Physicians have no right to complain

Physicians, as a rule, don’t bother to vote in elections for organizations that deal with the practice of medicine, so we shouldn’t complain about the results of those elections.

Organizations suffer two common diseases: regulatory capture and mission creep. In the former, the organization that is supposed to look out for all looks out for only a few. In the latter, the organization takes on more and more work outside its original mandate, which costs more and more. The institutions concerned with the practice of medicine (the College, CMPA, Doctors of BC, etc.) are no different.

One assumes there is rule of the majority in these institutions, but this is a fallacy.[1] Consider any Western liberal democracy. In these countries about half the population is under the voting age, bringing the number of eligible voters who decide the winners down to 50%. Usually about 50% of eligible voters bother to vote, meaning that 25% of the population does the deciding. Then, if you consider that two parties usually split the vote (say 51% to 49%), you realize that 12.5% of the population decides who rules 100% of the population.

For medicine-related organizations, voter turnout is even more pathetic, rarely topping 10%, and leading to an even more obvious example of minority rule.

The regulation of medicine is not a prescriptive thing. It is very much a give-and-take thing. In other words, there are rules, but these rules require interpretation. That is why unintended (unfair) consequences are unavoidable.

So if you don’t vote, then don’t criticize.
—Mark Elliott, MD


1.    Taleb NN. Skin in the game. New York: Penguin Random House; 2018.

Mark Elliott, MD, FRCPC. Physicians have no right to complain. BCMJ, Vol. 61, No. 7, September, 2019, Page(s) 276 - Letters.

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