The True Bottom Line

October 15, 2015 by | 2 comments

Fat cat, fat cat, what are they paying you?

Fat cat, fat cat, what are they paying you?

‘Fat cat’ is a phrase that both sticks and stings. It is like someone accusing you of a heinous crime. No matter how many times you say you didn’t do it, the accusation still resonates in people’s minds. To combat it we need to change the story, and talking about the impact of cuts on healthcare services and patient care is where the physician message is the strongest. So why all the numbers?

I have seen detailed excel sheets and analyses about why the government’s numbers are completely off the mark, and find myself both nodding vigorously as well as being deeply perplexed. I am nodding in agreement because the government numbers are misleading or downright dishonest. I am perplexed because it almost doesn’t matter – by focusing on the numbers game we are playing right into the government’s hands. Almost every public relations firm the OMA has hired has run focus groups that have consistently shown that doctors talking about money is without question a losing position, so why do we keep doing it?

I know we are all hugely frustrated by the misleading information that the government is spreading, and yes it has to be addressed. Pointing to a chart that shows doctors make way less than the stated government figures, but still way more than the average Ontarian is not going to effectively win over the hearts and minds of the public. You don’t have to convince me that doctors trained for many years and work hard for their income. You don’t have to explain to me how the take-home pay pales in comparison to the gross values. I am on board with digging through the data ourselves in preparation for future government interaction (negotiation, arbitration, etc). Spending all of our energy selling that message to the rest of Ontario, however, doesn’t seem to be the best approach. Why? Because they don’t really care. Sure they probably want their doctors to make a decent living, but how does us debating the cuts to our income impact them personally?
Decreased staffing? Longer wait times? Less equipment? An actual impact on patient care? Now we are talking in a language that everyone can understand, and that is what our message should be. We should be addressing the cuts by way of illustrating the impact of the cuts to patient care. Some of the vignettes that have been highlighted on social media are beautiful and resonate with the public because they are real to them. They can see the impact on the true bottom line: the care they receive. We need more stories and we need to help them go viral. Less stats, more stories. That should be our game plan, because trying to beat the government at its own game may not be worth it – they have many many years of experience over us.

But at least the high road has been left wide open…


About the Author

Taylor Lougheed is a physician in Family and Emergency Medicine, and passionate about sustainable public healthcare, quality improvement and patient safety, medical education, and global health.


  1. Andrew Lee

    You make an interesting point, Taylor, but I feel that as a profession we need to address the misinformation that the government is spreading. When they say we’re all making $360,000 but my own personal paycheck is way way less it is incredibly frustrating.

    • Taylor Lougheed

      I agree with you, Andrew, but worry that we run the risk of allowing the government set the tone in the media. We don’t want to leave the misleading numbers floating around unaddressed, but if we let the entire conversation revolve around dollar figures we won’t be doing ourselves any favours.

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