The abysmal offering from Dr.Hoskins to Ontario’s doctors Dec.14.

I hesitated to write about the ill advised proposition that Dr. Eric Hoskins brought to Ontario’s doctors Dec 14 by way of our association, the OMA. A thing he did a mere hour before he revealed it to the media in a press conference. I felt that to write about it was to lend it a measure of credence, something it does not deserve. The doctors in this Province have been without a contract for nearly three years and this was the best he could do?

Then the OMA rejected it out of hand as “disrespectful and totally unacceptable”. So now I feel I can write about it. https://www.oma.org/sections/news-events/news-room/all-news-releases/oma-statement-disrespectful-and-unacceptable/?utm_source=Member+Master+Enews+August+2016&utm_campaign=e736271e0c-OMA_Member_Update_12_15_2016&utm_medium=email&utm_term=0_52bf5db1f1-e736271e0c-23828229

There was never any real doubt this “refried” version of the contract offered to Ontario’s doctors this summer (only this one’s worse) would be rejected. A “deal” brought out to media prior to the OMA having any time to discuss its existence to its membership really only had one purpose: political grandstanding.

Dr. Hoskins says it was for transparency; the only thing transparent about this offering is its ill-mannered delivery. It was meant to shock, it was meant to unbalance the OMA and its members, it was not meant to bring better healthcare to Ontario. Its forebear was soundly rejected by 63% of my colleagues who voted this past summer.

It is not evidence of negotiations with doctors, it is simply another unilateral decision cutting healthcare to the people of Ontario.

While Dr. Hoskins asks the Federal government to continue with its 6% federal health transfer yearly to the Province, he is only willing to pay for 2.5% growth yearly for services provided by Ontario’s doctors.

The Ontario government’s own economists have stated a minimum of 3% growth in health care funding for doctor services is needed yearly to account for Ontario’s growing and aging population. That growth has been calculated to be as high as 7% some years.

So instead of funding healthcare to a suitable percentage of growth, this Provincial government is hoping to pit specialists against salaried team family physicians, against ALL other family physicians ( fee-for-service and capitation modelled family physicians) to try to contain costs.

You read that correctly; family physicians from different payment model types are also being pitted against each other with this “deal”. How does the government justify trying to “revolutionize” Primary Care, “helping” the smallest percentage of family doctors in the Province (salaried doctors), while ignoring the vast majority of Family Physicians that work in the more popular models. This proposal is a way to incorporate the unrelentingly flawed Bill 41 into Primary Care to “improve access” and “pay for more family physicians”, when really it won’t do anything of the sort.

The only way Dr. Hoskins can find to add some financial help to this small slice of salaried family doctors is to take away hard worked and LEGITIMATE earnings from our specialist colleagues (ophthalmologists, radiologists, internists). But these family physicians will have to work longer, later hours to earn this extra money. Where I come from, this isn’t called a “raise”, it’s your just due for working “overtime”. All this means longer wait times to see specialists, have interventions by radiologists, have sight-saving surgeries. Some physicians may have to reduce work hours to rein-in clinic costs, or even close clinics down altogether.

This is the most divisive proposal brought to doctors, dare I say ever? by an Ontario government.

Dr. Hoskins is missing the point. Most doctors do what they do because they want to help people, not make a pot of money. We as physicians in this Province are concerned with our patients' healthcare, with them having more than the right to a “place on a waiting list”.

This proposal doesn’t include any discussion of binding arbitration if negotiations come to a standstill between the OMA and the government. The OMA stated this fall that binding arbitration must be part of any further proposal from government to Ontario’s doctors.

But of course this proposal wasn’t born of frank negotiations between government and the OMA, this is a very cavalier, disrespectful further unilateral decision being made by the Ministry of health. If refused it is likely to be imposed anyway. For now, doctors are refusing to work in LHIN committees, LHIN meetings and any other misguided efforts to bring forth Bill 41, which this proposal encompasses.

The worst parts of this proposal are its underhanded delivery, its confrontational approach to “modernizing” healthcare and its utter disregard for the doctors of this province and their knowledge of frontline healthcare management.

This government ignored a wealth of resources and engagement it could have had, had it only approached doctors in a constructive manner. Instead, they chose political games and optics, with superficial LHIN meetings, and missed the chance to have help to create health reform that is meaningful and concrete to the people of Ontario.

This proposal is not worth the paper it is written on, the electricity used from Hydro One during Dr Hoskins media circus yesterday morning, nor Ontario’s doctors’ time and energy to read it.

Sorry Dr. Hoskins, the doctors of this Province aren’t interested in your lump of coal for the holidays.

Please share YOUR doctor memes that will be running from now until Christmas. I will be tweeting them daily at @MCfamdoc