Wednesday, November 19, 2008

Civil War at the BCMA

The public was given an interesting peak into what is clearly a nasty civil war going on at the BCMA this week as the British Columbia Supreme Court brought an end to quasi-discipline process the Board of Directors was pursuing against one of its own.

The case is interesting from a legal point of view as it shows an increasingly willingness on the part of the courts to intervene in the internal affairs of private organizations. I expect that this is particularly true where those organizations have the ability, through the granting or denial of membership or some other status, to have a real effect on someone's rights, reputation or overall standing in the community.

From the public point of view this case is interesting because it gives a hint about the debate that is going on within the medical community about how doctors should be paid and, perhaps more importantly, what the role of the family doctor/general practitioner is in our medical system. This is an incredibly important debate as one of the most important differences between our medical system and the American system is the importance placed upon the delivery of primary medical care rather than specialist medical care. This approach in Canada has, I expect, led to overall better levels of health through early detection of emerging medical issues and somewhat better coordination of health care services than can be achieved through the more silo-like approach of specialists. How does this tie in with this case? Well, the BCMA is effectively the union for doctors when it comes to negotiating with the government and anything touching on the way gp/gp's are paid has consequences for how we all get medical care.

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