Why Governance Matters- Changes at the OMA

The purpose of The Doctor Is In is to communicate directly as president of the OMA with the membership and the public.  To share with you my experiences advocating on behalf of the doctors of Ontario.

Today’s post will focus on the recent changes in governance at the OMA.  While the organization will continue to keep members up to date through OMA News, it is my responsibility as president to reach out to members and speak to these changes directly. 

When I first began my journey at the OMA, my understanding of governance was what I knew about the Canadian political system (needless to say, that is not what governance refers to).  I did not know that there is another language and entire area of expertise on the governance of organizations.  I have learned this language in much the same way medical students learn to understand the language of medicine-through immersion, study and practice.

Governance is a rather abstract concept in comparison to the tangibility of medicine.  The rules of engagement on how to run an organization can seem arbitrary in comparison to making care decisions in medical situations. But it is incredibly important—the same way physiology, pharmacology, and anatomy make up the building blocks of how we approach the practice of medicine, the rules of governance ensure we have a transparent and accountable association that advocates effectively on behalf of doctors.

And like medicine, governance continues to evolve.  It evolves because the needs and expectations of Ontario’s doctors change, the same way our patients’ health statuses change over time.  The last big period of evolution was the Governance Transformation 2020, which we affectionately refer to as GT20.  

It was at this time that the board of the OMA transitioned from a 26 person board of physicians to an 11 person skills-based board which included 8 doctors and 3 public non-physician members who brought other areas of expertise.  This was done to ensure the OMA had the right skills at the board table to guide strategic vision and provide oversight on behalf of Ontario’s doctors.

This transformation, while named for the year it was instituted, began before 2020 and has taken several years to fully implement because good governance takes time (if you are interested in more detail, let me know but I will spare the general reader).  We are entering a phase now where we are evaluating what is working and what could be improved as an organization.  An evaluation of this nature requires eliciting both internal and external feedback.   And the most important feedback comes directly from our members.  This year, review will take place about the board (both structure and function) and the presidency (through an officer role review).  Your feedback as members will be instrumental in this.

Separate from the planned review, the OMA recently underwent an annual general meeting (AGM) where members voted on 5 member motions.  Two motions that were passed will have significant bearing on the governance of the OMA.  Motion 1 related to the structure of the board.  It passed, and as such, the 11 person board of the OMA will now convert over time to an all physician board.  Motion 2 passed and changed the OMA bylaws to reflect that all eligible members running for a board director position must be included on the ballot (last year, the 64 candidates were shortlisted to 11 based on member feedback that the ballot was too long).

The messages heard from members who supported these motions were that Ontario’s doctors want physicians with lived experience voting at the OMA board table.  They want more member voice in the governance of their association.  And they want to ensure all who put their name forward to serve on the board are considered by their colleagues in the election. The OMA has heard you.

It is now our responsibility as a board and as an association to implement these changes.  They will not occur immediately.  For transitions to be done well, they require time, consideration and planning.  I know the lack of immediacy has been frustrating for some.  There have been comments that our public members should resign prior to their terms finishing because the spirit of the motion that was passed was that the membership want something and someone new.

The challenge is that good governance does take time and members need to have a say in how these changes are implemented.  There are many options as to how to incorporate the expertise of public members while moving to an all physician voting board — we could pay for consultants who have accounting expertise, legal acumen, organizational experience, etc.  We could have public members appointed to board committees but not on the board itself and other alternatives as well. Each of these choices has its benefits and risks.  And each of these choices have a cost which our membership will pay with their member dues.

The board is determined to allow members to have agency in shaping the future of the association and as such must consult the membership on the implementation plan, as well as the ongoing governance reviews currently underway.  We want members to feel confident in their board and their association.  The physicians of Ontario deserve that.  The changes voted upon at the AGM reflect a strong desire for members to be involved.  The board and the OMA want members connected to this process all year long, not only on one night a year when votes occur.  If we can connect our board, our association, and our members in a collaborative effort, we will be stronger for it.

In the near future, the board will ask the membership for feedback on transition options (both with membership outreach and our physician leaders of the General Assembly). Your voice matters not only in what happens at the OMA but also in how things happen at the OMA.

We are changing the way we listen to our members.  We are committed to real, fulsome consultation with Ontario’s doctors.  Please continue to engage in this process with us.  Let’s get to work.