To All Ontario Family Physicians                                 November 16, 2005

Time for Leadership

Energized to Lead the Fight for Embattled Family Physicians

Dear Colleagues,

Leadership: you know it when you see it. But leadership is in short supply when it comes to health-care transformation. You need to know what to look for and where to find it.

Leadership comes in many shapes and sizes and colours, but it is not a chameleon. Leadership does not change in its willingness to support those who follow. It does not waiver.

The Coalition of Family Physicians of Ontario (COFP) is not a chameleon. It is a leader in the support of family physicians across Ontario. This leadership has never been as important to the survival of family practice as it is now.

This past year has seen many changes in health care, the impact of which may not be known for some time. The Coalition understands that some changes will be positive and some will not, but leading requires the ability to envision what these changes will bring and what changes are necessary in the short and long term.

Short-term thinkers are plentiful in politics, including individuals who serve their own short-term interests and those of their political party. This leads nowhere. It is always politically convenient to blame physicians for health-care woes and to expect them to work harder for less in the name of “efficiency”. This cannot be a long-term solution.

The Coalition of Family Physicians of Ontario understands that by supporting family physicians, the best solutions will be found.

We have seen the damage done to physicians and the morale of the medical profession through the actions of the Medical Review Committee (MRC) enabled by the College of Physicians and Surgeons of Ontario (CPSO). The Coalition fought hard and was instrumental in bringing an end to this draconian audit system. Justice Peter Cory's recommendations in the Cory Report involve major reforms to allow physicians the right to “due process,” but these have yet to be implemented. Now there is a new threat to physicians by the CPSO – compulsory revalidation every five years; a process that we strongly oppose.

The Coalition of Family Physicians of Ontario understands the need to support physicians and provide them with the same justice conferred to every other citizen.

Leadership demands it.

The Supreme Court of Canada showed its leadership in the Chaoulli/Zeliotis case in Quebec, ruling that Quebec citizens have the right to purchase private health insurance if the public system cannot provide timely medical care. People must have the right to self-determination. Refusing to discuss private health-care options in the face of monumental changes in demographics, in technology, in pharmaceutical developments and in increasing health-care demand in general is not a long-term solution. This is not leadership but simply repression.

Health ministers at both the federal and provincial levels appear to put their own political self-interest ahead of the need to find viable long-term solutions for health care. Indeed, even the Ontario Medical Association (OMA) has not fulfilled its leadership role when discussing private health-care options. The OMA has stated that it does not want to be ahead of public opinion. Sitting on the sidelines, head down, and in the middle of the pack is not the way to lead.

Attempts to portray physicians engaging in unethical activity, such as the "double-dipping" that has lately preoccupied NDP leader Jack Layton, should be denounced by Ontario physicians' own representative body, the OMA, each and every time these types of accusations appear in the media. Strong leadership is loyal to its followers and a defender of their reputation.

Leadership requires a vision unclouded by self-interest. Despite billions of dollars pumped into our health-care system, the Fraser Institute annual report on waiting times found that waiting lists were essentially unchanged in 2004 from 2003. Their recent report, Paying More, Getting Less 2005 , unequivocally concluded that our system is unsustainable and will collapse if new approaches continue to be ignored. Yet the same old hackneyed solutions continue to be recycled, and physicians in the front lines of health-care continue to be left out of the decision-making process. How can they hope to assist their patients in accessing timely health care?

Local Health Integration Networks (LHINs) are the newest generation of bureaucratic entities that exclude physician input from the process of change. Good leadership encourages input from all, including front-line health-care providers. Leadership must be inclusive.

More than ever, visionary leadership and a sense of purpose and dignity are needed to move forward in the face of changes occurring within medicine and family practice. The Coalition of Family Physicians of Ontario believes in family physicians, supports them, and seeks to empower them.

And we will do so.

Sincerely,

Douglas Mark MD, President

and the Board of the Coalition of Family Physicians of Ontario

The Coalition of Family Physicians of Ontario
4190 Finch Ave E, PO Box 27033, Toronto, Ontario, M1S 5C2
Tel: (416) 412-1474 or 1-866-495-4346

Fax: (416) 412-7297 or 1-866-495-4349