concerned that clinicians, those at the 'sharp end' as Osler called them, who practice the ultimate purpose of our profession, patient care, have been in danger of losing power/control over these activities.

On November 28, less than one week before the close of voting on the new agreement, there was a scheduled BCMA Board meeting.

At that meeting, the CEO informed the directors that only 25 per cent of doctors had so far voted and presented to the directors a template letter to which they were asked to attach their name and send it through the association’s email system to all doctors in their district urging them to vote for the agreement. The directors were asked to send the letter unaltered.

Doctors receiving the email letter might presume it to be the view of their district delegate - not the prepared view of senior staff and more likely to vote in favour.

Is it proper, in the middle of a democratic voting period to use the full resources of the association to advocate one position - to vote in favour?

During the electronic voting period, what information has Everyone Counts Canada provided to the BCMA, to whom and when?

Is such campaigning for a specific outcome acceptable?

Or even in the public interest?

Will it make our public health care system better if it passes?

From the beginning, doctors have received controlled messages advocating one way to vote rather than being provided an agreement that is easier to understand and tools to answer their questions and assist their understanding.

Have controlled messages become the substitute for openness and transparency?

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