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Ontario asks doctors to resume negotiations

The Ontario government has asked the province's doctors to come back to the negotiating table – and has a list of ideas to fix health care that features same-day medical appointments for patients.

Before any decision is made to resume negotiations, Ontario Medical Association president Doug Weir said he wants to first meet Health Minister Deb Matthews, to gauge the government's intentions. So far, he said, the province's position has been "our way or the highway."

The two sides have been at odds since earlier this month when fee cuts – largely focusing on cardiologists, ophthalmologists and diagnostic radiologists – were made. Those specialty groups have projected billings of $585,000, $666,000 and $668,000, respectively, in fiscal 2011-2012.

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The cuts, expected to save about $338.3-million overall, reflect technological advances that have made tests or operations quicker and in some cases, easier, to perform. Others – such as echocardiograms before routine non-cardiac surgery – do not improve outcomes so fewer will be done.

"If you want to protect universal health care, then the status quo is not an option," Ms. Matthews said in a telephone interview on Sunday. "We have to drive change."

This need for change comes amid a $15-billion provincial deficit and the recognition that hefty increases to physicians over the past eight years – family doctors billings have increased 85 per cent over that time period – have not bought the change government had sought.

Patients continue to face lengthy delays to see doctors and go to hospital emergency rooms for care. Even the provincial auditor, in his December report, said the province has paid richer fees to family doctors with little proof patients are gaining better access. [On average, they each billed about $351,000 in 2011-2012.]/p>

Timely patient access has been a constant that has been difficult to change, despite government's attempt to buy their way out of the problem with fee increases and the graduation of more physicians. Though more Ontarians have doctors, fewer than half of patients are able to see them the same or next day when sick, according to an Ontario Health Quality Council report.

Moving more doctors toward a system of advanced/open access could make a big difference, said Ms. Matthews.

In her letter to the OMA dated May 18, she also suggested virtual visits for patients and recommended an expert advisory committee be struck to look at ways of improving access, suggesting former OMA president Stewart Kennedy as its co-chair. Reached through his answering service in Thunder Bay Sunday, he declined comment.

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This latest move may be the white flag needed in a battle that has spawned a fight for the public's trust. Doctors groups have warned fee cuts will have serious consequences for patients, while government has insisted that is not the case, but that it must get better value for money and improve access.

Health care has surged as a top provincial concern for 34 per cent of respondents, according to a Nanos Research survey of 500 Ontarians, conducted May 11-13. That's roughly double the percentage received by the other big issues – jobs and the economy.

"What we need to do is really drive the change so the system works in a way that is smoother, more streamlined for patients but also better value for money," said Ms. Matthews. "And we know what we need to do to actually drive that change, but we can't do it alone."

That is why in the letter to OMA president Dr. Weir, she says she wants to get back to the negotiating table.

Dr. Weir said doctors have suggestions on how to make care more efficient, and that he wants only to work in a "collaborative fashion" with government, "rather than having things forced on doctors."

At a board meeting of the OMA Sunday morning, he said it was imperative that before starting negotiations, it has confidence the government will negotiate fairly, he said.

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By Sunday night, a time had not been set for the meeting, though Dr. Weir thought it could happen as early as Monday or Tuesday.

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