The outcry against the Ontario Medical Association just got louder over the Civic Holiday long weekend.
To set the scene: two years of bitter impasse finally broke with a tentative agreement between the OMA and the Ministry of Health. Instead of open arms, the proposed contract was met with open furor by front-line doctors around the province.
Anger erupted over the inadequate funding offered by the contract. After 18 months of escalating cuts, hundreds of community physicians struggle to meet growing patient need and rising overhead costs; waitlists exploded and many specialists no longer accept new referrals until 2017. All this will worsen under a contract that caps funding well below calculated norms.
Doctors worry: will they have to ration medical services just to stay within the Liberals' irrational budget?
Marked by a disturbing lack of detail coupled with tight deadlines and severe consequences, thousands of physicians worry the contract will undermine patient care.
Tensions rose when whistleblowers revealed that checks and balances were skipped during negotiations. In the face of growing mutiny, the OMA ramped up their aggressive endorsement: ads appeared on Facebook, Twitter and Instagram. Calls for a balanced discussion were met with threats from the OMA: "it's either the PSA [Physicians Services Agreement] or more cuts."
If the proposed contract has merit, why spend millions to market it? Shouldn't the facts speak for themselves?
At their wits' end, 3,000 doctors signed a petition forcing the OMA's hand: a General Members' Meeting was called. The last such meeting was in 1991, so this would be a historic event. One where physicians could thoughtfully debate pros and cons. One that placed the power of a binding vote to ratify or reject the controversial contract into the hands of the ordinary doctor.
On a sleepy long weekend afternoon, the OMA released details of the highly anticipated meeting as well as voting instructions. Their email confused and alarmed hundreds of physicians across Ontario.
For one, pushy pleas for a "yes" vote drowned out the time and venue of the meeting. It literally took five doctors to figure out the where and the when. The agenda was a mystery. A bigger mystery was why many physicians had not yet received the instructions, while others who were retired or no longer practicing in Ontario did. Although the meeting itself would be webcast, the voting would be in person or more archaically, by proxy.
Then the robocalls started: an automatic message telling doctors to vote "yes." The over-the-top manipulative PR tactics made many question the contract and the OMA's loyalty by extension.
Rules govern how such votes occur. The OMA's methods rigged the votes towards a "yes," seemingly breaching them all.
If the proposed contract has merit, why spend millions to market it? Shouldn't the facts speak for themselves? Above all, shouldn't physicians be allowed to judge and vote with their conscience?
Not surprisingly, a Superior Court judge ruled against the OMA, demanding that an unbiased process be immediately established.
I have to wonder: once doctors have cleaned house, who will the Liberals find facing them from across the negotiations table?
Usually a mild-mannered profession, doctors now have whistleblowers, internecine warfare, manipulation and dissidence, robocalls and now, a backbone.
It's House of Cards meets Gray's Anatomy. It would be comical if it wasn't so damn inspiring.
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Many women start to feel like they're dragging in their late 30s and 40s. They're losing testosterone, which may act as an antidepressant, and experiencing a flux in their levels of estrogen and progesterone, which may also influence mood and energy. One of the most effective tactics for perking up comes down to how you plan your meals. "Many of my clients seem to think that by filling one meal with energy-generating nutrients -- say, a green smoothie for breakfast or a salad at lunch -- they've done their duty for the day," says dietitian Ashley Koff. "But your body needs several energy pit stops so you can refuel." Koff suggests small meals every three hours that combine a variety of nutrients. Her energy-boosting meal plan: Breakfast: Oatmeal with hempseeds. A.M. snack: Half cup of cottage cheese with berries. Lunch: Half a turkey sandwich with salad. P.M. snack: Half cup of tuna salad with wheat crackers. Dinner: Wild salmon with nonstarchy veggies.
Two free surefire solutions: diet and exercise. Losing even a few pounds can provide tremendous relief. One study found that for every pound you drop, you take four pounds of pressure off your knees. "Low-impact exercises -- walking, swimming, cycling -- help maintain a healthy weight and muscle mass as well as release endorphins, all of which can lead to a decrease in pain," says Roxanne Wallace, MD, an orthopedic surgeon at Marshfield Clinic in Wisconsin.
Down, girl. As long as you have no open wounds, you can welcome Sparky's affection. "A healthy immune system is strong enough to fight off most bacteria in a pet's saliva," says Jennifer Gabriele, a vet at Heart of Chelsea Animal Hospital in New York City.
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Sorry, cupcake, it doesn't look good. Too much of the sweet stuff can wreak havoc on your entire body. Added sugars have been associated with inflammation, a condition linked to obesity, type 2 diabetes, and heart disease. In fact, a 2014 study found that people who consumed 17 to 21 percent of their daily calories from added sugar had a 38 percent higher risk of dying from heart disease than those who got only 8 percent. For most women, the American Heart Association recommends no more than 100 calories from added sugar daily.
You can ignore the old eight-glasses rule: Six is typically plenty to hydrate you and keep everything in working order, according to a review in the European Journal of Clinical Nutrition.
You may have small intestine bacterial overgrowth (SIBO), a condition common among those suffering from chronic bloating. SIBO can occur when bacteria in the colon migrate up into the small intestine and ferment the carbs passing through, creating gas. Consider switching to a diet low in fermentable foods (which include dairy, wheat, and high-fructose fruits) so the bacteria will have less to feast on, says Johns Hopkins gastroenterologist Gerard E. Mullin, MD, author of The Gut Balance Revolution. Research has shown that the plan works: A study in the journal Gastroenterology found that the majority of subjects with irritable bowel syndrome reported significantly less bloating when they followed a diet low in bacteria-loving foods.
"If you misrepresent the facts, you limit what your doctor can do for you," says Lissa Hirsch, MD, an obstetrician and gynecologist at Lenox Hill Hospital in New York City. Some of your lies will be revealed by your blood work or the number on the scale, but otherwise your doctor has nothing to go on but what you report -- and that could be dangerous. Say you fib and tell her you're following a diet and exercise program to lower your blood sugar. When your "plan" doesn't seem to be working, she may prescribe medication you don't need, unwittingly putting you at risk for unnecessary side effects. In other words, when your pants are on fire, you'll be the one who gets burned.
Depends on what you're eating, says health reporter Catherine Price, who spent three years putting that question to more than a dozen top doctors and researchers for her recent book, Vitamania: Our Obsessive Quest for Nutritional Perfection. "If you're eating a good amount of foods naturally rich in vitamins, like produce, and those that are fortified, like cereal or bread, a multivitamin is probably superfluous," she says.* But if you do decide to take one, keep in mind that the FDA doesn't test dietary supplements to ensure that what's on the label is actually what's in the bottle. Check for a seal that says NSF or USP VERIFIED -- both are respected third-party companies that vitamin-makers can pay to review their products. *A multivitamin containing folic acid is always a good idea for women during their reproductive years.
Of course no one has a magic formula, but Marie Bernard, MD, deputy director of the National Institute on Aging, has a few ideas: See your doctor regularly. "At the turn of the 20th century, the average American life-span was about 45 to 50 years," says Bernard. "Today people live well into their 70s and beyond, and many experts believe that increase is due in part to preventive health measures." Maintain friendships. A new Brigham Young University review revealed that social isolation increases your risk of mortality by up to 32 percent -- on par with obesity. Learn a new skill. A recent University of Texas at Dallas study found that people who mastered a new and challenging skill (like digital photography or quilting) showed greater gains in memory than those who performed passive activities, like crossword puzzles. So get out there and start learning!
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