New Laws Crush Doctors' Rights Part 2

July 7 , 2009 - In Part 1 of our 2-part series, we revealed that changes to The Regulated Health Professionals Act (RHPA), currently being rolled out, seriously undermine our basic rights as citizens of Ontario.

We understand that behind the actions of the MOHLTC and CPSO rests the concern about public safety. Clearly, protecting members of the public from medical incompetence and errors is vital. It is incumbent on our profession to see that this is done effectively and fairly. However, the fundamental rights of health professionals must not be trampled or disregarded as the goal of improved public safety is achieved. In a civilized society the rights of all individuals, including physicians, must be valued . The right to remain silent, to be presumed innocent until proven guilty and to continue in their employment until proven guilty must be upheld. Consider these examples, which illustrate how criminals will have more rights than doctors under the new laws:

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Media Release (HTML)

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New Laws Crush Doctors' Rights Part 1

June 25, 2009 - One of the laws, which govern physician practice in Ontario - The Regulated Health Professionals Act or RHPA – has undergone major revision over the past two years (via Bills 141, 171 and 179). Many of the changes, which have come into force this month, give the College of Physicians and Surgeons of Ontario unprecedented investigative powers such that physicians now have fewer rights than criminals.

The OMA has expressed lukewarm “concerns” about RHPA changes and has not presented a course of action to be taken other than to participate in the process of legislative change.

Because of this, the COFP Board has sought the advice of one of the top health law firms in Ontario with respect to the impact of new provisions of the RHPA and its Procedural Code. We feel that Ontario physicians require assistance in understanding what a profound impact these changes will have on their practices.

Increasing regulations that fly in the face of our basic rights as citizens is not the way to attract or retain physicians in Ontario. In the past, we have seen the deleterious consequences of the draconian Medical Review Committee and similar results may be expected with new regulatory pressures. We hope to assist both our members and non-members by providing a legal overview that will help them anticipate the impact of these new regulations and avoid potential pitfalls.

Please read the attached newsletter, b y Lonny J. Rosen, LL.B., C.S. and Elyse Sunshine, B.A., LL.B. from Gardner Roberts LLP, to see why this matter is of critical importance and watch for further comments and a firm action plan in Part 2 next week.

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The eHealth Scandal

June 10 , 2009 - Government continues to tighten its stranglehold on the medical profession suffocating much needed innovation that could occur from the ground up while it heaps hundreds of millions of dollars at the feet of eHealth, the agency responsible for the task of creating an electronic health record for all Ontarians by 2015.

Unfortunately, millions of dollars are being wasted in untendered contracts given to acquaintances of various eHealth leaders such as Dr. Alan Hudson. Yes, the same Dr. Hudson who is involved in the Wait Time Strategy and who plans to penalize hospitals to the tune of millions of dollars if they are not able to meet their ER wait time targets; the same Dr. Hudson who blames family doctors for creating the wait for diagnostics; and the same Dr. Hudson who has been quoted as saying that nurses can do large amounts of what physicians do, but fails to identify any cost-savings in this approach.

What kind of leadership is that?

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Toronto Star Article - June 10, 2009

Video: CBC News at 6 - June 11, 2009

The Freeze on New Family Health Organizations (FHOs) Continues

May 19, 2009 - In our previous Bulletin to you, we brought to your attention two important developments, which are of serious concern to us all:

•  The freeze on new physician registration in Patient Enrolment Models (PEMs), and

•  The new OMA headquarters leasing fiasco.

The leasing matter remains unresolved and exposes us to potential increases in OMA dues and/or cuts to OMA programmes. However, the OMA recently announced that the freeze on new physician enrolment in PEMs has been lifted. Unfortunately, we believe this announcement is critically misleading for the reasons outlined below.

On May 14, 2009, The OMA President's Update announced that the Government has lifted its sudden freeze on physician entry into Patient Enrolment Models. The freeze on Family Health Teams (FHTs) continues. Although this as been hailed by the OMA as significant progress in resolving this contentious issue, a careful analysis of the announcement clearly shows that while the freeze on the other PEM's has been lifted,  the freeze on the formation of FHOs has not been lifted at all.

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Putting Patients First with Leadership and Innovation

COFP Calls On OMA, Government To Open The Door To Real Innovation

April 30, 2009 - New economic conditions in Ontario require urgent innovation in healthcare. The Coalition of Family Physicians of Ontario believes that real change – not just a re-shuffling of provider roles – can be driven by primary care physicians on the front lines who understand the challenges of day-to-day practice along with the needs of their patients.

