To All Ontario Family Physicians                                       August 12, 2008

NEGOTIAPAUSE?

One month has passed since Ontario Medical Association President, Dr. Ken Arnold, informed the doctors of Ontario that the OMA/MOHLTC negotiations had paused and that the Ministry had advised the OMA they would not be in a position to meet until at least Labour Day . So, is this a negotiapause – a little break in the action at the table to give both negotiating teams a rest – or has something else happened here? We believe that the OMA and MOHLTC are philosophically so far apart that negotiations have actually broken down – plain and simple . There is no other valid explanation.

Or in the immortal words of Yogi Berra: “It's like d éjà vu all over again.”

In spite of the efforts of the OMA and their negotiating team, we are once again facing the prospect of showing up at the office without a new contract indefinitely . Ontario physicians continue to soldier on to provide the best possible care to our patients with a paucity of resources and a fee schedule that ranks 6 th in country. Furthermore, one million Ontarians still do not have timely access to a family doctor, while healthcare demands escalate rapidly under the weight of our growing and aging population without any meaningful or constructive solutions put forth by the government.

Chronic underfunding, hospital restructuring, medical school cuts, clawbacks – and more recently, the creation of LHINs, nurse-practitioner-led clinics, and the provision giving pharmacists the authority to make medical decisions to extend prescriptions without physician supervision – all of these show a government bereft of any meaningful ideas or solutions. Everyone knows that family doctors are a proven and cost-effective means to provide quality complex medical care to the public.

Everyone, it seems, except the Government of Ontario.

The numbers speak for themselves. Ontario has one of the lowest ratios of family doctor to patient population in the country. Medical students' interest in family practice remains inadequate. Medical student debt load is reported to be $150,000. A typical patient encounter is rewarded with a meager gross amount of $30. Is it any wonder that only 25% of new family physicians end up in comprehensive care practice five years after completing their training?

Obviously, family practice remains in crisis. The government is not listening to our concerns. It needs to invest more resources to areas that will truly help patients. W e've said it in the past and we say again – the ministry simply does not respect our profession, and is trying to buy our services as cheaply as possible without any regard to the quality of care provided to the patients of Ontario. This is unacceptable. If the MOHLTC truly respects the contribution we have made – and continue to make on a daily basis – then they would still be working harder than ever with the OMA negotiating team to achieve an agreement that provides us with the tools we need to provide the best care for our patients.

This is no time to go on vacation.

Ontario has a third of Canada's population and a third of all of Canada's physicians. It behooves us to do something to get out of this mess. We have a plan to challenge government and make them listen to us. But we can't do it without your help. We need your support and will also need the support of your family and friends, your patients, the public, the media, and other physician groups.

Please show your support before it's too late.

Lastly, we wish to thank all of you who have already supported us – both with words and with your hard-earned dollars. Our strength comes directly from family doctors just like you . We need you more than ever now, and wish to remind those of you who haven't yet joined or renewed your COFP membership to do so today. Also, we would ask that you talk with your colleagues whenever the opportunity arises to encourage them to join us and support us. The greater our numbers, the more we will be able to exert our influence – now and in the future.

We close with a quote from Benjamin Franklin, “We must all hang together, or assuredly we shall all hang separately.”

Something to seriously ponder.

Sincerely,

Douglas Mark MD, President

and the Board of the Coalition of Family Physicians of Ontario

P.S. Stay tuned. We'll have more to say about this situation, as well as sharing the details of our plan with our members, in our next bulletin.

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