No concerns about ‘reduced supply’ of doctors in Ontario: ministry

Recruiting and retaining physicians in Ontario is “not a major problem,” the Ministry of Health suggests in arguments it is making in arbitration with the Ontario Medical Association over physician compensation.

The province’s argument comes as the OMA, which represents Ontario’s doctors, has repeatedly warned that more than two million residents do not have a primary care physician and thousands of physician jobs remain unfilled.

The province is in the middle of negotiations with the OMA on the next Physician Services Agreement, which will determine how physicians are reimbursed, for the next four years.

But talks are going so poorly that an arbitrator is now being asked to set compensation levels for the first year while the two sides work on the 2025-2028 period, one of the doctors involved said.

“Business is in such bad shape that this is the fastest way to get money out the door and stabilize primary care practices,” said Dr. David Barber, chairman of OMA’s Division of General and Family Practice.

The government’s arguments in its arbitration letter are unlikely to improve relations, he said.

“It’s really, really offensive,” Barber said.

“The numbers are one thing, right, but… the government’s approach here is that their briefing essentially says there’s nothing to worry about. I understand there’s some posturing, but this is actually a pretty dangerous attitude on the part of the government.”

The OMA proposes an overall price increase of five percent for this year, a “catch-up” of 10.2 percent to take into account inflation and “low price increases” since 2012, and a 7.7 percent to be spent on various health care programs. .

Compared to the 15.2 percent direct increases proposed by the OMA, the Ministry of Health proposes three percent. There is no need to ‘catch up’, he argues.

“The average income adjustments for physicians compared favorably with other settlements where retention and recruitment are not a major issue,” the ministry wrote.

“We will illustrate that there are no concerns about a reduced supply of physicians. In all of Canada, Ontario has the best track record of attracting medical graduates to train in Ontario. In addition, Ontario has experienced growth in the number of doctors that far exceeds population growth.”

Health Minister Sylvia Jones said the ministry is not saying retention is not a major problem, nor is it saying there is not a shortage of doctors.

“What we are saying is that Ontario physicians are a very important part of our health care system, and we will continue to work with them to grow the workforce,” she said after question time on Wednesday.

“We’ve done that through commitments to two new medical schools. We’ve done that by expanding residency positions… in fact, interest in practicing and working in the province of Ontario is high.”

The ministry’s arbitration submission cited several data points to support its arguments. The supply of doctors grew by 8.9 per cent between 2019-20 and 2023-24, while the population grew by 7.1 per cent, the report said.

During the same period, the average income of a doctor increased by about 10 percent, while the average number of patients per doctor decreased by 3.7 percent, the ministry said.

“It is concerning that as physicians’ incomes have increased and the number of physicians has outpaced population growth, patient access appears to have deteriorated,” the ministry wrote.

“Why is the number of physicians increasing while physician services decrease? It could be physicians’ desire for a better work-life balance.”

The ministry says an agreement for doctors should be approached differently than for nurses, where a recent deal puts shortages “front and center”.

The government also says there are many initiatives underway to increase patient care and access to GPs.

“These considerations are particularly relevant when the (arbitrator) considers issues such as physician retention and recruitment,” it wrote. “There is a completely different consideration for this hearing than recent health care decisions in hospitals.”

The OMA’s arguments also contain a multitude of figures. There are 2.3 million Ontarians without a primary care physician, they argued. According to a calculation based on census data, the province is short of more than 2,000 doctors, they say. Data from government agency Health Force Ontario shows more than 3,000 vacancies for doctors, they said. Additionally, Ontario has 234 physicians per 100,000 residents, one of the lowest rates in the country.

“Ontario is facing a physician staffing crisis,” the OMA wrote.

“The evidence of this is everywhere. It can be seen, for example, in the unprecedented number of patients not connected to a primary care physician, the closure and overcrowding of emergency departments, the long waiting lists to see a specialist, and the backlog of surgical procedures. procedures and diagnostic imaging in the post-pandemic era.”

The Ontario College of Family Physicians said in a statement Wednesday that while it is the OMA’s role, and not theirs, to negotiate, as an advocate for family physicians, the college agrees with the OMA that the government’s compensation proposal is a crisis would “further worsen”. .

“The compensation has not kept pace with inflation and does not reflect the increasingly complex care they provide,” the council wrote.

“The Ontario government must recognize the essential role of primary care physicians. The care and expertise they provide cannot be replaced, and compensation must reflect their true value to patients and the health care system.”

NDP health critic France Gelinas said the government must work with doctors to address the issues that keep doctors from using family medicine.

“More than two million people in Ontario do not have a doctor,” she wrote in a statement. “Instead of trying to solve this problem, the government wants to ignore it.”

This report by The Canadian Press was first published May 8.