This article originally appeared in the Fall 2023 issue of the Ontario Medical Review magazine.
Changes are coming to modernize the Ontario Medical Association’s sections so they can serve members better.
A new charter and strengthened leadership structure will bring flexibility and a tailored approach to the OMA’s 49 sections. The changes come as the association wraps up the second phase of its governance transformation.
The sections’ review was undertaken by a cross-functional group, including the OMA’s governance and constituency services teams, and was informed by member consultations. It comes on the heels of last year’s districts’ review, which also brought a new charter and executive structure. A review of the medical interest groups, the fora and branch societies will follow the sections’ review.
“The real crux of this is making sure that we’re bringing value to our members,” OMA Board Chair Dr. Cathy Faulds said. “Having a community of practice within their sections is a huge benefit that, I hope, members will see, join and find value in.”
Under the new charter, approved by the OMA’s Board of Directors in September, characteristics unique to sections – such as the speciality or sub-specialities represented, geographic location and broad physician base – can be considered when electing leaders, prioritizing needs and establishing individual section rules and regulations.
The leadership structure has also been standardized, strengthened and streamlined to equalize the playing field among sections, with most constituency leadership positions now elected by members.
The new section structure may include the following positions:
Executive changes include a newly titled tariff lead position, optional past chair and secretary/treasurer positions and introducing flexible member-at-large roles that can be aligned to specific section priorities, such as an education chair or speciality/subspeciality representative. New roles will be filled through the upcoming single election period with nominations opening in November and term lengths have been adjusted to align with key dates (i.e., the OMA AGM) for simplicity.
“The real crux of this is making sure that we’re bringing value to our members” – Dr. Cathy Faulds
“The way things are being set up is not prescriptive,” said Dr. David Barber, chair of the Section on General and Family Practice, the OMA’s largest section with more than 15,000 family physician members from various primary care facets. “There are guidelines, but we have a lot of flexibility.”
Dr. Barber said that sections will benefit from this flexibility by being able to determine the size and structure of the executives more accurately to best serve the membership, considering, for example, not only the geographic region but the skills leaders require.
“The best thing that would come out of this would be a way to better represent and reflect our members,” he said. “SGFP is a heterogenous group...so, the question is: how do you represent all those doctors and how do you represent the geographic regions? I think we could do a better job at representing family doctors...”
Dr. Karima Khamisa, a hematologist and compensation panel member, said the new tariff lead position is an important outcome of the governance review. A tariff lead will work closely with the section chair on remuneration issues (such as billing, fees, etc.) and is critical to informing Physician Services Agreement negotiations and the physician payment/fee-setting process.
An Individual occupying the role, Dr. Khamisa added, must have expertise in billing, practice management and be prepared to advocate for appropriate compensation and understand the negotiations process.
“While there is heterogeneity amongst the different sections in terms of executive composition and functioning, broadly speaking the membership expects the section leadership to advocate for appropriate remuneration,” she said.
“By incorporating a formal position such as tariff chair or lead to each executive, sections can ensure remuneration issues are given the appropriate attention needed for successful negotiations.”
Member consultation was an important component of the review process. All section chairs were invited to two rounds of virtual sessions (eight meetings in total), which took place in March, April and June, to learn about the project, review the section mandate and discuss the unique governance needs of the sections.
The purpose then and now, Dr. Faulds said, is to engage with section chairs, as the subject matter experts, and ensure they are resourced to do the work they need to do, not only for negotiations, but for health-care delivery.
“This wasn’t done to the membership. This was done with the membership to better understand the sections’ needs and concerns, not only from a structural perspective in terms of the executive, but also a financial and a resourcing perspective from the OMA,” Dr. Faulds said.
“The board, as governors, is not dictating how the sections fill those positions. It’s how they’re going to work best for their section on behalf of the membership.”
Other governance issues, identified through member consultation and being addressed by the OMA, include:
The governance transformation efforts, said Dr. Faulds, are an opportunity for the OMA to boost its reputation, showcasing to members rigorous governance, increased stability and a commitment to modernize.
“This governance work is going to make a massive difference for the organization,” she said. “It is not light work. It’s heavy work that requires a lot of expertise from the whole organization. It’s wonderful to be able to see the organization mature and modernize.”
Sophie Nicholls Jones is a staff writer with the OMA.