RE: STC is broken
"McLauchlan, Kevin" <Kevin -dot- McLauchlan -at- safenet-inc -dot- com>
"Keith Hood" <klhra -at- yahoo -dot- com>, <richard -dot- melanson -at- us -dot- tel -dot- com>
Tue, 29 Apr 2008 15:12:27 -0400
Does the mere fact of having had a doctor father give you extra leeway?
You could read what I said, rather than what you wanted me to have said
so that you could get offended about it.
My points were observations about THE GUILD (into which you can read
Ontario Medical Association, and by extension, Canadian Medical
Association, and by further extension-due-to-similarity the AMA).
As with any guild, members are not the executive. All members are
members because they must be. Only some members are members because they
wish to be. Because the guild has disciplinary powers and great
latitude, members must be very careful what they say and do. If they
offend the wrong people in the positions of power - those whose primary
skill and motivation is political (the ability to further themselves in
organizations) rather than technical (the science and practice of
medicine and direct health care), then their careers and livelihoods are
My own doctor agrees with me - as does my wife's doctor. They are both
overworked and underpaid, as doctors and as mothers. They will both be
retiring sooner than has been traditional for male doctors... because
female doctors traditionally just have more sense in that respect (yes,
that observation is also a generalization which you or somebody is free
to misinterpret as a precise rock-hard claim to which you can object and
take offense.....go nuts.).
It is a fact, well documented in the press in Canada, and especially in
the province of Ontario, that:
a) there is a critical shortage of doctors - long evident in remote and
non-urban areas, and growing more critical day-by-day in the cities.
b) it's going to get more critical as the existing doctors retire (many
are boomers who are retiring as their patients do, however not only the
patients but also the doctors are just entering the years when they will
need ever-increasing medical services from the remaining practicing
doctors), and as newly minted doctors take a more sensible approach to
work-life balance -- meaning they won't willingly work the 60-to-90 hour
weeks at multiple clinics and hospitals, each.
It's also a fact that the medical association controls what medical
teaching establishments are allowed to come into existence, and which
new doctors are allowed to be accredited, and what hoops foreign-trained
doctors must jump through to achieve accreditation, despite having
graduate well from fine schools and despite having practiced
successfully in their countries of origin.
Rank-and-file doctors not only disagree with the restrictiveness,
they've been raising the alarm for some time. Their leaders/masters in
the upper hierarchy of the associations are only lately coming round and
loosening the reins a little, even though the writing on the wall was
obvious more than a decade ago. . . when they were _lowering_ the quotas
and class sizes at medical schools, citing an ostensible oversupply of
physicians that wasn't even true then and is laughably untrue now. The
pipe-line is not a fraction as full as it needs to be.
Public pressure is mounting, and even politicians are starting to wake
up and jump out in front - now that they see which way the wind blows.
So what will happen is that the medical establishment (not my GP nor the
dermatologist I saw last month after 7 months of waiting, but the upper
political echelons of their association leadership) and the government
that supplies their clout will "reconsider" and suddenly find that most
of those icky foreign-trained doctors are actually fine physicians who,
instead of remedial (repeat) med-school and three or four years of
supervised OJT, actually need only a quick-and-dirty orientation and
maybe a few English (or French) lessons and they can hit the ground
running. Of course, this will still take a few more years to even begin.
Rank and file doctors - the non-political ones who are still in practice
and haven't saved their health and sanity by retiring - will heave a
sigh of relief as newcomers begin to take up some of the enormous
A little look at history and at human psychology shows that that sort of
conservative, protectionist, pull-up-the-ladder-of-the-treehouse
worldview is the normal outcome of guilds.
The people who argue to start one - whether based on the STC or some
other foundation - all assume that they will be insiders, or
The key would be to get the government clout. Otherwise, you can't
implement the controls that make it worthwhile. Being able to exclude
people is valuable only if by doing so you keep them from legally being
employed in your/their field, or at least make it unlikely, difficult
and marginal for them. Make no mistake; you have to exclude people, a
lot of them. Setting the bar too low dilutes the brand, the cachet.
Setting it too high makes for great exclusivity, but not enough
dues-paying fodder... er... members to be attractive.
If you and I lived in China, and foreigners complained about what
China-the-government/regime was doing, you would understand yourself and
your father and all your neighbors to have been maligned. That's a
cultural thing that has a lot to do with the fact that they've had only
one government for a few successive generations. We're seeing that
sociological quirk in the counter-protests to the Olympic-torch
protests. We in the west like to change our governments (at least the
overtly political, elected portions) whenever we get tired of them, so
we don't identify government with country with "me". Similarly, people
who are members of the AMA, the CMA, the OMA, etc are members, not
because it-is-me-and-I-am-it, but because it was a requirement of
working in their chosen field. Only some_ of those members have the
political gene and are compelled to become insiders and seekers after
higher echelons and positions of power. Those are the members who begin
to think "organization-equals-me" and you insult my gang, you insult me
(or vice versa).
