December 16, 2008

The axe drops on Dr. Larry Reynolds: the REAL reasons

To any experienced journalist there was always a strange subtext to the abrupt removal of Dr. Larry Reynolds from his posts as Head of the Department of Family Medicine and Professor at the University of Manitoba and Head of the Winnipeg Regional Health Authority's Family Medicine Program.

Something rang wrong in the alleged reasons his contracts were not renewed. And why he was given all of one month's notice to clear out. It took a while, but now we can reasonably conclude the real reasons he was axed. (Yes, we know, technically his contract was not renewed, but essentially he was dismissed from jobs he didn't want to leave without an explanation.)

Watching the university launch a campaign of character assassination against Dr. Reynolds was one thing. But when they breached his legal rights to privacy by leaking bits of his personnel record, it was clear something was up.

Usually institutions hide behind the privacy legislation, deflecting uncomfortable questions with the door-closing statement "It's a personnel matter. We can't comment." So when the university dropped that defence to engage in a smear offensive, a red flag went up.

The reports in the daily newspapers failed to answer the central question: why was Dr. Reynolds fired? Then we read the Manitoban.

There, in the newspaper published at the University of Manitoba, we found the best and most thorough account of the Dr. Reynolds affair.

Reporter Tessa Vanderhart not only left the mainstream reporters eating her dust, she provided us with the clues we needed to find the answers.

There's an old saying in the news business... the timeline tells the tale. And Tessa filled in that timeline.

Brock Wright, the health authority vice-president said performance reviews concluded Reynolds wasn't a "team player." Wright said WRHA evaluations of Reynolds in 2003 and 2004 raised concerns about his ability to work with others.

In announcing the appointment of Dr. Reynolds in 2001, the University of Manitoba noted he had " received the Ian McWhinney Teaching Award for Excellence in Resident Teaching." A quick Google search for the award tells us "This award, named in honour of Dr Ian McWhinney, the first Professor and Chair of a Canadian University Department of Family Medicine (University of Western Ontario, 1968 to 1987), is presented to an outstanding family medicine teacher deemed by peers to have made a substantial contribution to family medicine education."

Obviously Dr. Reynolds played well with others at he University of Western Ontario. His problems with co-workers appear to have surfaced in Winnipeg.

Wright huffed that "a number of people complained Reynolds breached the WRHA's respectful workplace policy." The Black Rod found the WRHA's respectful workplace policy whose essence is this:

2.2 Harassment – abusive and unwelcome conduct or comments that are inappropriate, demeaning or otherwise offensive behaviour that creates an uncomfortable, hostile and/or intimidating work environment. Types of behaviour that constitute harassment may include, but are not limited to:
2.2.1 Unwelcome remarks, slurs, jokes, taunts, or suggestions that are related to a person’s ancestry, race, national or ethnic origin, colour, religion, age, sex, sexual orientation, marital status, family status, source of income, political belief, physical or mental disability;
2.2.2 Unwelcome sexual remarks, invitations, or requests (including persistent, unwanted contact after the end of a relationship);
2.2.3 Displays of sexually explicit, sexist, racist, or other offensive derogatory material;
2.2.4 Written or verbal abuse or threats;
2.2.5 Leering (suggestive staring) or other offensive gestures;
2.2.6 Unwelcome physical contact, such as patting, touching, pinching, hitting;
2.2.7 Patronizing or condescending behaviour;
2.2.8 Humiliating staff in front of co-workers;
2.2.9 Abuse of authority that undermines someone’s performance or threatens her or his career;
2.2.10 Bullying;
2.2.11 Vandalism of personal property; and,
2.2.12 Physical or sexual assault.

Nobody has alleged Dr. Reynolds was accused of pinching his secretaries' asses or praising them on their mini-skirts. Nobody has claimed he told politically incorrect jokes. "So a priest, a rabbi and a GP go into a bar..." Or that he stole anyone's lunch money, keyed anyone's car or bitch-slapped anyone in the washroom.

In fact, a quick look at his public writings demonstrates the exact opposite. He's written about "Improving interpersonal skills" in the context of doctor-patient interactions.

