If I were the health minister I would….

  1.  Go back to the table with the OMA with binding arbitration as a last resort if no agreement met. In the meantime accept the OMAs offer of a two year freeze on fees retroactive to January 2015.
  2. Immediately reverse the decision to have doctors fund increased growth in healthcare via clawbacks.
  3. Immediately convene a committee to look at the advantages and disadvantages of fee for service (FFS) billing and its alternatives. Delist codes which are not medically necessary and tackle relativity (income discrepancies between specialties) in a meaningful way. Implement changes to physician compensation as needed. Some of those changes will be unpopular, but necessary to sustain a publically funded health care system.
  4. Reform primary care WITH input from doctors and other stakeholders. Again, some changes necessary are going to be unpopular, with both patients and doctors, as well as other health care providers, but necessary to ensure a fair, accessible, and sustainable system.
  5. Immediately convene a committee to work with all stakeholders regarding physician and healthcare human resource planning in Ontario. Realize that stakeholders sometimes (always?) have conflicts of interest.

If the Minister and government really believe that fee for service (soon to be free for service) is a form of institutionalized fraud, then they need to reform it, not just continue across the board cuts, which punishes all doctors, not just those billing inappropriately. My husband (an accountant who does my billing) finds it astounding there are very little checks and balances in the (mostly) honor FFS system. The suicide of a doctor audited and asked to hand back a huge portion of his billings retroactively some years ago seems to have made the auditing of FFS almost a no go zone. The amount of wasted $ and manpower simply in administrating the FFS system is astronomical, with a nearly 800 page document full of codes and rules, and ZERO, NONE, ZIPPO training to teach you how to use it at all, much less appropriately. Across the board cuts to FFS means physicians (especially those who run offices) must work harder to maintain their incomes. This is not good for patients as less time is spent on each visit , and is also patently unfair to physicians, who cannot refuse to work, and cannot participate in any job action.

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