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March 1, 2002.

Doctors reluctant to form networks

Early results of survey reveal scepticism about Ontario government's proposal

by Graeme Smith


The Ontario government faces an uphill battle trying to launch a $250-million program that encourages family doctors to try a new way of practising medicine, a survey suggests.

More than 98 per cent of about 1,200 doctors who answered a survey by the Coalition of Family Physicians last month said they don't approve of a deal offered by the government to form family-health-network groups.

"This shows that many of us are quite happy to be independent," said Doug Mark, president of the coalition, which represents 3,000 of the province's 8,000 family doctors.

The survey is the first measure of whether Health Minister Tony Clement is likely to achieve his goal of enlisting 80 per cent of family doctors into teams, or health networks, by 2004. Each group would consist of at least five doctors, who would share patient information electronically and provide 24-hour services.

A government agency, the Ontario Family Health Network, has been asking doctors to sign up voluntarily since Jan. 27.

None have formally enrolled in the program so far, OFHN chairwoman Ruth Wilson said, although some are already in OFHN pilot projects and more are expected to join after they've had time to evaluate the government's offer.

"Hundreds and hundreds of doctors have phoned in with serious expressions of interest," Dr. Wilson said.

The survey was mailed to 10,000 family doctors in early January. It was prefaced with a letter outlining the coalition's concerns about the program, such as the suggestion that the government's proposal to pay doctors a base rate of $97 a patient each year is too low.

The letter also warns doctors about possible "legal entanglement" with government contracts: "A legal opinion on only the template agreement will likely cost you thousands."

Responses to the survey are still coming in, Dr. Mark said, and hundreds more will likely be included in the final tally.

But the initial results show doctors' reluctance to break with tradition, said Kathryn Lockington, chairwoman of the Ontario Medical Association's section on general and family practice, who has been educating doctors across the province about the program.

"What this study shows is that doctors are concerned about this because it's a major change, and they're skeptical," Dr. Lockington said. "But I don't think it reflects anything more than that."

Many doctors get past their knee-jerk reaction to the program, Dr. Lockington said, once they understand the complex details. Still, she added, many others won't be persuaded.

"Maybe the government will have to take another look at this," Dr. Lockington said.

Ken Hook, president of the 6,000-member Ontario College of Family Physicians, said the results point to the need for the government to give doctors more options than their current choice of staying independent or joining a health network.

"This clearly demonstrates that there are going to be many who are not satisfied," Dr. Hook said. But the status quo is also unacceptable, he added, because family doctors are overworked and underpaid.

Dr. Mark said he's worried that the government might force some doctors to form health networks if they're not initially accepted.

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