"Ont. FP Coalition rips OMA PCR sites"

By Catherine Teasdale

THE ONTARIO Ministry of Health/Ontario Medical Assosciation's plans for primary care reform have come under fire again, with one of the most recent salvos being fired by the Coalition of Family Physicians.

Calling the government/OMA sites "a joke," and "a  big waste of money," Dr. Sharla Lichtman, president of the coalition, said they are not representative of Ontario's population and would be too costly to inplement province-wide.

In June, the Ontario College of Family Phsicians issued its own variation of primary care reform in the discussion paper entitled "Famiy Medicine in the 21st Centrury:  A Prescription for Excellence in Health Care."  In it, the college argues for family doctors to be the co-ordinators of patient care, the keepers of patient records and to revamp fee-for-service in favour of a blended funding formula.

Both the Coaltion and the College disagreed with the MOH-OMA's physician patient contract.  The two say that patients need to identify with one specific family doctor, as about 90% already seem to do.  "We don't think it is necessary to sign a 70-page contract," said Dr. Lichtman.  "It's not realistic.   You are not going to get patients to be accountable in any contract."

In a September letter, the coaltion challenged the college itself on specific issues pertaining to the OCFP's position on primary care.   At a subsequent meeting, the college brought together a number of stakeholders with ifferent ideoloy to discuss PCR issues.

After the meeting, Dr. Lichtman said, "The important thing is that we do agree with the college's main principles."  But there are some details, she said, that they differ on.  "The biggest is that we do not believe that we necessarily need to revamp the entire healthcare system."  The coaltion would rather see the current system modified.

Physicians, she argued are not adequately paid for emergency care, on-call service, obstetrical care and preventive medicine.  If the government can't cover this care now, she said, "I find it difficault to imagine that they will be able to finance the entire (PCR) infrastructure and pay us adequately."