Doctor claims fee cuts may push physicians out of Ontario

TORONTO — Dr. Philip Alves doesn’t expect a tidal wave of public sympathy over the fact that the government will slash his fees by 1.3 per cent starting Oct. 1.

After all, he’s a doctor. And the assumption is doctors are well-compensated.

But some doctors say that small cut could compromise patient care and even force them out of the province.

READ MORE: Ontario doctors reject province’s offer, say it would compromise health care

The Oct. 1 cut comes on the heels of Feburary’s 2.65 per cent which the government imposed after contract negotiations collapsed between doctors and the province. And while that may still sound like a small cut, Alves warns they could have a major impact on his practice.

“I don’t know whether with these clawbacks, I’m going to be able to staff my clinic properly,” he said.

“I’ll probably have enough for a secretary but then to have someone like a nurse … I’m not going have the funds to support that.”

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“It makes it harder on me to provide good care,” he added. “It makes it harder for me to see as many people as I’d like or to give them the due time they want. It makes it harder on me to support my own clinic and pay off my own debts. (Doctors) don’t have employment insurance, we don’t have a pension, we get paid for what we do.”

A recent medical school graduate, Alves estimates he has about $250,000 in student debts, and faces another $150,000 in costs to start up his new clinic.

And while many doctors do make good money, it doesn’t always add up to the big paycheques the public might think.

“I think the public has been misinformed by the Wynne government that we’re living high off the hog and in reality, we make a lot of sacrifices to get to the position we’re at to try and help our communities,” he said.

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A spokesman for Health Minister Eric Hoskins said Ontario doctors are among the highest-paid in Canada, with an average income around $350,000, an increase of 61 per cent since 2003 — what the ministry claimed is more than any other health care professional.

Alves counters that the number is misleading.

“It’s a good amount of money coming in, but I would respond that it’s kind of a gross billing for a business,” he said.

“That’s not my salary. Out of that I have to pay my rent, I have to pay my employees, I have to pay for monthly variable incomes; just having electronic medical records costs $500 a month. I have to pay for my medical supplies.

“It’s not as if we’re living like fat cats, we just want fair negotiating rules with the only person that can pay us, which is the government.”

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The ministry said it had agreed on a framework in 2012 with the Ontario Medical Association for how negotiations would unfold and the OMA agreed that if a deal could not be reached, the ministry would then be able to move ahead with implementing changes.

“Together with the OMA, we selected retired Chief Justice Warren Winkler as a Conciliator, who encouraged the OMA to reconsider our offer,” a Ministry spokesman said.

“Unfortunately, they rejected our offer after a year of negotiations and we had no choice but to move forward with the changes necessary to manage growth in physician compensation.”

READ MORE: Alberta and Ontario comparing notes on doctors’ pay, Redford says

The ministry said it continues to meet with the OMA regularly to discuss the “big issues” facing the health care system, but understands the OMA wants to continue to talk about physician compensation.

“We will continue to increase the amount of money we set aside for our doctors but we can’t afford to continue providing them with raises at that level,” a spokesman said.

“We need to be able to invest in other areas of health care — areas like home and community care. That money has to come from somewhere.”

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OMA President Mike Toth says it was unfortunate that negotiations with the government broke down but maintains the government has always had the ‘power’ to act unilaterally, something that they are opposed to, and a reason why talks stalled.

“Since January 2015, the government has taken a number of unilateral actions that negatively impact patients, physicians, and the Ontario health-care system.  These actions include large funding cuts,” Toth says. “The OMA is opposed to these damaging unilateral actions, none of which were negotiated with the OMA.”

The ministry said the number of physicians in Ontario will grow by 13 per cent by 2021, which is almost triple the rate of Ontario’s population growth.

But Alves said that if the cuts were to continue in this manner, he and his peers “wouldn’t hesitate to leave at all.”

“They’re just saying, ‘I’m gonna look for greener pastures elsewhere if this is how Ontario treats their doctors,'” he said.

This year alone, the ministry said Ontario will add 700 net new doctors (after accounting for retirements and departures) — 250 of them in family medicine — adding that they are “confident that physicians will continue to choose to practice here.”

With files from Adam Miller