The COFP has obtained an independent legal analysis on FHGs from Mr. Brian Shell, a prominent labour lawyer, senior counsel at Shell Jacobs Lawyers of Toronto.

Click to download a copy of the “Shell Report”

Please read the OMA FHG analysis prepared by OMA’s counsel and FHG negotiator Mark Geiger. Then read the Shell Report. Which provides you with the Information you need to make an informed decision about FHGs? Mr. Shell comments on Mr. Geiger’s letter: “As far as I can assess…it is less a legal ‘analysis’ of the FHG than a partisan ‘description’ with qualifications and ‘insight’. It does not assist a physician in his/her decision to transform the way s/he practices family medicine in return for certain limited material inducements.”

Just some of the very serious concerns that Brian Shell uncovers include:

1. You cannot just ask a patient to sign up; the “rostering” process must provide complete disclosure to the patient of benefits to you and potential FHG problems that may affect their care as well as confidentiality of patients’ medical information. A fsailure to provide proper disclosure may expose you to legal action and/or professional misconduct allegations.

2. You cannot just quit a FHG. FHGs are legal entities and you may face the risk of legal action for breach of contract. To try to reduce your risk, you must have a detailed governance agreement – in effect a partnership of sorts.

3. You may be professionally liable for THAS advice and for certain of the actions of other participating member FHG physicians.

4. You may be obligated to provide 24/7 care. It s unclear to Mr. Shell what the FHG contract irequires, Rememeber that Brian Shell is an employment law specialist. If someone with his experience is uncertain about the meaning of the contract and how it might be interpreted and aplplied – if he is not sure – what will the CPSO and the MOHLTC want?

5. You are subject to MOHLTC imposed penalties if you breach the contract. However, you are probably powerless to seek redress from the Ministry if it fails to meet the terms of the contract.

6. You have to rely on the OMA to try to protect you against future potentially unfair and costly amendments. Faced with imposedc changes in ytour working lige, you may be left with no option but to leave the FHG. Don’t forget that the amendments will have OMA and MOHLTC support because they do the amending together.

7. You have no choice but to to accept the PSC for disputes even though the PSC may is not required to allow any procedural fairness and may not consider individual complaints and is not likely to follow anything remotely similar to the rules of natural justice.

8. You may be responsible for confidentiality of patient information despite the fact that you cannot know how the Ontario Family Health Network or the government will use, protect or maintain the confidentiality of patient information which they will have access to one yuour patients have been enrolled.

9. CMPA insurance and legal assistance will likely not extend to many contractual FHG-related issues, including patient complaints to the College arisding from allegations that a FHG member physician has not fulfilled all obligation to have the FHG clinic doors open exactly in accordance with the requirements of the FHG contract.

Brian Shell concludes that “the interests of the Ministry may be met through the FHG concept, but the interests and economic needs of family physicians are not.” “It is simply wrong as a matter of law for a family physician to consider that practicing family medicine from ‘within’ a FHG is the same as before.”

The Shell Report raises many additional serious problems. We think that the CPSO and the CMPA have a lot of answering and explaining to do.

We will be writing to them immediately to seek their opinions regarding conflict of interest issues and the liability concerns. We will make the OMA Board aware of the risks to their members as a result of the creation of FHGs.

If you have any questions abour FHGs, whether arising from the Shell Report or otherwise, please send your inquiry to us and we will forward it on for consideration.

NOW ASK YOURSELF: “WHO IS ACTING IN MY BEST INTEREST?”

Then go to our Website at www.cofp.com and: JOIN the COFP if you are not already a member.

Please make a donation to our legal action fund to assist us in paying for “The Shell Report.”

We need your support to ensure our ability to continue to look out for your interests!

Thank you very much – and thanks to the over 3,500 family physicians who have already joined the COFP and to those who have voluntarily contributed to our cause.

Your support is greatly appreciated!