New OMA notice - cuts to fees

[Robin Hood]

I shoulda read closer.

 

I disagree however that the majority of people entering medicine are motivated by financial gain primarily. In my experience, for most, it's a secondary or tertiary motivation. A really nice bonus. Maybe your experience is different, in which case I pity the med class you are in.

 

I'm still a premed, but isn't money the reason why the application pool is so high? I don't think human beings are that nice for the majority of aspiring physicians to not be there for the money. Hope I'm wrong.

[Robin Hood]

Isn't a car almost essential for med school anyway? At least during clerkship?

 

I hope it won't be at the med school I will attend (if I get in), because I can't drive (because of my vision).

[NLengr]

I'm still a premed, but isn't money the reason why the application pool is so high? I don't think human beings are that nice for the majority of aspiring physicians to not be there for the money. Hope I'm wrong.

 

It's a combination of things. Rewarding, respected, challenging job. High degree of autonomy. Strong science aspect, minimal big business idiocy. Work extensively with people to improve lives. Good compensation.

 

Put it all together and you have a very appealing career.

 

It wasn't just the rural aspects that required a car. Hours are random and frequently very late or early. You may need to switch learning sites throughout the day. It doesn't lend itself well to busses. Toronto or another major center might be easier because of more extensive public transit and poorer car infrastructure.

[aaronjw]

McGuinty seeks provincial allies in fight to reduce doctors fees

http://www.theglobeandmail.com/news/politics/mcguinty-seeks-provincial-allies-in-fight-to-reduce-doctors-fees/article2431541/

 

LMAO. He can't led his own province (unless into financial disaster) yet is trying to lead a Canadian alliance against Doctors?

[Robin Hood]

McGuinty seeks provincial allies in fight to reduce doctors fees

http://www.theglobeandmail.com/news/politics/mcguinty-seeks-provincial-allies-in-fight-to-reduce-doctors-fees/article2431541/

 

LMAO. He can't led his own province (unless into financial disaster) yet is trying to lead a Canadian alliance against Doctors?

 

Seems B.C. is following suit.

[Prince Medward]

Here is a comment to a Globe and Mail article on the impact of Ontario doctor fee cuts on Family Doctors. It's hard to find info on the imact of the cuts on GPs and this is one of the few bits of info I have seen.

 

Can anyone share their insights on the impact of the cuts on GPs?

 

I see some posters commenting that just the specialists are getting severe cuts....actually I have seen the entire agenda being imposed by the MOH for the next 4 years and starting next year, Family physicians are getting SEVERE cuts....we are losing all our chronic care bonuses to care for diabetics and elderly, our fees for general visits are being slashed, and our gross income getting clawed back. All our Medical Education updates are now not being reinmbursed, and our liability insurance is not going to be subsidized any more, so for most of us it will triple or quadruple. Worst of all, within 2 years, the goal is to eliminate fee for service, and have all family doctors working as "employees" (still without benefits, of course! ) of the LHINs, being answerable for all their visits and work hours to administrators. We will be docked for our patients not only going to walk-in clinics, as we are now, but even to the Emergency room! We are to absorb costs for all the new doctors getting liscensed in Ontario (presuming there will be any!) Talking with some very experienced docs who have been through many cycles of ebb and flow with government funding, the thinking is that this will result in approximately a 50% cut in net wages to most docs in the province by year 4. (Remember our rents and supplies continue to climb, and our employees continue to expect raises and performance bonuses!). It is, for the first time, going to be financially unfeasible for the average doc to earn a decent living here. I do not think it is crazy to say that Ontario may lose 50% of its MDs to retirement, moving to the US where Obamacare is searching for 90,000 new MDs to provide 5 yr contracts, or other sunnier provinces. If this worries you, please write to your MPP and ask him or her who will provide you primary care when your doctor closes her practice? Or, just don't get sick.

 

 

http://www.theglobeandmail.com/news/...rticle2431541/

 

NOTE: this was posted as a new thread in Primary Care Residencies but maybe it is better here.

[1234]

Not sure if you all have been made aware of this.

 

Proposal: "New physicians will receive scaled payments in the first five years of practice and encourage practice in needed specialties and geographic areas."

