Last Thursday, The Ontario Medical Association (OMA) Board voted unanimously to reject the last offer from the Government of Ontario. This signals the beginning of a period of uncertainty between the OMA and the Liberal Government that is not good for patients in Ontario and likely not good for the province either. There’s no doubt that it’s bad news for doctors.

As both sides rush to stake out the high ground in the debate, everyone with an opinion on how to pay doctors has tweeted, blogged, or posted their views on what went wrong and on what should have happened; everyone from the Health Minister himself to all the little twitter people like me.

One or two of my blog followers or followers on facebook or twitter will read this and I do want people to know why, as a Doctor in Ontario and an OMA Board member, I could not support the government’s proposal.

The reason can be found not in the cut to services themselves – and make no mistake, services are being cut – but in 9 specific adjustments the government is making to programs and incentives that will primarily affect family doctors working in teams. As a consulting specialist, I depend on my patients getting their basic medical care from family doctors and since the government introduced Primary Care Reform with the assistance of the OMA just over 10 years ago, my patients’ general health has not been better. Also, my community has gone from having a shortage of family physicians to having enough to care for most of the population. I have no idea why the Government of Ontario would want to destabilize a system that is working and, as a physician, I do not support these actions.

Also, if you examine these 9 specific measures carefully, you will see that they will affect young family physicians just starting up practice more than their established colleagues. Again, I cannot imagine the reason the government would want to discourage family doctors trained in Ontario from practicing in Ontario, but these 9 measures will do exactly that. To get an idea of how much a family doctor in Ontario gets paid for looking after your healthcare, I think Dr. Boris Kralj’s bar graph is the best illustration:  Is a doctor in Ontario not worth a cup of coffee?

As for the cuts to the overall Physician Services Budget that the government is making, I am discouraged that the government did not appreciate how difficult it has been in the past two years to find $850 million in savings in a health system that continues to grow for the very good reason that people who move to Ontario, or are born in Ontario, need health care. The population of Ontario grows by approximately 140,000 annually. Also, in general, the population is aging and requiring more health care to manage the health issues that arise as we age. Even so, the OMA has helped the government find $850 million in savings from physician services in the past two years. The government has not been willing to provide the funding for physician services for all Ontario patients for almost 3 years. Not providing enough funding for doctors to care for patients cuts services for these patients, if for no better reason than there’s only so much a single doctor can do in a day.

Really, the last thing the public likely needs is yet another person commenting on this predicament but, in the last 5 days, a number of people have asked me why I voted to reject this offer and these are the reasons. My colleagues locally, whom I represent at the Ontario Medical Association Board, want to know and so do a number of my patients and colleagues at the hospital where I work. I want to emphasize that, despite my position at the OMA, these are my views. I did ask the OMA to check my facts before publishing this, because I am very much a member of the OMA team: a member, a Board member and an Executive Committee member. I will work to keep that team strong and united in the difficult years ahead.  Right now, the only partners I have to look after my patients are the OMA and my colleagues. That’s the last thing you need to hear.

3 thoughts on “The last thing you need to hear

  1. Your made two comments that got my attention.
    1. “A doctor can only do so much in one day,”…this is the truth. 2. (summarized) The government is making adjustments to programs and incentives to those physicians who practice in teams.
    If you are referring to physicians who are practising in an Interdisciplinary (various professional services) team practice, this is truly, “a shame on you government for doing this!” This is the “best way for patients to get optimal health care and be able to provide care that isn’t fragmented.”

    It isn’t clear to me whether this government has the intent to destroy interdisciplinary teams or whether their intent is for disincentives for a group of physicians who share space only.

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