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Ontario targets high-billers with new physician budget

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TORONTO

Just when you thought the relationship between Health Minister Eric Hoskins and the Ontario Medical Association (OMA) couldn’t get worse, the minister — a physician himself — delivered a thinly-disguised declaration of war on doctors.

Reporters were summoned to an early morning briefing on the new physician compensation agreement that Hoskins is throwing down to the OMA.

Hoskins couldn’t have picked a more provocative way to deliver the news. The head of the OMA, Dr. Virginia Walley, was handed the deal at the same time as reporters. And she’s outraged.

The OMA has been without an agreement with the government for almost three years and the government has been arbitrarily clawing back billings from physicians.

It’s hard to argue with some of Hoskins’ proposals.

He says he’ll claw back payments on the province’s high-end docs. Who could question the examples he gave: An eye doctor billing $2 million would have 10% clawed back — so he’d “only” be able to bill $1.8 million.

No one’s going to go to the barricades for downtrodden millionaire specialists. Then again, if your eyesight’s at risk, perhaps it’s money well spent.

Hoskins is putting an extra $2 billion in the system over three years — with $186 million of that directed at family doctors.

He’s hoping more physicians will move into family health teams to provide better coverage for patients on weekends and holidays. Again, who can argue with that? We’ve all been there — needed a doctor over Christmas and no one’s available.

Except Auditor General Bonnie Lysyk was critical of that model in a recent report.

In the group enrolment model, doctors are paid $3 per patient per month — whether the patient visited them or not.

Many of those patients still use walk-in clinics or ERs, and the doctor with whom they’re enrolled rarely pays back the monthly fee.

You’d be hard pressed to attack Hoskins for wanting to get high-billing doctors under control. About 470 docs each billed more than $1 million last year.

Hoskins denied it’s a take-it-or-leave it deal for doctors.

He said it’s delivered, “in good faith,” and delivered transparently.

“I’ve decided that I want to share this with the full membership directly and transparently as well as with Ontarians,” he said.

Walley’s not ruling out a job action by physicians.

“This just underscores the power imbalance there is between the government and members of our profession,” she told me in a telephone interview.

When I asked her what kind of action doctors might consider, she said she’d have to consult the OMA membership.

“We’re not ruling anything out at this time,” she said.

This has put the entire consultation process in jeopardy, she said.

So once again, the Liberal government has plunged us into a nightmarish battle with our doctors. Sure, we like to complain about doctors generally, as a highly-paid profession. Individually, we know them as skilled professionals we trust with our lives. Literally.

We may think those highly-paid specialists make a lot of dough. Those skills are portable — to the U.S.

This is the season of peace on earth. Let’s just hope the doctors and the health minister can find it in their hearts to show a little good will to each other — and sort this out before patients get hurt.

 

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