"Attacking" the organization (in this case as an example of a type to
which we might aspire if we are collectively bent that way) is not the
same as attacking the profession or the calling. Nor is it the same as
attacking the ordinary members who have little choice but to be members
(by the law of your country, as by the law of mine), and who don't
necessarily agree with some/many of the guild's policies. You are free
to see the situation differently and to choose to be offended on your
own behalf or that of your dear Dad. He wasn't a senior, policy-making
AMA official and/or government liaison man was he?
By the way, if you would care to read without the blinders and
selectively tinted filters, you would note that I said nothing about the
doctors in Canada disobeying the laws of our country. I didn't even say
it about the senior CMA and OMA people. What I said is that by colluding
with government, they (their policies) _become_ the law.
I think it's the same in the US as in Canada, that you can't legally
practice medicine if you are not a accredited member of the guild? Is
that not so? If you try to practice anything that even smells like
medicine without their blessing, not only are you open to lawsuits just
for the lack of that accreditation, but you are open for criminal
prosecution, isn't that true?
We've already established that a union is not going to do much for our
widely scattered membership of techwriters, but that if we want
collective clout, the next closest thing is a guild. A guild that
doesn't have government sanction is just a club with no power to enforce
its edicts. But gaining that government sanction is not without costs.
Offense Theft - the taking of offense where none is offered.
> -----Original Message-----
techwr-l-bounces+kevin -dot- mclauchlan=safenet-inc -dot- com -at- lists -dot- techwr-l -dot- com
[mailto:techwr-l-bounces+kevin -dot- mclauchlan=safenet-inc -dot- com -at- lists -dot- techwr-
> l.com] On Behalf Of Keith Hood
> Sent: Tuesday, April 29, 2008 13:46
> To: McLauchlan, Kevin; richard -dot- melanson -at- us -dot- tel -dot- com
> Cc: techwr-l -at- lists -dot- techwr-l -dot- com
> Subject: RE: STC is broken
> I found your post especially interesting, as my father
> is a retired doctor who practiced medicine in the USA
> for more than 45 years.
> No, I am not writing to castigate you for insulting my
> father's profession. I have no intention of debating
> with you the rightness or wrongness of your
> statements. My interest is in knowing whether you, a
> fellow writer, a presumed professional in the art of
> communicating exactly your true meaning, are engaging
> in slander by design or by accident. I know that
> sometimes, when people are writing on their own and
> are not at work, they will use a more personal and
> emotive means of expression than they would use in
> job-related communications. I am interested in knowing
> whether you understand the full awfulness of the
> insult and accusation expressed in your post, and the
> possibility of you having left yourself open to a
> For example, you made the following statements which
> are characteristic of the entirety of your post:
> > Doctors and lawyers don't often work in groups of
> > hundreds or thousands,
> > but their guilds regulate them (a little) and keep
> > their clubs exclusive
> > (sorta), and collude with government, thereby
> > keeping membership numbers
> > controlled and prices up.
> > Between government (that gives them the clout to
> > enforce) and the
> > medical association that does the enforcing, the
> > number of doctors is
> > kept artificially low.
> In these lines you have written of doctors engaging in
> behind-the-scenes machinations for the purpose of
> artificially restricting the availability of medical
> services. In your post you are literally accusing the
> doctors in your country of engaging in an unethical
> greed-based conspiracy to deliberately deny your
> countrymen vitally necessary services.
> Are you fully aware of the fact that you are quite
> literally publicly accusing an entire class of
> professionals of engaging in a conspiracy against the
> health and the very lives of their own countrymen?
> I admit I am not aware of how Canadian law would
> address such a matter. I am not very knowledgeable of
> the exact nature of American law in such matters
> either, but I do know enough about American law to
> make me feel relatively certain that, had you directed
> your remarks against American doctors, you probably
> would have left yourself wide open to a slander
> lawsuit. I imagine that there are similar
> possibilities under Canadian law.
> I very strongly suggest that, before you make serious
> public accusations against the ethics, morals, and
> actions of every last practitioners in an entire
> professional field, you should amass a huge body of
> corroborating evidence to support the charges you
> make, and have it ready to present to any lawyers who
> may come calling, just in case. If your post ever
> comes to the attention of any Canadian doctors, you
> may need it.
> If the doctors in Canada really are the underhanded
> Machiavellian types that you seem to believe they are,
> if they really are the type of people who willingly
> abuse the laws of their country and the lives of their
> countrymen for their own economic benefit, then they
> must be expected to be the types of people who would
> have no qualms about using the law to take revenge
> against someone whose public expressions displease
> them or offer some threat to their prestige or
> reputation. In short, if they're really that crooked,
> you may have just painted a target on your forehead.
> Have any opinions you want; I have no argument against
> your way of thinking. But I really, honestly think you
> need to be a little more concerned about not leaving
> yourself open to legal attack.
> In any case, good luck.
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- RE: STC is broken, Keith Hood
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