"Effective communication is the hallmark of effective clinicians. When confrontations arise, it is natural to become defensive. Unfortunately, this usually shuts down the conversation."

Here's some of his advice to new doctors on "Coping with family medicine put-downs"

"In crafting responses to put-downs, we should acknowledge the issue but challenge the stereotyping or injustice and promote dialogue."

So it looks like Brock Wright is talking about sections 2.2.7, 2.2.8, and 2.2.9. That means Dr. Reynolds made some enemies powerful enough to affect his career.

It didn't take long to identify some suspects. And with the WHO came the WHEN.

In 2003, a student was failed by the University of Manitoba School of Medicine. The reason? He informed his Obstetrics and Gynecology instructors he would refuse to perform or refer for any abortive procedure. He appealed the denial of his degree three times without success. The matter became public in March, 2004 when his final appeal was denied.

A story in sa, "He is being supported by several pro-life doctors in Manitoba, who are concerned about the university's intolerance."

It's not hard to imagine that one of those doctors was Dr. Larry Reynolds.

Reynolds was a regular contributor to pro-life publications. He sat on the editorial board of Vital Signs, the newsletter of Canadian Physicians for Life. And while still with the University of Western Ontario he was quoted in a story in Vital Signs headlined "No Duty to Refer."

"Dr. Larry Reynolds, Professor of Family Medicine at the University of Western Ontario, has often experienced the tension of counseling a woman requesting an abortion. He explains that as he believes abortion to be harmful to both mother and baby, he cannot participate in any way, including referring the woman to another physician who performs abortions.

"Some have argued that this means that we are imposing our beliefs on vulnerable women. Of course, this is not the case. We are maintaining our own moral conscience in refusing to become a mere instrument of someone else's moral decisions. If we do anything less than this, we allow ourselves to become mere objects. That same argument also promotes the idea that women are helpless victims dependent on physicians to rescue them. Women are strong independent moral beings and deserve to be treated as such, as do physicians."

CJOB Radio News reported on the student's fight for a degree, including this explanation from the University.

"Dr. Brian Magwood Associate Dean at the Faculty of Medicine told CJOB that university policy states that students are obligated to tell patients about all treatment options which fall within the medical standard of care."

Who's Dr. Bryan Magwood? We asked the same question.

Bryan Magwood is the Associate Dean, Undergraduate Medical Education, at the U of M's Faculty of Medicine. He directs the Medical Humanities Program. A pediatrician, his specialty is Intensive Care Medicine and Clinical Ethics.

He would be a powerful enemy to someone whose ethics are in direct opposition to his.

As the storm clouds of abortion gathered over Dr. Reynolds, he stepped further into the abyss. The Summer, 2004, issue of Vital Signs published the agenda for the:

Annual National Pro-life Conference
Life 2004 – Alive and Loving It
October 14 – 16
Delta Hotel, Winnipeg, Manitoba

Scheduled to speak between 2 and 3 p.m. on Saturday, Oct. 16, was Dr. Larry Reynolds. His topic: Issues of Conscience.

If Dr. Reynolds was fighting internal battles within the Faculty of Medicine at the University of Manitoba, he was engaged in a more public fight war elsewhere.

The WRHA had decided to close the low-risk maternity ward at the Victoria General Hospital. Their argument---the number of deliveries at the Vic was declining and doctors couldn't keep up their skills.

Reynolds saw the move for what it was, another slap in the face for general practitioners. Reynolds has always argued that natural childbirth is exactly what GP's should be involved in.

This June he was interviewed by the health reporter for Canadian Press where he let loose on the new attitudes to having a baby. (Record high caesarean rate raising concerns among Canada's obstetricians, Sheryl Ubelacker, Health Reporter, THE CANADIAN PRESS,
Jun. 25, 2008)

"Dr. Larry Reynolds, a Winnipeg family doctor who has been delivering babies for about 30 years, said the number of primary-care physicians who provide maternity care has been declining for the last two decades, especially in urban centres.

Much of that decline can be blamed on a culture of fear that has grown up around childbirth as it has become increasingly medicalized - affecting not only mothers-to-be but also doctors, nurses and other care providers, he said.

