Open letter to Premier Wynne & Minister Hoskins re: unilateral funding cuts for physician services

Subject: Open letter to Premier Wynne & Minister Hoskins re: unilateral funding cuts for physician services
From: Family Doctor
Date: 17 Sep 2015

Dear Premier Kathleen Wynne and Minister Eric Hoskins,

I am a Family Doctor, starting a new practice in Ottawa. There are 700 patients on the waiting list at the clinic I joined, who are in need of a family doctor. Many of the patients I am meeting have not had a regular physician in years.

Yesterday I saw a 55 year old woman who felt fine. She hadn’t seen a doctor in 8 years. Her blood pressure was elevated, she smoked, and had a family history of heart disease. I will be working with this patient to control her blood pressure (with lifestyle changes and/or medication) and assist her in quitting smoking. I am confident that without such interventions she would be at high risk for a heart attack in the future. The price of a few family doctor visits (A007 = $33.70, soon less), or the cost of that patient’s yearly capitation amount in a Family Health Organization is minimal compared to the cost of treating an acute heart attack (ER / inpatient stay +/- ICU +/- interventional procedures +/- surgery +/- rehabilitation). The savings to the health care system by investing in preventative health are huge, and often intangible. I will also be screening this patient for cervical cancer with a pap test (adding $6.75 to my earnings that visit), screening for breast cancer and colon cancer, and recommending vaccinations to help prevent pneumonia & shingles. The burden on the health care system of treating any of those conditions would be much larger than allowing me to help prevent them.

I also saw a 20 year old girl who has been struggling with depression, anxiety, and addiction for years. She has had two months now where she is sober. She feels she has mostly been self treating her anxiety with alcohol and is ready to make a change. We had a long session discussing treatment options, and she opted to start antidepressant medications and pursue therapy. We talked about her dreams and career goals, and what steps she could take to pursue them. We also talked about her previous suicide attempts, and emergency supports available should she have those thoughts again. Unfortunately the wait list for Psychiatry is long, so I will be following this patient on my own for a while. If this patient is able to stay out of the hospital, stay sober, and get a job which she enjoys, it will be tremendous for our society.

I am not complaining about making too little money.
I am complaining that the MOH has imposed a unilateral agreement on Physicians, rather than working with our “union”, the Ontario Medical Association, to come up with a solution for cost-savings. Cuts, clawbacks, and limiting Family Physicians from entering into Family Health Organizations / Family Health Teams, is truly short-sighted.

I am a Family Doctor. I love my job and am proud of the work my colleagues and I do. We help to prevent acute diseases, manage chronic diseases, manage psychiatric and medical conditions in patients of all ages. We keep people out of hospitals, out of long term care units, out of psychiatric care facilities. I see patients who range from rich to poor. Whether a patient is working a minimum wage job or at a prestigious law office, they are all equal in the face of disease, and all equal in the face of the health care system. That is one thing I have always valued about our system, and it saddens me to hear about colleagues considering leaving the province or turning to private medicine because they cannot afford to keep their practices open. Our clinic has been struggling financially and these upcoming cuts may threaten the services we are able to provide.

I ask that your government please go back to discussions with OMA so that we can all work together to find savings within the health care system.We deserve respect from the government, just like any other public servant in Ontario, which includes a fair negotiation process.