 

Cut to first year staff physician could be as high as 50% of salary.

 

That is from an official document from MOH to OMA.

[A-Stark]

**** McGuinty.

[aaronjw]

**** McGuinty.

 

I'd rather toss him off a cliff in a burlap sack but you do what you want instead lol

[1234]

Well, when we lose 50% of physicians to the US, its going to be quite a disaster. All the new recruits are going to leave and physician needs will be met by international physicians. I'm sure the population will love spending money training top tier physicians only to watch them leave.

 

The government has been notoriously poor at predicting physician requirements. When we have concurrent mass retirement (which is expected upon further rebound of the economy) and mass exodus due to physician remuneration, those health care metrics such as wait lists will skyrocket. Right now, they are oblivious and think the oversupply of physicians is going to last.

 

 

I'm just waiting for two-tier in Canada.

[aaronjw]

Well, when we lose 50% of physicians to the US, its going to be quite a disaster. All the new recruits are going to leave and physician needs will be met by international physicians. I'm sure the population will love spending money training top tier physicians only to watch them leave.

 

I'm just waiting for two-tier in Canada.

 

We already have it. It's called rural and urban health care.

[1234]

We already have it. It's called rural and urban health care.

 

I'm talking an overt two tier system, not some under the radar system that is applicable to 2% of the population.

[aaronjw]

I'm talking an overt two tier system, not some under the radar system that is applicable to 2% of the population.

 

try 20% of the population that's serviced by less than 10% of all family physicians and less than 3% of all specialist physicians.

 

Equates to 1 family physician for every 1757 people and 1 specialist physician for every 6327 people.

[1234]

try 20% of the population that's serviced by less than 10% of all family physicians and less than 3% of all specialist physicians.

 

Forgive the hyperbole. Nonetheless, that is not the two-tiered system I was referring to, as it isn't a private-public split. It is simply a urban-rural split that does nothing to increase fiscal resources within the system.

[Prince Medward]

My prediction is that if it is true that GPs are facing a 50% reduction in net income, most GPs will opt out of the public system and bill patients directly.

 

I'd say that 80% of people would not object to paying $50-$100 out of pocket for a visit. The other 20% will suck it up and complain. A few people will die because they don't want to sacrifice thier cell phone or cable TV for a month to see a doctor.

 

Doctors will be paid enough that they can do prescription refill freebees via phone or email. Most people, patients and doctors, will be happier. Insurance companies will love it because they can market insurance for this.

 

Remember, at the beginning of Canadian public medical care, only hospital stays were covered. Eventually all MD services became covered.

 

I expect that we will come full circle.

[japlanet]

My prediction is that if it is true that GPs are facing a 50% reduction in net income, most GPs will opt out of the public system and bill patients directly.

 

Except that is illegal in Ontario, is it not?

 

The 50% reduction to GPs sounds unrealistic. The OMA was quoting 16% on average per physician over 5 years, but I imagine most of that is going to be felt by rads/optho/cardiology, and to a lesser extent anesthesia.

[aaronjw]

So, in something like this: are you willing to pay back the FULL cost of your medical training to the taxpayer who funded your ability to go to medical school and practice medicine?

 

My prediction is that if it is true that GPs are facing a 50% reduction in net income, most GPs will opt out of the public system and bill patients directly.

 

I'd say that 80% of people would not object to paying $50-$100 out of pocket for a visit. The other 20% will suck it up and complain. A few people will die because they don't want to sacrifice thier cell phone or cable TV for a month to see a doctor.

 

Doctors will be paid enough that they can do prescription refill freebees via phone or email. Most people, patients and doctors, will be happier. Insurance companies will love it because they can market insurance for this.

 

Remember, at the beginning of Canadian public medical care, only hospital stays were covered. Eventually all MD services became covered.

 

I expect that we will come full circle.

[apache]

that would depend on how much in taxes your family pay, i suppose. 100 g a yr?? times 4 years? i'd have a phd in clin psych in 6, so they're getting value for the last 3 years of protrusively long residency, i guess i'd pay the 100 g or so residual. least then u'd have more autonomy and wouldn't bill the same as hack with the same title down the street.

