Media Release

FOR IMMEDIATE RELEASE

COALITION OF FAMILY PHYSICIANS OF ONTARIO ISSUES PRACTICE ADVISORY;

RECOMMENDS FAMILY PHYSICIANS EXPLORE OPTIONS IN MORE HOSPITABLE JURISDICTIONS

( May 13, 2003 , Toronto , Ontario ) – Dr. Douglas Mark, President of the Coalition of Family Physicians of Ontario (COFP), held a media conference today to issue a practice advisory for all family physicians practicing in Ontario . Saying that the family practice environment in Ontario is under severe strain, and that planning for the future is virtually impossible due to system instability, Dr. Mark announced that Ontario family physicians would be operating under an “ Orange ” Advisory Code until further notice. Joining Dr. Mark at the media conference was Coalition Vice President Dr. Chris Pinto.

“During the past year, both the OMA Section of General and Family Practice (SGFP) and the Coalition of Family Physicians of Ontario independently developed solutions to the Family Medicine crisis – new payment models that would recognize and reward the provision of comprehensive care,” Dr. Mark said. “The intention of both the SGFP and the Coalition was to make available a new comprehensive care funding formula as an expansion of traditional Fee-For-Service (FFS), and also as an alternative to Family Health Networks (FHNs), the government’s primarily capitation-based funding mechanism.” Dr. Mark went on to say that it was not surprising that the Coalition of Family Physicians of Ontario’s model was remarkably similar to the SGFP model, as both are solutions based on Fee-For-Service, simply understood, quickly deployable, robust, sustainable and likely to find widespread favour with grassroots family physicians.  

The Ontario Medical Association Board presented the SGFP model to the Physician Services Committee (PSC), a committee of OMA and MOHLTC representatives, for consideration during the recent 2003 “reopener” negotiations for the final year of the 2000 Master Agreement. Unfortunately, these negotiations resulted in a new and completely different PSC version funding formula that has been used to create something called Family Health Groups (FHGs).   

“Inexplicably, the OMA Board signed the 2003 ‘reopener’ Memorandum of Agreement with the Ontario Government just days before OMA Council was due to meet in April,” Dr. Mark said. “The OMA Economics Department provided the Board with an analysis of the agreement, but the Board prohibited prior release of this document. Council had no meaningful opportunity to discuss this entirely new model. FHGs and FHNs represent the most significant change in our practice environment in the last 35 years. Incredibly, as with FHNs, there was no ratification by family doctors and there was no approval from Council.”  

Dr. Pinto then listed a number of the concerns that the Coalition has with the government’s new plan, including the lack of a pension initiative and the fact that the government can unilaterally amend the FHG contract by giving just 30 days notice.

“Under the SGFP/COFP models, there are no legal contracts for doctors to sign,” Dr. Pinto explained. “The only piece of paper to sign would be a simple declaration by patients confirming the names of their family doctor. These doctors would provide these patients continuous comprehensive care and receive appropriate remuneration. If the patient were to become dissatisfied with the care provided, then the patient would have every right to leave that practice and seek care elsewhere. This type of arrangement allows for healthy competition and encourages quality care.”

In contrast, Dr. Pinto went on to explain, the FHG doctors enter into a contract with the OMA and MOHLTC that is binding on the physicians, but can be unilaterally amended with only a 30-day notice. The FHG contract requires a commitment to a detailed and extensive list of service expectations. These expectations are still open to interpretation. It also has to be pointed out that the very same people who created the contract are the ones who will arbitrate any dispute doctors may have.

“It is for these reasons that the Coalition of Family Physicians of Ontario feels it necessary to advise family physicians that the stability of the comprehensive care environment is now so severely compromised that prudence dictates that each physician consider minimum protective measures be undertaken as outlined in the Family Practice Advisory,” Dr. Pinto said.

Dr Mark concluded by saying, “While the ‘reopener’ provides marginal incentive for established FFS practitioners to continue providing continuing comprehensive care, it will not reverse the profound lack of interest in family medicine by medical students. As well, it will not assist the majority of the 900,000 Ontario citizens currently searching for a family physician. This is why we are so deeply dismayed that the OMA/MOHLTC negotiating team did not properly incorporate the grassroots solutions made available to them by the OMA Section of General and Family Practice and by the Coalition of Family Physicians.”

The Coalition of Family Physicians of Ontario, representing front-line providers of health care, is a grassroots organization dedicated to the provision of top quality health care to the people of Ontario . We strive to protect the rights, freedoms and independence of family physicians of Ontario and to continually improve the health-care system. To learn more, please visit the Coalition’s Web site at www.cofp.com.

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