While we recognize that solutions to primary healthcare delivery issues in Ontario are likely to manifest themselves in many forms and that there is no single “one size fits all” solution, we believe that each solution must overcome the barriers to innovation, which include physician complacency, dependency on government by both patients and physicians, and a lack of patient-driven care. All three of these obstacles must be dealt with if we are to move forward with real innovation.

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Urgent Notice To All Ontario Physicians

May 11 , 2009 - The Coalition of Family Physicians wishes to inform you about two disturbing recent developments, which have important implications for physicians practising or intending to practise in Ontario.

A. UNILATERAL GOVERNMENT FREEZE ON REGISTRATION IN PATIENT ENROLMENT MODELS

On April 17, 2009, the Ministry of Health and Long Term Care unilaterally and unexpectedly announced a freeze on new physician registration in all Patient Enrolment (rostering) Models (PEMs), including the FHN, FHT, FHO, FHG and CCM. No specific reason was provided, except that over the next two to four weeks the ministry wants to evaluate the financial impact of its push from fee-for-service to capitation in the patient rostering models. The Ontario Medical Association has likewise encouraged physicians to switch to the Patient Enrolment Models as the way to significantly improve our income and promote sustainable primary care in Ontario. (continued)

B. MOVING OF THE OMA HEADQUARTERS TO A NEW LOCATION

On April 6, 2009, the OMA moved to a larger office space at 150 Bloor Street, from its former location on University Avenue, anticipating leasing of its former headquarters to another tenant. Unfortunately, a new tenant was not secured prior to the move, and now the OMA is facing the prospect of having to spend $6.1 milllion on rent for its old, and now empty, office space, while carrying the cost of both facilities. Although the OMA has laid the blame on the economy as the culprit, it should have been cautious precisely because of the poor economy rather than leasing new premises prior to securing a tenant for the old site.

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Primary Healthcare Train Derails

Patients Deserve More Than Government Patchwork for Primary Care

January 19, 2009 - Two recent developments in Ontario healthcare have provoked serious concern amongst physicians and the Ontario Medical Association (OMA):

•  Plans for the creation of 25 independent nurse-led (Nurse Practitioner) clinics to provide primary medical care, the first located in Sudbury; and

•  Plans for the expansion of pharmacists' scope of practice to include the right to prescribe medications.

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2009 Membership Drive Begins

December 8, 2008 - The Coalition of Family Physicians as begun its 2009 membership drive campaign.  Fax, email and mail versions of our campaign began distribution today. To find out more, follow the links below or visit our membership page.

2009 Membership Letter

2009 Feedback Questionnaire

2009 Membership Form

..or visit our online payment site.

CPSO Council Passes New Policy on Accepting New Patients

November 21, 2008 - Despite our concerns that this new policy would further worsen the family doctor shortage, CPSO council approved this new policy on Accepting New Patients.  We believe that the the law of "unintended consequences" will result because of this.  In the CPSO's spirit of doing its best for the public and Ontario's doctors, we believe that family physicians will view accepting new patients at increased risk of a complaint to the CPSO and will completely stop accepting any new patients into their already over-burdoned practices.

Proposed New Contract - Part 2

October 11, 2008

To all Ontario Physicians

Re: Proposed New Compensation Contract (Part 2)

As you know, the Coalition of Family Physicians of Ontario (COFP) has decided to NOT SUPPORT the new deal. Our previous bulletin generated a tremendous amount of discussion, which we believe deserves further comment on our part.

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OMA Emergency Section Executive Position (PDF)

Proposed New Contract - Part 1

October 6 , 2008

To all Ontario Physicians

Re: Proposed New Compensation Contract

(Part 1)

After extensive consultation with members of the OMA negotiating team and other leaders, and careful debate at our Board, we have decided to NOT SUPPORT the new deal offered by the OMA/MOHLTC.

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2010 Membership Campaign

December 14 , 2009 - Our annual membership campaign mailing to over 11,000 Ontario family physicians was sent this week.

2010 Membership Letter

2010 Feedback Questionnaire

November 9th Bulletin

When will our health hurricane hit?

November 13, 2009 - This is an article that appeared in yesterday's Toronto Sun. Please post and share with your colleagues, staff, and patients. We can't agree more! – COFP

By Lorrie Goldstein – Toronto Sun

Twice in recent years, first with SARS and now with H1N1, Canada's readiness to deal with a pandemic has been tested.

Both times, we failed miserably.

