Closed shop gives doc the hammer in New Brunswick strike

While hundreds of foreign-trained immigrant doctors await permission to work, the medical guild keeps up pressure to keep them out and keep docs' wages high

By: Linda McQuaig

  One of the amazing things about globalization is how flexibile it is. One minute it is invoked to justify suppressing workers' wages; the next it is used to explain the need to hike doctors' fees.
  Workers must learn to do with less, we're told. Otherwise, companies will move overseas, leaving workers here jobless. On the other hand, doctors - and other high-end professionals - benefit from the new mobility of the global economy. Since they can earn more elsewhere, we're told that we have little choice but to give them what they want or we'll lose them.
 

Foreign-trained doctors may soon swell the numbers of physicians leaving Canada

  So when doctors in New Brunswick went on strike earlier this month, they backed up their demands for a 30 per cent raise by noting that doctors are leaving the province for higher-paying venues and no new ones are arriving to replace them. It certainly conjured up images of an ominous future for New Brunswick, with babies born in snow banks, ailing maritimers slumped on street corners, and 15-year-olds unable to get breast implants.
  Now I too would like a 30 per cent raise. And I have every expectation that when I threaten to withhold my next column, the Post will come through with the money. On the other hand, there's a chance my editor might just replace my column with one written by someone in Bolivia or Somalia.
  So it is, we're told, in the global economy. But there's no reason that the same globalization principle that keeps most workers in line these days couldn't be applied to doctors too. No reason, except that doctors enjoy enormous political clout. Politicians who seem to welcome a good fight with public sector janitors and clerical staff tend to shy away from getting into fights with people they're likely to run into later at the golf club.
  It should be pointed out however that there's no shortage of fully-trained doctors around the world who would flock to New Brunswick in a second, if given a chance.
  We don't even need to raid the Third World to find them. There are plenty of fully-trained doctors already living in Canada, who received their training at medical schools recognized by the World Health Organization, and who want nothing more than to practise medicine in Canada.
 

The apparently immutable laws of globalization seem to have left the medical profession unscathed

  This would seem like a perfect fit: we need doctors, and there are doctors here wanting to take care of us. What could be more fortuitous?
  But these foreign-trained doctors - who cover specialities as exotic as neurosurgery, pediatric cardiology, oncology and nuclear medicine - find themselves blocked whenever they try to realize their dream. It seems that the medical establishment here, backed by provincial governments, has ensured that only a tiny portion of them can ever hope to get a licence to practise in Canada.
  In Ontario, despite doctor shortages in many parts of the province, there are well over 1,000 foreign doctors, who now mostly specialize in pizza delivery and cab driving. About 750 of them have formed their own organization - the Association of International Physicians and Surgeons of Ontario - which may sound like the local branch of a prestigious Geneva confederation but is in fact a struggling operation funded by the Maytree Charitable Foundation.
  Under requirements set by the medical profession, foreign doctors must go through a lengthy retraining process of three to six years, essentially repeating most of their medical training. Even so, the foreign doctors are keen to do so - and willing to make commitments to serve in remote areas.
  But the province allows only 36 foreign doctors a year to enter into this re-training. A new speeded-up qualification process is under consideration, but the medical profession wants to limit admission to this program to an additional 25 foreign doctors a year.
  The ultimate irony is that many of these frustrated foreign doctors are now making inquiries south of the border, and finding the U.S. more responsive. So these people may soon swell the numbers of physicians leaving Canada, apparently bolstering the argument that high marginal tax rates here are driving out our trained professionals. Most of these foreign doctors could only dream of paying Canada's top marginal tax rate or worrying about the tax rate on capital gains.
  Doctors have managed to maintain enormous bargaining power in Canada by threatening, from time to time, to abandon us for more prosperous climes. But these threats only have teeth because doctors can rely on the fact that there is no one here to replace them if they go - even when potential replacements are already here and desperate to get to work. (Janitors and clerical workers - not to mention left-wing columnists - would probably also have more bargaining power if there were restrictions on the number of people allowed to perform their work.)
  As the global economy juggernaut rolls on, most workers have found their bargaining power diminished as they are forced to compete with a global pool of labour. Governments have further contributed to this worker disempowerment by reducing social protections here like unemployment insurance and minimum wage laws.
  But the apparently immutable laws of globalization seem to have left the medical profession unscathed. We're told that's because doctors are highly educated, which is key in the global economy. But having the political clout to exclude foreign competitors seems to help too

Linda McQuaig is an author and journalist. This column, reposted with permission, appeared in the National Post.

Posted, January 22, 2001

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