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B.C. anesthesiologists mired in internecine conflict

For those of you intently following the teachers' war with the provincial government, let me say you are missing an ugly internecine battle between the B.C. Medical Association and the province's anesthesiologists.

It's as nasty as it gets.

The anesthesiologists are threatening to withdraw their services for surgery for non-life-threatening conditions effective April 2 unless something is done to address their grievances with the BCMA, which negotiates on behalf of all doctors in the province.

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At its core, the central issue is money. The B.C. Anesthesiologists Society doesn't believe the BCMA is doing enough on its behalf in negotiations with the government. It believes the reason the province has a shortage of qualified anesthesiologists – and no one disputes this – is the lousy pay and long hours anesthesiologists say they experience here.

It's on that point and beyond that opinions differ.

Since first writing about this dispute last week, I've been bombarded by angry e-mails from anesthesiologists claiming that the BCMA and provincial government have grossly misrepresented their position on a range of matters. I was also deluged with letters from rank-and-file physicians who have little sympathy for the anesthesiologists and call their association "the Teamsters of medicine."

A 20-volume set might not accommodate the list of complaints that the anesthesiologists' society has with the BCMA. The two sides disagree on just about everything that has a number in it.

The truth is, the numbers being tossed around can be interpreted in different ways, depending on which side you're on. And I caution anyone who encounters a person offering to explain how these figures are calculated. I've endured some of these tutorials in recent days and I'm still a little nauseous from the experience.

But let's take a look at a few issues, starting with remuneration, to give you an example of the dramatic divergence of views among the two sides.

The BCMA says the average wage for an anesthesiologist in B.C. (excluding part-timers) is about $340,000 a year. The anesthesiologists say it's much lower. When the independent Canadian Institute for Health Information looked at physician wages a couple of years ago, it showed B.C.'s anesthesiologists making about $250,000 a year. (The CIHI study included only physicians making $60,000 a year or more to eliminate those playing bit roles in the delivery of health care).

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Meantime, the BCMA says the number of anesthesiologists in the province has increased to 472 today from 359 in 2001-02. The BCAS says that number includes any anesthesiologist who billed the system one dollar in 2010-11 and does not accurately reflect the number of specialists making a daily contribution – a number it insists is more like 350.

The BCMA insists that it's the anesthesiologists who are blocking new hires and creating a staff shortage to protect the cartels they operate in hospitals that help drive up their wages. The anesthesiologists say that's simply a lie and they have allowed dozens of specialists to come in – many foreign-trained – to fill holes.

The anesthesiologists say the BCMA has distorted just about everything when it comes to their gains over the past decade, including their pay increases. And they further contend that the BCMA is run by family doctors for family doctors, and not specialists, who form a minority of the association's membership.

Anyway, you get the idea. It is a completely dysfunctional, broken relationship.

Last week, the anesthesiologists issued a damning news release suggesting that the BCMA is skimming money the government gives it to fund physician benefit plans to cover internal expenses such as staff salaries, office space and public advocacy – with the government's knowledge. It has asked the auditor-general to investigate.

Instead of fighting the charge, the BCMA has so far refused to comment.

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That does not look good. If true, it would be like the B.C. Teachers' Federation taking government money meant for teachers' salaries to run its office and underwrite its labour negotiations. (Imagine how taxpayers would feel about that!)

At some point, the BCMA or the government needs to respond to this allegation. If it turns out to be a bogus claim, it further damages the anesthesiologists' reputation among doctors. If true, well then, there would seem to be some explaining to do.

The anesthesiologists plan to withdraw their services for elective surgery in a week's time. Lawyers speaking on behalf of B.C. health authorities said on Monday that the licences of anesthesiologists who do so will be revoked.

Whichever way this goes, the problem underlying this conflict will not go away. It will almost certainly take a mediator to sort out myth from mythology and pave the way for a more constructive relationship between the anesthesiologists and the medical association that represents them.

The status quo is not an option.

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