Back to Media Releases 

VOLUME 35, NO. 18, May 11, 1999

Family physicians' group prepares for its next big battle

By Matt Borsellino

Primary care reform to hinder freedom, Ont. group says

TORONTO - As it approaches its third birthday, the Coalition of Family Physicians of Ontario is setting its sights on its next major challenge.

"Primary care reform will undoubtedly provide the government with control over physician incomes, practice size, and freedom to practice quality medicine," COFP co-chair Dr. Sharla Lichtman told a gathering of about 200 members here late last month. "We must only agree to changes that will benefit the patients we serve as well as general practice."

With several primary care reform initiatives starting up in the province, Dr. Lichtman added the government is interested in making changes "to save money in the short run and gain more control of the system."

There's historical perspective to explain why COFP members continue to be so suspicious of government plans. On July 15, 1996, about 100 family doctors from 20 urban hospitals were "ready and ripe to react, if not explode" against increasing clawbacks and government restrictions, Dr. Lichtman noted.

The coalition was born by the end of a meeting at North York General to deal with those frustrations. Today, the association claims 3,000 members from across the province, and Dr. Lichtman says that even though the Ontario Medical Association still refuses to fully recognize the group, inroads have been made to link the two organizations.

"A lot of our members now have positions within the OMA," she said. "We've also had some positive meetings with the section on general and family practice which has been receptive and more welcoming of the coalition. They now recognize the valuable role the coalition can play, and we recognize their important role as well."

Clearly, the coalition has accomplished a lot. Just as clearly, there's plenty of work left.

"We needed representation willing to advocate on behalf of family physicians that would act as a unifying force," Dr. Lichtman said. "The fact we still exist nearly three years later attests to the continuing need to have an organization representing grassroots family physicians and their patients."

Under reform, Dr. Lichtman noted, the province will be able to determine how many patients can be rostered in each practice and what capitation rates will be.

"It's imperative that we learn from our mistakes," she remarked in reference to OMA agreements reached in 1991, 1993, and 1996. "The doctors of this province must start taking the offensive as physicians in other provinces have. It's time for us to start negotiating fair and reasonable increases in our fees and to stop taking financial responsibility for increases in patient utilization."

Dr. Lichtman promised the coalition would also work on two other fronts: keeping medical school tuition fees affordable and ensuring corporate caps on laboratories services don't restrict access particularly for the elderly.

"After years of oppression, physicians have assumed the role of victim," she said. "Many think (the OMA's recent) 1.4% (fee) increase is great, but it's not enough, not for caring for patients with increasingly complex problems."