On Political Power
What is Political Power
Simply stated, political power is power within the realm of politics.
Politics is the governance of the land, the people, and public systems. In our specific case, the politics also applies to the public healthcare system; how it is regulated, directed, and limited.
Power is the practical ability to influence/control on the behaviours, thoughts, beliefs, decisions, actions, and alliances of others. Since behaviours, thoughts, decisions etc are the manifestation of individuals, and not lands, systems or agencies, we will speak only of individual politicians.
Brought together, political power is the influence/leverage one holds over politicians, to affect their actions and decisions (etc).
Having, realizing and wielding political power comes with risks. Risks we wish to mitigate. As such, despite power being held over individual politicians, we will organize and mobilize in order to, amongst many other things, exercise that power as a collective.
What is our inherent potential political power?
This section will likely be the most often updated as I grapple with what our potential political power actually is. Most labour action literature focuses on “low skill, low value work, with a private employer producing a service or product for public consumption, not as governance”. In those realms, the skillset of the worker can be relatively easily trained into new individuals. The individual’s contribution to the value of the product is relatively low and can be mitigated (machinery, automation). The humanity of the individual can be swept away, leaving only the product or the service of the employer to be presented to the public. Finally, the public is not spending tax dollars on, nor voting on the management of the employer. Their labour struggles are corporate, not political. As such, their labour power is commonly thought to derive almost completely from their numbers, and the completeness of their solidarity.
Our struggle is different. As such, we can derive political power from more facets of our careers. However, our “employer” recognizes these things; it can be seen in the actions they take to limit these facets.
Our power is currently inherent in the nature of our careers, profession and our service to the public. I will detail them below. However, our power is only currently a potential. Without organizing and learning to wield that power, we essentially have no power at all.
Power of numbers. There are 11,000 doctors in Alberta, approximately 4,200 are family doctors. If we family doctors organize, consolidate and act as one unified entity, we become the single largest unit of medical (medical = doctors, nurses far outnumber us) labour in the province. But that power of numbers only exists if we act as one. Our opponents seek to prevent that, by obstructing our ability to communicate with each other (try to get an email list out of the AMA), they obstruct our ability to act as one (the college SOPs), they seek to undermine the legality of us organizing (labour laws, public employee labour act…which the govt proposed changes to today Nov02’23).
Power in authority. We are currently recognized, as physicians, as having the authority of medical practice. Only we are permitted many actions of medical practice that others are not allowed. It is a crime to practice medicine without a license. We are currently self-regulating. Our craft is derived from a science-based background, raising it beyond reproach. Our opponents seek to limit this through SOPs, laws to allow doctors to act in “conscientious” ways (lessening the authority of science), allowances to bring doctors in with lesser qualifications, and to allow scope creep from other professions. Further, the govt seeks to directly subjugate our self-regulation.
Power in skill/knowledge. We not only have the authority of science-based medicine, we have the war-hardened skill and knowledge to properly use that authority. These things were not obtained typically in anything less than 10 years of training. The perception of this is undermined by elevating doctors who do not practice those skills in credible ways, and again scope creep of other professions.
Power in public prestige/respect. Not only do we have the things mentioned above, but the public believes and perceives we have these things. We are seen as generally benevolent, acting professionally in the best interest of the patient. Avoiding conflicts of interest and exploitation. We currently enjoy a relative belief that we do not seek personal aggrandization. However, political attacks on physicians undermines this, attacks from professions seeking to scope creep on us undermines this.
Gatekeeping. We are currently the primary way for citizens to engage the healthcare system. We enjoy a public system that arbitrarily has decided that triage and a “first generalist, then specialist” approach is the foundation of public health. As such, almost all access to the healthcare system passes through a family doctor. Privatization efforts will work to eliminate the professional advantage of this gatekeeping.
Sharing these things with the public is what makes these things powerful (e.g. no one would care about your sacred medical knowledge if there was zero chance you would ever share the fruits of that knowledge)
Until the time we are written out of the plot of healthcare in Alberta, family doctors hold the keys to the door of the healthcare system.
How do we develop our realized political power?
All that mentioned above is only potential power until it is used constructively to apply influence on our targets. Each of those sources of power is diluted into uselessness by isolating it within non-organized individuals. Thus, regardless of us having multiple sources of potential power, these all require organization and solidarity to implement. So, our primary concern is to solidify the numbers of family doctors, in order to implement the other powers
Recognize our inherent potential political power. Having read this document, you will maybe better understand which levers we may be able to creatively pull when the time comes.
Recruitment. You can’t get people to “move as one” until you can get them to show up to the conversation. The literature suggests repeatedly that recruitment is about building relationships. Networks of individual relationships. Not spouting your views at someone, but hearing their concerns, and working to find common ground, and common alliance. Recruitment happens somewhere along the spectrum of stranger <—> comrade. It is also noted that all actions should entail some recruitment. If your movement is not growing, then it is shrinking.
Structure Tests (yes…job action is in the spectrum of Structure Tests, but there is so much more than that in this concept). See sections in Members’ section on structure tests, see “Wielding Power” below. These are the group actions that move us towards our goals, incrementally, sequentially.
Leverage on Government. This is structure tests targeting politicians,
Leverage on our certified Labour Representative. This is structure tests targeting the individuals in our representative body. This is also “infiltrating” the positions of the AMA to ensure better representation of family medicine. While still techincally structure tests, these will commonly be more subtle and less hostile. Getting elected/appointed into positions, and developing relationships/alliances with other AMA members is decidedly less confrontational.
Cultivation of Public Support. Leveraging our access to and reputation with the public in order to better apply leverage on politicians. Politicians don’t provide a product/service for purchase. They execute their roles upon the landscape of public opinion. Cultivating our public image, to influence the public opinion directly affects the politicians landscape.
Cultivation of Specialist Support. This is alliance building with other specialties. While cultivating public support indirectly affects a politician’s options in behavior and decisions, cultivating support from specialists affects the behaviours/decisions of AMA functionaries.
Alliances across Provinces. When the time comes, linking up with similar groups forming in BC, Ontario (these are the known groups), and other provinces (not yet known to me) allows us to expand and amplify our influence, which ultimately impacts and magnifies our power in Alberta.
How does one Wield their political power? (through structure tests)
A) Having shared the objects of our power with the public, with a reliability that creates a sense of dependence, then withdrawing the objects of our power, while both a) publicly attributing the causation of this withdrawal to the undesired actions of those we wish to influence and b) offering a means by which this withdrawal can be remedied that involves the desired alteration of the actions of our target. (the spectrum of job action)
B) By creating a credible sense within the target and the public that A could happen, in either predictable or strategically unpredictable fashions (threat of job action)
C) When we wield our political power for change to our working conditions, we must also remember to ensure the preservation of our power. It will be hard work to realize the potential of our power. We should maintain it from that point forward. Our employer will become even more aware of our power and seek even more ways to curtail it in the future.