Ontario’s plan to contain second wave needs a dose of primary care engagement
OMA
Is a court challenge the right prescription for dispute between doctors and the Ontario government?
For the third time in three years, the Ontario government has moved to unilaterally cut the fees it pays to Ontario physicians. In response, Ontario doctors have taken to the social media airwaves, engaging in a Facebook and Twitter campaign opposing the cuts and attempting to convey that cuts to physician compensation will lead to …
Is the OMA an appropriate vehicle for negotiating doctors’ fees?
In the wake of the recent agreement between the Government of Ontario and the Ontario Medical Association, it is time to reevaluate the appropriateness of the OMA as the bargaining agent for Ontario physicians. I will spend most of this opinion piece using ophthalmology as an example since that is the specialty that I practice. …
Why the tentative agreement is the right deal for Ontario’s doctors
The Ontario Medical Association and Ministry of Health and Long-Term Care have reached a tentative Physician Services Agreement. So what does this mean for doctors and patients, and the Ontario health care system? In contemplating this question, I thought I might impart a recent personal experience that provides some context to consider not only the …
“Re-chartering” The OMA/government relationship
An Assessment Of The New Agreement On Negotiation And Representation Rights As readers know, the OMA and Government have now, subject to OMA ratification, resolved their differences over fees and money, entering into a new two year Physician Services Agreement. I will leave to others the task of assessing whether the Agreement will truly result …
What does the government’s tentative agreement with doctors mean for Ontario’s health care system?
Last week, the Ontario Medical Association and the Ontario government announced they had reached a tentative agreement that they hope will end their current dispute. The tentative agreement, which will run until March of 2014, will affect doctors in a number of ways and also has implications for the wider health care system. In this article, …
Cutting doctor’s fees: penny wise, but pound foolish
As a recent ophthalmology and retina surgery graduate, I was shocked by the dramatic unilateral healthcare cuts announced in May. This left me with a poor first impression of the relationship between the health care profession and government. Although the OMA and government are back at the bargaining table, I am concerned that the best …
Did the OMA go too far with its childhood obesity recommendations?
The uproar has been furious. Literally. And I certainly understand why. But it’s not because the Ontario Medial Association (OMA) went too far, it’s because the OMA lost control of the message. For readers who aren’t aware, on Tuesday the OMA held a press conference where they outlined multiple initiatives that they hope if enacted, …
The false dichotomy of fee cuts
Recently I had a discussion with some physician colleagues about the Ontario Medical Association (OMA) campaign and specifically the principle of communicating non-neutral, political information to our patients. The campaign to which I am referring is that seeking to solicit the support of Ontario patients for physicians who are trying to get the government back …
Patients lose in showdown between doctors and ministry
The current negotiation process between the Ministry of Health (MOH) and the Ontario Medical Association (OMA) is deeply flawed. Currently, the negotiations focus primarily on physician pay and not on the best interests of the patients. The broader issue lies not in the details of which physician services received fee cuts and by how much, …
Unchartered waters: bad faith bargaining or responsible government?
On June 12, 2012, the OMA announced its intention to launch a constitutional challenge to the Ontario Government’s decision to reduce physician fees for 37 procedures and services. No doubt the OMA’s decision to attempt to shift the locus of its dispute with the government from the bargaining table to the courts was motivated by …
Standoff with Ontario’s docs may hold back broader health reforms
Changes to the fee structure of Ontario’s Docs are stoking a fiery dispute between the Ontario government and physicians. But the current standoff takes the momentum out of physician-centred reforms with durable opportunities for cost savings in the health sector – such as having doctors commission care on behalf of their patients. Getting better value …
Healthcare cuts: lessons from pharmacy
If I harm a pt by making poor surgical decision for which evid was available to guide me;there is recourse. How is gov’t different? #onpoli — Dr. Shady Ashamalla (@AshamallaMD) June 1, 2012 Evidence-based policy. For those of us in the healthcare field, it resonates as an ideal. What better way to allocate resources than …
Perspective on payment negotiation for Ontario’s doctors
The Ontario Medical Association (OMA) and Ministry of Health and Long Term Care negotiate fee schedules on a four year basis. This year, the process has garnered a great deal of attention as negotiations broke down, and the Ministry of Health unilaterally imposed fee reductions in some areas. Understanding the history of bargaining between doctors …
Fear and the politics of medicine
I’d like to talk to you a little bit about fear. As many who visit this site are no doubt aware, the Ontario Medical Association (OMA) and the provincial government are in the midst of a fee dispute. The government has decreed that the total physician services budget will be frozen. This means that physicians …
Punishing all self-referral is not the solution
If I were a respirologist, I would receive many referrals from family doctors asking me to determine whether patients with shortness of breath have asthma or chronic obstructive pulmonary disease. I would take a history from each patient and conduct a physical examination. Depending on the situation, I might occasionally order some blood tests or …
Ontario’s dust-up over doctor’s fees
The public squabble between the Ontario Medical Association and the Ontario government about tweaking physician payments is to be expected: no one likes cuts to their income. But in this case the cuts are concentrated in a few sub-specialties, so the pain is concentrated, prompting a particularly loud response. So what’s it about? There’s an …
Is Drummond realistic? The challenge of achieving zero increase in physician compensation
The Drummond Report recommended no increase in total compensation for Ontario’s doctors. A number of factors affect how much Ontario pays doctors including the number of doctors in practice, how many patients they see, and how much they are paid for each service. Achieving zero growth would require difficult decisions and trade-offs. The February 2012 …
Contract negotiations and the “bigger picture”
It was sometime before Christmas and I was headed to a meeting at Queens Park when I saw the large bus shelter ad promoting how much money Ontario’s physician’s had saved the province. I knew immediately that it must be contract negotiations time again. Don’t get me wrong. I’m not cynical at all. It’s just …
Making sense of Ontario’s fee codes
Most of Ontario’s doctors bill the Ontario Health Insurance Plan for their services on a “fee for service” basis. The amount doctors are paid for each service is established through negotiations between the Ontario Ministry of Health and Long-Term Care and the Ontario Medical Association. Although fees are reviewed every few years, there is disagreement about …