 

So, in something like this: are you willing to pay back the FULL cost of your medical training to the taxpayer who funded your ability to go to medical school and practice medicine?

[aaronjw]

that would depend on how much in taxes your family pay, i suppose. 100 g a yr?? times 4 years? i'd have a phd in clin psych in 6, so they're getting value for the last 3 years of protrusively long residency, i guess i'd pay the 100 g or so residual. least then u'd have more autonomy and wouldn't bill the same as hack with the same title down the street.

 

No. The point is if a physician trained with tax payer money wishes to withdraw from the public system and bill patients directly then they should be forced to pay back the FULL amount of their medical education and training.

[PhoenixFlare500]

McGuinty seeks provincial allies in fight to reduce doctors fees

http://www.theglobeandmail.com/news/politics/mcguinty-seeks-provincial-allies-in-fight-to-reduce-doctors-fees/article2431541/

 

LMAO. He can't led his own province (unless into financial disaster) yet is trying to lead a Canadian alliance against Doctors?

 

The only way these changes will stick (especially the one about cutting family doc pay in half) is if the other provinces get in on it. Otherwise there'll just be a big rush from Ontario to places like Alberta, leaving a huge gap in Ontario for a few years until the government decides to smarten up. If the other provinces do join, then all those increases in medical school spots will have been for nothing 'cause a lot of grads might just leave Canada, and it'll make other people less likely to go for med. Or maybe this would start a big push towards mainly privatized health care.

[PhoenixFlare500]

No. The point is if a physician trained with tax payer money wishes to withdraw from the public system and bill patients directly then they should be forced to pay back the FULL amount of their medical education and training.

Nobody forces cosmetic plastic surgeons to pay back the full amount of their education and training. As such it's pretty unreasonable to force other docs who would opt out of the public system to do so.

[aaronjw]

Nobody forces cosmetic plastic surgeons to pay back the full amount of their education and training. As such it's pretty unreasonable to force other docs who would opt out of the public system to do so.

 

I'd have no problem with them being required to pay back their cost of training either.

 

My stance is: if physicians wish to operate outside of a publicly funded system which they were more than happy to enter into in order to receive their training then they should be required to pay back the cost of training.

 

There's a reason why many prefer to receive their training in Canada as opposed to the US: its cheaper

[PhoenixFlare500]

I also have to point out that all university education is subsidized by the government. Even Quebec students, bless their financially disadvantaged souls.

 

Some of these grads go onto have jobs that revolve around private billing as well e.g. psychologists. Some go on to be businessmen and get outrageously disproportionate bonuses from the companies they work for (and end up getting paid more than physicians). Do you feel more comfortable with these outcomes, or would you rather overhaul our entire educational system?

[1234]

I'd have no problem with them being required to pay back their cost of training either.

 

My stance is: if physicians wish to operate outside of a publicly funded system which they were more than happy to enter into in order to receive their training then they should be required to pay back the cost of training.

 

There's a reason why many prefer to receive their training in Canada as opposed to the US: its cheaper

 

Canadians want to train in Canada because they want to practice in Canada. They are Canadian. If the cost was $250 000, matching the US, Canadians would still want to train in Canada.

 

So, by your logic and extension, if the population does not serve the country, they should not be entitled to subsidization. What kind of foolish logic is that? My tax payments ENTITLE me to the privileges of society, not my loyalty to serve the country. I, nor anyone else, shouldn't have to pay for their autonomy. I AM NOT A SLAVE BECAUSE I RECEIVE RESOURCES THAT I AM ENTITLED TO RECEIVE AS A TAX PAYER. This would be different if MOH and OMA were in negotiation. They are not. The government is set to unilaterally make contractual changes without approval.

 

So, by extension of your rationale, should students that get job offers in the US after training in Canada be forced to pay back their educational subsidies?

[NLengr]

I'd rather toss him off a cliff in a burlap sack but you do what you want instead lol

 

Ontario is in full fledged panic mode now that they have realized how broke they are.

 

Unfortunately, because it's panic and not sound financial reasoning Mcguinty is continuing to waste huge sums of money (for example, full time kindergarten), while simultaneously gutting other areas without consideration to the consequences. I have no idea why they commissioned the Drummund report because all they are doing is ignoring it.