The assembly that wasn’t: When the Alberta Medical Association tried to change its constitution

Alberta always seems to be such a confident province.But did you know that, not really that long ago, the Alberta Medical Association had an identity crisis coming up with a way to govern itself well.It all came down to whether or not the group was going to get improved representation from a general assembly.The AMA proposed conversion to a general assembly was made in an effort to increase attendance at annual meetings and maximize decision-making efficiency. As a proactive move to encourage participation by more members, it sounded like a great idea. Trying to pull it off was different.While a board would retain responsibility for day-to-day operations, a general assembly of elected representatives from eight districts would meet yearly to confirm assembly and board actions.What could go wrong?Some supported the move, saying it seemed a number of districts were “comatose” in terms of representing their constituents well.In the early 1990s, this was viewed as a real problem. The province’s doctors were about to consider a number of looming, complex, political issues, such as: professional ethics, income re-distribution, healthcare funding and government antagonism.AMA mandarins felt the quality of output would depend on the quality of input.“Every issue will be looked at more than once,” said AMA president at the time Dr. Ronald Fraser on sizing up the proposal, “and with more and more controversial issues finding their way to the AMA, this should improve the chances of each of them being adequately investigated.”A senate-like body would draw a specified number of elected representatives from each district to the general assembly. Board members, representatives from clinical sections, College of Physicians and Surgeons of Alberta and delegates from the province’s two medical schools would form the assembly of 65 when all was said and done, “depending on how many delegates (from each district) was allowed,” Dr. Fraser noted. The assembly would meet twice annually, including during the annual meeting.As boring as all this probably sounds, it was a substantive proposal. It would be the tool through which the AMA would determine how it felt about specific issues. But 75% approval was needed.It wouldn’t get that . . . at least not at this meeting. And the reason really had more to do with circumstances than politics.The item was debated intensely during the first morning of the AMA’s October annual meeting. Speakers opposing it outnumbered those favoring it by an apparent four to one. Opponents trying to make their case also spoke longer and more forcefully than proponents.But the debate ran out of allotted time and discussion needed to move to developing an AMA strategy for upcoming negotiations toward a new fee agreement with the province.After that, many weary members left, unable to stomach going back to what seemed like a theoretical issue.Only a small core of top-level AMA members remained, but instead of recognizing the sensitivity and meaning of the morning session, about a dozen persons voted to refer the general assembly scheme back to the constitution and bylaws committee for refinement.If enough general assembly opponents had hung around, they almost assuredly would have got the measured killed. As it turned out, it was just delayed.So what was learned?A general assembly would have been expensive, Dr. Fraser noted, although “if it allowed concerns and problems to be aired adequately, then it would be worth the extra expense.” Further, in the end, the board of directors and district representatives would maintain the right to approve policy and confirm motions.Many older members felt the association was running just fine. “The AMA has always been able to respond well to complex issues in the past,” one told the Medical Post.But some felt district representation, as outlined in the proposal, wouldn’t necessarily ensure district representation. Having one voice screaming from the political hinterland wouldn't likely spark a political revolution.The hinterland could form a bloc, but so could the delegate-rich cities of Edmonton and Calgary if need be.The discussion also had a more wide-ranging impact. The Manitoba Medical Association has always been almost exclusively governed by the Winnipeg contingent . . . when it was able to get a quorum to its annual meetings in the ‘90s. The Saskatchewan Medical Association’s general assembly was generally regarded to be working. Like Alberta, though, it also had two major cities and a whole lot of hinterland.The Ontario Medical Association's 250-member general council and Alberta's general assembly model would have worked differently. The OMA council was effective at comprehending what the group's 20,000 members (in 1992) were thinking. At least it was back then.Matt Borsellino was national editor of the Medical Post for many years.

The assembly that wasn’t: When the Alberta Medical Association tried to change its constitution

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