Physician recruitment and retention in Ontario “is not a major concern,” the Ministry of Health suggests in arguments it is making in arbitration with the Ontario Medical Association over physician compensation.
The province’s argument comes as the OMA, which represents Ontario doctors, has repeatedly warned that more than two million residents do not have a family doctor and thousands of medical jobs are unfilled.
The province is in the midst of negotiations with the OMA for the next Medical Services Agreement, which determines how doctors are compensated, spanning the next four years.
But the talks are going so badly that an arbitrator is now being asked to determine compensation levels for the first year while both sides work on the 2025-2028 period, said one of the doctors involved.
“Things are in such a dire situation that this is the quickest way to get money to stabilize family physician practices,” said Dr. David Barber, chair of the OMA Section of General and Family Medicine.
The government’s arguments in its arbitration brief are unlikely to improve relations, he said.
“It’s really quite insulting,” Barber said.
“The numbers are one thing, right, but… the government’s approach here is that their report essentially says there’s nothing wrong. I understand there’s a position, but it’s actually a pretty dangerous position on the part of the government.”
The WCO proposes a general price increase of five percent for the year, a “catch-up” of 10.2 percent to account for inflation and “low price increases” since 2012, as well as a 7, 7 percent that will be allocated to various health system programs. .
Compared to the 15.2 percent direct increase proposed by the OMA, the Ministry of Health proposes three percent. He maintains that there is no need to “catch up.”
“Average earnings adjustments for doctors compared favorably to other settings where retention and recruitment are not a major concern,” the ministry wrote.
“We will illustrate that there is no concern about a decline in the supply of physicians. In all of Canada, Ontario has the best track record in attracting medical graduates to train in Ontario. Additionally, Ontario has enjoyed growth in physicians that far outpaces the growth of the population”.
The ministry cited various data to support its arguments. The supply of doctors increased by 8.9 per cent between 2019-20 and 2023-24, while the population grew by 7.1 per cent, he said.
In that same period, the average income of a doctor increased by about 10 percent, while the average number of patient consultations per doctor fell by 3.7 percent, the ministry said.
“It is worrying that while doctors’ incomes have increased and the number of doctors outpaces population growth, patient access appears to have worsened,” the ministry wrote.
“Why is the number of doctors increasing and at the same time medical services decreasing? It could be the desire of doctors to achieve a better work-life balance.”
The ministry maintains that a deal for doctors should be approached differently than for nurses, where a recent deal put the shortage “at the forefront.”
The government also says many initiatives are underway to increase patient care and access to family doctors.
“These considerations are particularly relevant when (the arbitrator) considers issues such as physician retention and recruitment,” he wrote. “There is a completely different consideration for this hearing than there was in recent hospital healthcare decisions.”
The WCO’s arguments also contain a multitude of numbers. They argued that there are 2.3 million Ontarians without a family doctor. According to an estimate based on census data, the province is short more than 2,000 doctors. Data from the government agency Health Force Ontario shows more than 3,000 vacant positions for doctors, they said. Additionally, Ontario has 234 doctors per 100,000 people, one of the lowest rates in the country.
“Ontario is facing a medical workforce crisis,” the OMA wrote.
“The evidence of this is everywhere. It can be seen, for example, in the unprecedented number of patients without a family doctor, the closures and overcrowding of emergency departments, the long waiting lists to see a specialist and the accumulation of surgical patients. Procedures and diagnostic imaging in the post-pandemic era.
Health Minister Sylvia Jones said she disagreed with Barber’s assertion that the province’s position is insulting.
“I think we’ve shown through many different initiatives that we are very focused on ensuring that we have a health care system that continues to serve patients,” he said, citing more powers that have been given to pharmacists in the last two years. of years.
“When we increased (pharmacists’) scope of practice we saw a decrease in the number of patients going to the emergency department.”
NDP health critic France Gelinas said the government needs to work with doctors to address the problems that are driving doctors out of family medicine.
“More than two million people in Ontario do not have a doctor,” he wrote in a statement. “Instead of trying to solve this problem, the government wants to ignore it.”
This report by The Canadian Press was first published May 8, 2024.