Province pulls out of arbitration with Ontario Medical Association

[ploughboy]

And to clarify, I'm not making excuses for Christine Elliot.  Though at the moment, I still dislike her less than I did Eric Hoskins.  That may change with time, though...

[A-Stark]

Elliott is fairly useless but Hoskins was an erstwhile physician who was the worst. 

Also anyone who has watched Doug Ford’s political career would know him to be a liar and an asshole. And incompetent. Aside from his longstanding enabling of his late brother’s substance abuse, he managed to lie about things like his wife’s being Jewish during his mayoral campaign. Making any assumption that under him the PCs would be better than any of the alternatives was demonstrably false. Not because I liked the alternatives, but because it was clear that the establishment types like Elliott and Mulroney would be utterly spineless. And they have been. 

The only things Doug is good at are cronyism and policy chaos. 

[blah1234]

3 hours ago, ploughboy said:

Governments come, governments go.   I'm beginning to think the problem lies a layer deeper; and that the upper-level bureaucracy in the MOH has decided that their best strategy going forward (likely for financial reasons) is to play hardball, no matter what colour of necktie is being worn by the premier of the day.

I would agree with this. A lot of core policy analysis and drafting are done by non-elected bureaucrats. However, I think the parties have no incentive to help us either. I have some friends that are relatively senior in both the Liberal and PC party and every decision comes down to the calculus of voters impacted.

I think someone has done the shortsighted math and found that losing 30k physician votes is worth the short-term financial savings. 

[NeuroD]

Does anyone have a sense of how difficult it is to start working in another province? Given how toxic Ontario has become for doctors, I'm curious if it would be challenging or time consuming to get credentialed in another province? Or is it just some simple paper work?

[Crash Bandit]

On 12/11/2018 at 10:14 PM, blah1234 said:

I think that's the way medicine is heading in Canada as a whole. Having talked to friends in other provinces I think the pressure on physicians will only increase no matter where you go. 

That seems to be the way the wind is blowing.

[la marzocco]

26 minutes ago, PhD2MD said:

Does anyone have a sense of how difficult it is to start working in another province? Given how toxic Ontario has become for doctors, I'm curious if it would be challenging or time consuming to get credentialed in another province? Or is it just some simple paper work?

 

16 minutes ago, Crash Bandit said:

That seems to be the way the wind is blowing.

Well, the CMA is exploring a pan-Canada license. Really not sure how that will play out logistically, but there seems to be a sustained effort from gigi osler on this matter. If a pan-Canadian license does become a reality, barriers for interprovincial migration will be lowered. It's all nice and theoretical at the present time, here's the hoping it comes to fruition.

[rmorelan]

1 hour ago, PhD2MD said:

Does anyone have a sense of how difficult it is to start working in another province? Given how toxic Ontario has become for doctors, I'm curious if it would be challenging or time consuming to get credentialed in another province? Or is it just some simple paper work?

I didn't find the paperwork any more difficult in or out of my training province. They want the same stuff and of course as you know our credentials through the college are canada wide. It is just more money basically and more time. Annoying to constantly keep multiple ones active for that reason but there isn't a real barrier. 

[indefatigable]

There's a notorious language test in QC which has prevented physicians from staying and practising in the province in the past.  I think it's being updated, but if working in Montreal is of interest, it's something to be aware of.    

[rmorelan]

9 minutes ago, tere said:

There's a notorious language test in QC which has prevented physicians from staying and practising in the province in the past.  I think it's being updated, but if working in Montreal is of interest, it's something to be aware of.    

what a french language test? 

Ha Quebec always has to do things differently 

[indefatigable]

.

[Let'sGo1990]

The government has once again agreed to arbitration for this upcoming Tuesday.

[rmorelan]

1 hour ago, Let'sGo1990 said:

The government has once again agreed to arbitration for this upcoming Tuesday.

Ha well that is good - while there is a ton of anger here form people in both the OMA and OSA now I don't actually think either side wanted to stop arbitration. Not only that but the government's response was also quite reasonable - how do you arbitrate when you don't even know the parties involved ha. We have been waiting a long time for anything to happen, and a few weeks at this point isn't the end of things.

 

[jfdes]

6 hours ago, PhD2MD said:

Does anyone have a sense of how difficult it is to start working in another province? Given how toxic Ontario has become for doctors, I'm curious if it would be challenging or time consuming to get credentialed in another province? Or is it just some simple paper work?

Physician compensation is still lower in BC I believe

I think the medical association is on better terms with government though

[NeuroD]

32 minutes ago, jfdes said:

Physician compensation is still lower in BC I believe

I think the medical association is on better terms with government though

No, they're almost identical. Mean payout for all non- family docs is about ~425k in both provinces (before overhead and taxes).

[blah1234]

7 hours ago, PhD2MD said:

Does anyone have a sense of how difficult it is to start working in another province? Given how toxic Ontario has become for doctors, I'm curious if it would be challenging or time consuming to get credentialed in another province? Or is it just some simple paper work?

