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Alberta Politics Medicine

Tyler Shandro And All That Is Hole-y

Trust dies

but mistrust blossoms

Sophocles

There’s scarcely a canon as packed with simple truth as the First Law of Holes:

“When you find yourself in a hole, stop digging.” 

The original version, published in 1911 by The Washington Post, stated it thusly: “Nor would a wise man, seeing that he was in a hole, go to work and blindly dig it deeper.”

Alberta Health Minister Tyler Shandro, by that reckoning, is as acquainted with wisdom as East is with West. 

Mind you, to state that Mr. Shandro dug himself a hole in his dealings with the province’s doctors is to make a mockery of the word “hole”.  So ferociously did he dig, and with such unbridled intensity, that he excavated a crater the size of the Grand Canyon.

By July of last summer his relationship with doctors had become so toxic that 98 per cent of doctors voted “no confidence” in the Minister.  This, unbelievably, in the teeth of the Covid-19 pandemic, when Albertans desperately needed — like never before — physicians and the Minister of Health to be working together.

The acrimony abated somewhat in recent months, after the Minister deferred or walked back some of his most ruinous changes.  But doctors have still had no contract (he ripped up the last one), have enjoyed no stability, and have received no respect. 

As oblivious as Mr. Shandro was to the First Law of Holes, he was equally ignorant of the lesser known (but equally valid) Second Law:

“When you stop digging, you are still in a hole.”

As recently as last month, just after he and the Alberta Medical Association finally came to tentative terms on a new contract, the Minister denied that a hole existed.  “There was no fight with the Alberta Medical Association”, he announced in the legislature (with a straight face, no less).

It’s hardly surprising that doctors this week rejected the new “agreement”.  Although it contained some concessions to doctors, the document was peppered from start to finish with references to the “unfettered” power of the Minister.

After enduring the carnage wrought in the last 18 months by an unfettered Shandro, it’s perfectly understandable that doctors wouldn’t sign up for more of the same.  Many saw the pact as “a deal with the devil”.

What is surprising, perhaps, is that the vote was close: 53 per cent opposed, 47 per cent in favour.  Surprising, that is, until one understands how weary doctors are of conflict, how desperately they crave some stability, how fiercely they want to return their full attention to where it belongs: to their patients (especially as the third wave of the pandemic crashes down upon us).

There were some signs, in the waning days of the period allotted to voting on the new agreement, that Mr. Shandro may have finally realized the mess he had created.  Perhaps someone finally clued him in to the Laws of Holes, and specifically to its third tenet:

“A hole not filled in will cause more issues in the future.” 

Perhaps that’s why he issued a near-apology for trying to erase key remuneration to doctors for complex patient care; or why he sent an open letter of contrition to all Alberta physicians.  “I want to leave the rhetoric behind and rebuild trust,” he claimed.

He may have realized, at long last, that he was in a hole; but he certainly didn’t appreciate its magnitude.  His efforts were not only much too late; they were far too little — akin to trying to fill the Mariana Trench with a few handfuls of dirt. 

After he spent more than a year fostering acrimony and mistrust, his letter to doctors came across as authentic as a Bernie Madoff investment letter — as in, not worth the paper it was printed on.  Maybe he meant it; who knows.  But his words had the opposite effect of what he presumably intended: they tipped the undecided vote firmly onto the “No” side of the ledger.

There likely aren’t enough shovels in the world to backfill the cratered relationship between doctors and this Minister.  Trust is dead; mistrust is in full bloom.

If Premier Jason Kenney is wise he’ll consider a couple of important steps to bring an end to this unseemly battle:

First, he should grant some of the concessions contained in the just-rejected tentative agreement.  He doesn’t need a contract, for example, to restore responsibility to the AMA for managing medical liability fees and for disbursing continuing education funds.  He doesn’t need a contract to create reasonable virtual-care fee codes that keep family doctors from going broke while providing safe and responsible care to patients.  He doesn’t need a contract to recognize the AMA as the legitimate voice of doctors (and by extension, patients).

Secondly, he should appoint a new Minister of Health.  Tyler Shandro may indeed have turned over a new leaf.  But any semblance of trust is gone.  His relationship with physicians is shot through with, ahem, holes; and it’s highly doubtful that it can be mended.

We all know that Mr. Shandro has been doing the Premier’s bidding.  It might seem unfair that it should be his head that rolls.  But that’s politics; it’s the name of the game. 

For the sake of Albertans, it’s best that Mr. Shandro be replaced.

And if he isn’t? 

Then by all that is hole-y, Premier Kenney will lose the next election. 

And it won’t even be close.

By dredles

Physician, veterinarian, father of four... the makings of a sturdy soapbox.

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