To All Ontario Family Physicians:                                        April 26, 2005

The Future of Family Practice

Reality After the New Deal

The endorsement of the second OMA-MOHLTC Master Agreement must be respected and accepted as the will of the majority of Ontario Physicians.   We were instrumental, along with other groups, in successfully bringing about a rejection of the first contract offer because it did not fulfill the needs of Ontario physicians and our patients.   The result was that Ontario physicians received a better second offer.

The COFP believes that family physicians were negotiation-fatigued and prepared to approve the new offer, in spite of any flaws, while also accepting the reality that it was the best the OMA could negotiate.    Negotiating represents the most crucial service the OMA provides us.   We staunchly believe that a full and open debate about how we should be represented and the need for a proper negotiating framework including statutory binding arbitration is mandatory.

Although all the COFP/OMA board members endorsed the deal, we believe this clearly demonstrated that they continued to fulfill their responsibility to their OMA Districts and not only to the COFP.   This is as it should be and reflects the diversity of opinion, responsibilities and honourable conduct of our members; they must represent all their constituents and as such, their decision may differ from official COFP policy.   Nonetheless, their commitment to family practice and practice choice remains steadfast.

In spite of gains made in the new agreement, the future of family practice remains uncertain.   The over-riding sentiment is that the contract deficiencies will not revitalize family practice into a desirable specialty and will not make Ontario attractive enough to adequately retain or recruit physicians in general.  Indeed, OMA president Dr. John Rapin recognised these deficiencies in a recent fax to Ontario physicians.

The COFP's focus over the past few years has been to emphasize the need for a strong fee for service (FFS) option for family physicians.   FFS forms the foundation upon which all payment models are based.   Physicians must have the opportunity to choose their mode of practice and must have viable funding options to select without suffering undue economic hardship and practice instability.

Overall, our long-term concern for family practice, given a deal that lacks backing for FFS physicians, influenced our decision not to support it.   We remained opposed on principle - FFS should never have been given such a meager increase.   Yet, we understand and respect the financial pressures and other reasons that led to the “yes” vote.

The agreement in itself is another step in the direction of what promises to be a period of continued change.   How this change is managed and how it will be implemented will require input from many representative groups.   The COFP's record speaks for itself.   We have steadfastly represented the rights of family doctors and have succeeded in influencing the government on major policy issues:

• Revisions to Bill 8:   The Commitment to the Future of Medicare Act
• Revisions to Bill 31 that dealt with changes to medical records, privacy, and physician accountability matters
• The MRC moratorium
• The Justice Cory Report
• The doctor shortage public awareness media campaign that greatly influenced negotiations

Next Steps – Remember, only 18 months before negotiations of the re-opener begins

With the support of our members, we will embark on the following actions:

• Monitor the implementation of the new OMA-MOHLTC Agreement
• Ensure the selection for the Physician Services Committee (PSC) and its subcommittees fairly represent the physicians of Ontario
• Prepare for the fourth year re-opener negotiations slated to begin in 18 months
• Continue to advocate for a legislated proper negotiating framework including statutory binding arbitration
• Ensure that family physicians in rostered practices have fairness in contractual relationships
• Advocate for a benefits and pension package that Ontario physicians so rightly deserve
• Scrutinize the recent Justice Cory Report and ensure that it is accurately and promptly implemented
• Advocate for compensation to past MRC-audited physicians
• Continue to promote the family practice issues through the media further raising public awareness
• Research and implement methods to assist family practice to remain a viable specialty as we deal with increasing demands of complex patients having multiple problems in a resource-challenged healthcare system
• Seek government to accept front-line family physician input into Local Health Integration Networks (LHINs)
• Lastly, we believe our members, indeed all Ontario family physicians, need analyses and information from many sources.   We plan to organise a fall meeting of interested family physicians to discuss current issues and review our “Next Steps” in preparation for the Master Agreement re-opener.

We Need Your Support!

Campaigns, media and public education efforts, submissions to government committees, and expert legal and political advice are costly.   Your COFP board has willingly contributed thousands of hours to represent and protect your interests.   The COFP relies on each member to support its work - you absolutely cannot leave this to your colleagues and hope the COFP can continue to achieve its goals on your behalf.   If you have not yet done so, it is now up to you, to reaffirm your support through your membership.  To those of you who have still not joined, we invite you now to do so.   Remember, the stronger your support is, the stronger the COFP remains and becomes.

Yours sincerely,

Douglas Mark MD, President

and the Board of the Coalition of Family Physicians of Ontario

Join, renew, give feedback, and make political action & legal challenge contributions online at www.cofp.com