It's just paperwork to apply for a licence and whatever the processing time is. Although a lot can change from now until the time you're finished residency. 

I personally think many provinces will follow Ontario's lead. The maritime provinces also have similar funding issues and there's no pressure to treat doctors well if there is nowhere left to run. 

[NeuroD]

3 minutes ago, blah1234 said:

It's just paperwork to apply for a licence and whatever the processing time is. Although a lot can change from now until the time you're finished residency. 

I personally think many provinces will follow Ontario's lead. The maritime provinces also have similar funding issues and there's no pressure to treat doctors well if there is nowhere left to run. 

Agreed. Those who are looking to run seem to be focused on either running south or into non-clinical careers, based on my conversations conversations with residents/med students. How much of a drain we eventually get, hard to tell.

[medigeek]

On 12/12/2018 at 8:35 PM, maybe1313 said:

With "off the book" camper cars and lowering requirements to put your bff in charge of the OPP,  this government is shaping out nicely. The OMA and a large amount doctors were super enthusiastic and supportive of this government. They deserve everything this government does to them. But dougy seems to love "helping" out his friends, so maybe Dr. Jacobs will get something out of this. 

Well the NDP would have put worth the same atrocious BA offer and spiked taxes + other costs of living. It's one thing to not get a raise and/or take a pay cut but what about adding staggering costs on top of that? And not to mention imposing an idealogy that threatens our way of life? 

[medigeek]

3 hours ago, PhD2MD said:

Agreed. Those who are looking to run seem to be focused on either running south or into non-clinical careers, based on my conversations conversations with residents/med students. How much of a drain we eventually get, hard to tell.

Run south for family medicine and you get a nice 210k salary as an employee and get told what to do by an MBA. Lol. American medicine is not in any way nice for doctors (minus subspecialists). You'll also have triple the paperwork to do for just about everything. 

[blah1234]

1 minute ago, medigeek said:

Run south for family medicine and you get a nice 210k salary as an employee and get told what to do by an MBA. Lol. American medicine is not in any way nice for doctors (minus subspecialists). You'll also have triple the paperwork to do for just about everything. 

OHIP seems to be the lesser evil compared to dealing with multiple insurers and dealing with pre-authorizations and chasing down payments. The US has it's own pros/cons and job market issues and it does depend on your specialty. 

[medigeek]

4 minutes ago, blah1234 said:

OHIP seems to be the lesser evil compared to dealing with multiple insurers and dealing with pre-authorizations and chasing down payments. The US has it's own pros/cons and job market issues and it does depend on your specialty. 

Yep. And not to mention the incredible surge of midlevels that are coming out in a 10000:1 ratio to doctors. The US is not a better place for doctors in any form unless you're a specialized surgeon or procedural based specialist. 

[blah1234]

15 minutes ago, medigeek said:

Yep. And not to mention the incredible surge of midlevels that are coming out in a 10000:1 ratio to doctors. The US is not a better place for doctors in any form unless you're a specialized surgeon or procedural based specialist. 

I've heard horror stories about the proliferation of CRNAs, and independent practice PA/NPs down there. I wonder if that trend will spread to Canada. 

[medigeek]

1 minute ago, blah1234 said:

I've heard horror stories about the proliferation of CRNAs, and independent practice PA/NPs down there. I wonder if that trend will spread to Canada. 

Oh yes, but it's much worse than what you've heard. CRNAs have taken over anesthesia. PAs and NPs do primary care on their own with minimal knowledge levels. 

The trend will spread in a sense but we don't have the same # of schools for PAs/NPs. They win by numbers, units and mobilization. But numbers is the underestimated factor. 

[NLengr]

8 hours ago, blah1234 said:

I've heard horror stories about the proliferation of CRNAs, and independent practice PA/NPs down there. I wonder if that trend will spread to Canada. 

I expect NP numbers will increase more and more in rural areas at least. Very hard to get/keep family docs in those areas. 

Unfortunately, in my experience, the knowledge base of the average NP seems to be less than the knowledge base of the average family doc, at least for the referrals I get in my specialty. 

[NeuroD]

9 hours ago, medigeek said:

Run south for family medicine and you get a nice 210k salary as an employee and get told what to do by an MBA. Lol. American medicine is not in any way nice for doctors (minus subspecialists). You'll also have triple the paperwork to do for just about everything. 

The first half of that sentence doesn't sound too bad lol...nearly 300k CAD in take home pay as an employee who doesn't need to worry about overhead, perhaps with potential for growth as well...but of course its not that simple

[blah1234]

4 hours ago, NLengr said:

I expect NP numbers will increase more and more in rural areas at least. Very hard to get/keep family docs in those areas. 

Unfortunately, in my experience, the knowledge base of the average NP seems to be less than the knowledge base of the average family doc, at least for the referrals I get in my specialty. 

I agree. I think we dug our own grave. Hard to fight against the encroachment when doctors aren't willing to work in those areas. Citizens deserve some access to care and NPs are willing to provide it.