Both times, all that stood between us and real panic and societal breakdown was not anything our politicians and governments did, but dumb luck.

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Are you feeling uncertain and uneasy about your professional future?

November 9, 2009 - Lately, a number of troubling events have taken place that should be of serious concern to Ontario's physicians:

•  The Harmonized Sales Tax (HST) in Ontario, which will have to be absorbed by physicians without any tax credit, thus further eroding our incomes with no offsetting benefits. The government, after all, must somehow pay for its irresponsible eHealth spending, and is therefore unilaterally postponing our fee increase while increasing our practice costs. 

•  The desperate selling off by government of family practice - piece by piece - to far less qualified non-medical practitioners in the upcoming Bill 179;

•  The eHealth fiasco, which evaporated one billion dollars - or nearly one-third of the total family physician payment budget - from the healthcare coffers, giving us no prospect for a universal EMR system in the foreseeable future.

This is just a short list of recent developments, which threaten our futures. Others could be added as well. It is no wonder that many Ontario physicians are becoming increasingly concerned. We, the Coalition of Family Physicians of Ontario (COFP), are also concerned. We are frankly puzzled by the lack of effective representation of our interests by the Ontario Medical Association (OMA) that has allowed the above to take place, to the detriment of both physicians and our patients. We believe that effective and fair representation of all physicians is the key to achieving real solutions that are required in our healthcare system now and in the future.

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Submission Before the Standing Committee on Social Policy on Bill 179 - The Regulated Health Professions Statute Law Amendment Act, 2009

October 5 , 2009 - COFP President, Dr. Douglas Mark, and Board Member, Dr. Felix Klajner, appeared before this committee to express concerns about the proposals in Bill 179 that amends the Regulated Health Professions Act.

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“Physicians and Health Emergencies” CPSO Draft Policy

September 24 , 2009 - Ontario physicians provide exemplary care to their patients. Professional self-regulation is a privilege that we appreciate and respect. However, our relationship with the College of Physicians and Surgeons of Ontario (CPSO) has been under strain to the point of being at times adversarial particularly during the time of the Medical Review Committee (MRC) audit process. In contrast, other provinces and territories seem to have cooperative or even collegial relationships between physicians and their respective regulatory colleges. We hope that the CPSO is actively engaged in improving this state of affairs.

In recent weeks, the CPSO released its draft new policy called “ Physicians and Health Emergencies ” for Ontario physician feedback. Similar guiding principles have been adopted across Canada for physicians and other health professions in the wake of SARS. Today, as pH1N1 is poised to sweep through Ontario, the CPSO Council is meeting to determine the final outcome of this draft policy. Our response letter appears below.

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CPSO Final Policy (PDF)

COFP Official Response to Draft CPSO Policy - "Health Emergencies and Physicians"

September 18, 2009

Ms. Maureen Boon

Associate Director, Policy

College of Physicians and Surgeons of Ontario

80 College St

Toronto, Ontario M5G 2E2

Dear Ms. Boon,

RE: Physicians and Health Emergencies draft policy

Thank-you for requesting our opinion on your new draft policy, Physicians and Health Emergencies . Our Board has carefully read over the draft and background information and has come to the following consensus.

•  We support the reaffirmation that Ontario's dedicated physicians provide exemplary care to patients often putting their lives at peril particularly at times of crisis.

•  We also acknowledge that government and healthcare institutions are responsible to do their utmost to support physicians and other healthcare workers particularly at times of crisis.

•  We agree that under a temporary health emergency, physicians should be allowed to provide care outside their areas of expertise as you have detailed.

•  We are concerned that that this proposal is in the form of an official CPSO policy , which is enforceable by law under the legislation that govern our profession. This may cause physicians to feel compelled to provide care beyond their level of comfort and risk. Physicians must be free to choose their own level of risk, including the risk of death, based upon their professional skills weighed against their responsibilities and commitments in their personal lives. We recommend that this proposal would be better categorized as a position statement.

•  Lastly, rather than recommending individual physicians to contact The Canadian Medical Protective Association (CMPA) to determine whether or not their malpractice insurance coverage would be extended beyond their usual scope of practice in health emergencies, we recommend that the CPSO itself should carry out this undertaking or ensure that another physician representative body such as the Ontario Medical Association (OMA) or Canadian Medical Association (CMA) does. Physicians must not be held back by the concern that they may not be insured under this scenario.

On behalf of the Board of the Coalition of Family Physicians of Ontario, I hope that our feedback and recommendations will assist you in this undertaking.

Sincerely,

Douglas Mark MD, President