"Pretty well everyone's afraid to get involved ... because you're really developing a system based on fear - something bad is going to happen. So why would you want to get involved in something that's risky or where bad things are going to happen?"

Maternity wards used to be places where doctors and nurses enjoyed working, he said, "but they've sort of become 'intensive scare units,' where everybody is often at a higher level of anxiety."

Reynolds, a member of the College of Family Physicians of Canada's maternity and newborn care committee, believes more of his colleagues would embrace maternity care if a shift in societal attitudes were to occur.

A key change would be to stop perceiving birth as a disease to be conquered, "where pregnant women are unexploded bombs and we're the bomb-disposal unit, moving away from that model to birth as a celebration, birth as a life event with appropriate uncertainties."

Dr. Reynolds was passionate about the closing of the Victoria Hospital maternity ward. He took his concerns up the ladder, then off the ladder and directly to the Minister of Health.

With that, he made more enemies. Powerful enemies. Enemies who now could ally themselves with his enemies at the University of Manitoba.

Dr. Reynolds lost the battle of Victoria Hospital. The maternity ward was closed in the spring of 2005. By then, Reynolds knew he was in the eye of a storm.

Tessa Vanderhart filled in the missing pieces in her piece in the Manitoban.

"In 2005, Reynolds was considering whether to seek a second term. He conducted an anonymous survey of his colleagues, who overwhelmingly wanted him to continue. When Reynolds told the dean about the survey, he says they were “less than enthused.” A few days later, a colleague of his saw an advertisement in a newspaper for the position of the head of family medicine at the U of M in a newspaper."

Then she added something curious.

"Reynolds then took a year-long sabbatical, and when he returned he assumed his position. Medicine appointments continue on unofficial one-year terms." He took a year-long sabbatical in his last year of a five year contract? Did he return to finish Year Five? Or was he on year-to-year appointments in '07 and '08 both?

Dr. Reynolds could not be dismissed in 2007.

There was a little something that year called a provincial election. Getting rid of the head of family medicine could turn into an election issue.

And the next year?

From Oct. 11 to 13, 2007, Winnipeg was the site of the Annual Scientific Assembly of the College of Family Physicians of Canada. It was their 50th anniversary.

"It is poetic that its golden anniversary will be held a stone’s throw from The Golden Boy, one of Canada’s most famed landmarks, perched atop of Manitoba’s Legislative Building.
Each year, Family Medicine Forum (FMF), with the ASA as its central activity, brings together hundreds of family physicians, residents, medical students, other specialists, and colleagues from other health professions who work with family doctors. With a program planned by CFPC members, FMF has become a highly recommended stop on the continuing professional development highway for Canada’s family physicians," read the ASA news release.

Imagine welcoming the country's family doctors celebrating their 50th anniversary and announcing you've just fired the province's chief family doctor.

Uh huh. A one year extension of that contract. But by Thanksgiving, 2008, Dr. Reynolds' luck had run out.

The University of Manitoba wanted him gone because of his high profile in the pro-life world. Imagine how galling it was to see his every article ending with "Dr Reynolds is a Professor in and Head of the Department of Family Medicine at the University of Manitoba in Winnipeg. Correspondence to: Dr J.L. Reynolds, Department of Family Medicine, University of Manitoba."

There had to be an end to that. The WRHA wanted him gone because he had committed the cardinal sin, he opposed Kim Il- Sung--oops, sorry, Dr. Brian Postl.

Nobody, but nobody is allowed to embarass Dr. Postl in public. Steps had to be taken.

The confusion over the dismissal of Dr. Larry Reynolds stems from the fact there were two separate attacks --- from two separate powerful fiefdoms. The U of M, and the WRHA.

Both turned on stifling his right to speak out on issues of conscience and professionalism.

And the way to stifle him was to attack the credibility he has earned among colleagues and students by painting him as having some sort of personality defect, and by removing him from standing in front of medical students as a role model for family medicine.

And this is what passes as ethical treatment of doctors under the NDP in Manitoba, at the University of Manitoba and WRHA which they fund.

In their haste to eliminate Reynolds, they showed their disregard for family physicians, just as he had always warned. As reported in the Manitoban "the residents he was training are without a professor until the university hires a replacement."


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