Never has Canadian medical politics been so accessible, informative and, frankly, entertaining – all thanks to social media.
For good or bad, this is the new reality for a profession used to dealing with its financial negotiations in confidential discussions behind closed doors.
The current knock ‘em down drag ‘em out fight between those supporting and those opposing a new draft professional services agreement between the Ontario Medical Association (@OntariosDoctors) and the provincial government comes to a head this Sunday at a general meeting of the association to vote on the proposed deal.
The backstory behind this particular agreement to set fees for Ontario doctors is too long and complex to explain in this blog post. Suffice it do say that the leadership of the OMA is lobbying the membership hard to support the deal, while a well-organized opposition is urging its rejection and a return to the bargaining table to better halt government cuts and gain the right to binding arbitration.
All of this is being played out daily on social media and especially Twitter and blogs, as advocates for both sides post thoughtful essays on their views or engage in lively wars of words with their opponents. For its part the OMA has supplemented tweets and blog posts by leaders such as @GailYentaBeck, @ScottWooder and @VirginiaWalley with YouTube clips from well-known provincial physicians voicing support for the deal.
The profile of the whole situation has been raised by the involvement of André Picard (@picardonhealth), the nation’s leading health reporter and Steve Paikin (@spaikin), a leading provincial TV political affairs commentator, who together have more than 120,000 followers on Twitter. Picard especially has taken an active role in the debate challenging some views and chiding others for inappropriate comments.
Ontario doctors were among the first in Canada to recognize the potential for advocacy offered by social media platforms such as Twitter. It is sad that probably only a minority of the province’s physicians are observing Twitter and other channels to follow the discussions, debate, arguments, and bon mots.
Some leading Ontario physician bloggers and social media commentators were asked whether social media had inflamed or informed the current debate about the Ontario deal.
“I believe all communication does both,” said Dr. Shawn Whatley (@shawn_whatley). “Social media is no exception.”
“In my now nearly 40 years as an Ontario physician I have never witnessed such passionate engagement with OMA affairs or the political process,” said Dr. Alan Drummond (@alandrummond2). “That ‘movement’, if I can call it that, was directly fueled by the use of social media and the enhanced connectivity between different regions and specialties.”
“I was surprised by how many of my physician colleagues in Perth have expressed that their opinions were being formulated by arguments made on Twitter. This was not necessarily all for the good. Initially they were pleased with the nuanced concerns about the agreement; as things dragged on they were starting to get pissed off with all the negativity. Nevertheless, it is clear to me that social media has changed the game.”
Drummond noted the “vitriolic and misguided personal attacks” by some on social media and added “if we are going to put ourselves out there in public we have to remember that “the whole world is watching” and behave accordingly.”
Dr. Cathy Faulds (@fauldsca) said there are pros and cons to using social media for such discussions. On the plus side she references the ability to spread a diversity of views, prevent groupthink and “eliminate the paternalism that has plagued organizations and our medical culture.”
“The depth of learning and sharing is fantastic and reminds me of the surgeons’ lounge in my earlier days of practice. It is generally fun to be part of this (Twitter) crowd and the majority respect boundaries and are collegial),” she said.
The downside of debating on Twitter according to Faulds, include the 140 character limit, the “conversational swirl” that can make it difficult at times to follow discussion threads, and anonymity that can make it difficult to give context to some comments. She also noted the presence of “schoolyard bullies” and the fact cliques can easily develop that people block others they do not agree with.
Dr. Mario Elia (@supermarioelia) has a much broader condemnation of the social media element of the current debate.
“SM has allowed this (debate) process to spiral right out of control, allowing opposing positions to be distorted and for each side to attribute their worst fears to the opposing group. It has been horrific.”
Dr. Nadia Alam (@DocSchmadia), has possibly been the most active Ontario doctor in the social media debate and she describes that discussion as “eye-opening.”
“Normally mild-mannered docs now appear fierce, antagonistic even. Normally complex ideas are distilled into pivotal moments of wisdom.
“Social media decentralizes communication and is unparalleled in its reach across time and physical boundary. The price though is in the steep learning curve. I find it can be an unforgiving environment: adept users will judge and sometimes shame the clumsier novices.”
She describes the use of social media as a “two-edged sword” in that “it informs but it can also inadvertently ignite hostility. It can bring people together or tear them apart. It can be inclusive, but can also be used to ostracize people. It can help in the spread of information, but it can also feel like you’re lost amidst the noise.”
From these comments it appears that to many Ontario doctors, the social media platforms that most of their colleagues are reluctant to use for professional purposes has changed forever the nature of political discourse within the profession in this country.
(The author would like to thank all physicians who provided input into this post)