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Ontario Premier Dalton McGuinty speaks to the media at the Waterloo Region, International Plowing Match opening ceremonies in Roseville, Ontario, Tuesday, September 18, 2012. McGuinty won't be challenging Justin Trudeau for the federal Liberal leadership. The Ontario premier has decided to look for challenges outside politics altogether.DAVE CHIDLEY/The Canadian Press

Physicians in Ontario have overwhelmingly endorsed a deal with the government that freezes their overall pay for two years, putting a cap on the second-largest item in the province's health-care budget.

The Ontario Medical Association announced on Sunday that 81 per cent of doctors who cast ballots voted in favour of the new agreement. The deal marks one of the few bright spots for Premier Dalton McGuinty, whose embattled government is embroiled in an escalating dispute with the province's elementary teachers.

The new OMA contract, which runs from Oct. 1, 2012 to March 31, 2014, modernizes the fee schedule by compensating doctors for communicating by e-mail with patients, and cuts spending by reducing unnecessary patient tests.

The OMA reached a tentative accord with the province last month after the government backed down on fee cuts for some services and agreed to introduce a new system for resolving disputes. The accord ended a bitter standoff between the government and the province's 25,000 physicians.

Nearly 21,000 doctors cast a ballot, representing the highest voting turnout in the history of the OMA.

"These negotiations were challenging but I'm very pleased we were able to roll up our sleeves and reach an agreement that not only enhances patient care but also protects the improvements that have been made in recent years," Doug Weir, president of the OMA, said in a statement.

The accord freezes total funding for physician services at $11-billion a year, a move that will help the cash-strapped province eliminate its deficit of $14.4-billion. Doctors' compensation represents just over 20 per cent of Ontario's health-care spending, second only to hospitals.

The accord also contains measures that drastically curtail the government's ability to unilaterally change doctors' pay through regulations. Under a dispute resolution measure contained in the accord, the OMA will be able to call in a facilitator, or failing that, go to conciliation.

"This agreement marks a renewed era of partnership with doctors as we work together to transform and sustain our precious health care system," Health Minister Deb Matthews said in a statement.

Tensions between the OMA and the province escalated earlier this year after the government moved unilaterally to cut fees for 37 services, mainly targeted at high-paid specialists, such as radiologists, ophthalmologists and cardiologists.

As part of the tentative deal reached last month with the OMA, the government agreed to adjust six of the 37 fees. These include reversing the fee reduction for self-referrals – doctors who refer patients for tests to clinics they own; increasing the flat fee for anesthesia services to $75 from $60; and restoring the premium for laproscopic surgery to 25 per cent from 10 per cent.

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