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Dr. Brian Day, who advocates for increased privatization of the medical system, had originally been declared the winner by a one-vote margin.Rafal Gerszak/The Globe and Mail

Both candidates in an important battle for the leadership of the Doctors of BC are urging physicians to take the time to vote after a recount of last week's election showed a run-off is needed to break a tie.

Brian Day, an outspoken Vancouver surgeon who advocates for increased privatization of the medical system, had originally been declared the winner – by a one-vote margin.

But the losing contestant, Alan Ruddiman, a rural physician who favours working with government to improve efficiencies of the existing system, asked for a recount.

In a statement Monday, Allan Seckel, chief electoral officer and CEO of Doctors of BC, said an independent verification of election results found one vote hadn't been counted when it should have been. And when that single vote was tallied, Dr. Day's slim margin vanished, and Dr. Ruddiman had gained a second chance.

"It's been the most energizing week in my adult life," Dr. Ruddiman said Tuesday as he did a flurry of media interviews following news of the surprising tie.

Dr. Ruddiman said the run-off election is a good thing for the Doctors of BC because it is a jolt to the system that could stimulate more involvement from physicians. Only about 20 per cent of doctors eligible to vote actually cast a ballot initially.

"There's too much at stake here for a coin toss to decide what direction our leadership goes," he said, urging doctors to get engaged. "I would love to anticipate a doubling of the voter turnout."

Dr. Ruddiman, an association insider who has been serving on the Doctors of BC board, played down the differences between him and his rival.

"There's probably a lot of alignment in how Dr. Day and I are approaching the health-care system. I think we're closer together than we're being characterized," he said. "We both believe in quality improvement, we both believe in introducing efficiencies into the system and we both believe that change is necessary."

But Dr. Day, who opened the private Cambie Surgery Centre in 1996 and has launched a constitutional challenge of the province's restrictions on private health care, says the differences between him and Dr. Ruddiman are substantial.

"This is a very important vote for doctors. It's either stay as we are, or change, that's how simple the question is," Dr. Day said. "With Ruddiman at the helm you are basically voting for the status quo, and with me you are voting for trying to realign ourselves with what we should be doing, which is advocating for access [to greater health-care choices for patients]. In my specialty of orthopedics, we have the longest wait list and yet there are 150 orthopedic surgeons who can't get a job because hospitals won't give them operating time."

Five years ago, Dr. Day and a group of patients who say they were denied access to privately available health care launched a suit against the B.C. government, claiming the province was violating the constitutional rights of British Columbians by limiting their access to health care.

That long-awaited trial is expected to start soon in the Supreme Court of B.C., but Dr. Day said the case wouldn't affect his ability to serve as president of Doctors of BC, if he wins the re-vote.

"I would not be president through the course of this trial. It has been delayed and delayed and delayed, but it will be over for sure … by June of 2016 [when the next president takes office]," he said.

Dr. Day also urged physicians to get out and vote, saying the Doctors of BC is an important organization with a key role in shaping government health policies. "Please vote," he said. "If you don't vote … you're not fulfilling your obligations and duties."