The head of the Ontario Medical Association managed to survive a vote on Sunday to keep her position despite harsh criticism from some doctors who say she is failing them in their fight with Queen's Park, even as the profession makes plans for a possible job action.

In a statement released Sunday afternoon, the OMA said the province's doctors had "affirmed their confidence" in OMA president Virginia Walley and her six-member board and that doctors were "united in their goal of sending a strong message to government; and, planning is now underway for job action."

However, at a meeting Sunday morning of the OMA's 260-member governing council, motions to kick out Dr. Walley and the rest of her board received substantial backing – half of the council, in Dr. Walley's case – but failed to clear the two-thirds majority hurdle required to pass. And a no-confidence vote in Dr. Walley and her board did succeed, with 55 per cent of council votes in favour, an OMA spokeswoman confirmed. A request for an interview with Dr. Walley was declined.

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The OMA, which represents Ontario's 29,000 doctors, warned in December that job action – including moves that could affect patients – was on the table, as the provincial government refuses to submit its talks with doctors to binding arbitration.

Meanwhile, the OMA's own internecine fight played out in a hotel meeting room near Pearson International Airport behind closed doors, although some doctors inside the room relayed details from the council meeting on Twitter despite an OMA request not to. So many council members attended that some arrived to find the hotel's parking lot jammed, forcing a delay to the meeting's 9 a.m. start.

The motion of no-confidence and the other motion calling for the tossing out of Dr. Walley, the incoming president-elect Stephen Chris and the others on the association's six-member board, were put forward for debate soon after the meeting got under way.

A long line of doctors stood up to speak on the motions, the first of which was moved by Nadia Alam, a Georgetown, Ont., family doctor and anesthesiologist who had co-founded a doctors protest group, Concerned Ontario Doctors, and now sits on the council.

Groups of doctors have been waging a campaign against the association's board, alleging it has done too little to counter moves by the Liberal government of Kathleen Wynne. The board's "poor leadership" has "contributed to an environment where physicians are routinely marginalized, disrespected, insulted and ignored by the current government," a letter signed by Dr. Alam and a list of 24 other dissident doctors demanding Sunday's special meeting reads.

In an interview, Dr. Alam, who is herself about to take a position on the board in May, said the vote and "intense" discussion on Sunday gives the OMA's leadership a clear message. However, the press release the OMA sent out never mentions that the board actually lost a vote of no confidence.

"There is a bit of a concern with the way the media release is worded," Dr. Alam said, going on to say that both the OMA and the profession as a whole want to move past what she called an internal matter. "I think for members, what they want out of this is that the board behave differently. …The message to the OMA board, to the OMA exec, is pretty clear: We expect them to change, we expect them to act. We expect them to take member concerns seriously, and not constantly dismiss or overrule member voices."

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She said Sunday's vote will allow the current board to demonstrate its willingness to listen as the OMA heads into elections that wrap up in March.

The rebels had outlined a long list of detailed grievances in a submission to the OMA before Sunday's meeting, alleging that the OMA had engaged in "censorship" of e-mails being sent out to members, launched lacklustre PR campaigns to counter recent health-care reforms by the Wynne government, and retained lawyers about whom some OMA members had concerns.

They also accused the OMA board of wasting $16,000 on a table at NDP fundraiser in December and blame the board for failing to address member concerns about the "lack of impact" from the OMA's recent "I am not an activist" marketing campaign launched to fight Queen's Park.

The board denied their critics' allegations and defended its efforts and leadership in a lengthy document distributed to council members before the vote.

Doctors in Ontario have been operating without a contract for three years, under terms unilaterally imposed by Queen's Park, and many have been railing against health-care reforms that would change the structure of primary care in Ontario. But doctors appear split about how aggressively to protest Queen's Park's moves.

The divide among doctors was on public display in August, when OMA members decisively voted down a proposed deal with Queen's Park that included a 2.5-per-cent annual boost to the budget for doctors' services and was endorsed by Dr. Walley and her board. Two groups of dissident doctors, Concerned Ontario Doctors and the Coalition of Ontario Doctors, led the forces against the deal.

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In a clear sign of mounting doctor anger at a meeting in November, OMA members even endorsed a non-binding motion calling for job action to protest the government's reforms in what it calls the Patients First Act, which would dramatically expand the role of Local Health Integration Networks (LHINS) in the delivery of primary health care in the province. Critics warn it will increase bureaucratic waste, and the reforms have provoked a firestorm of opposition from many doctors.

In an e-mail,‎ Ontario Minister of Health Eric Hoskins said the government "continues to be willing to discuss arbitration" as part of talks with doctors, and urged the OMA to return to negotiations.

"We respect the democratic process underway at the OMA," he said. "We have worked hard to try to negotiate a deal for Ontario's doctors with the OMA and remain hopeful that can be achieved."