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Are any Ontario med students turned off from starting practice in Ontario?


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It's definitely on my radar. Fortunately I have a 5 year residency ahead of me and so I am going to watch and see how it all pans out. My family is in Ontario but my fiance's family is in BC (where there may be more opportunities for me to open a private lab etc). In addition, I hold US citizenship. Bottom line, while compensation won't be my deciding factor, given that I might have various factors pulling me in various directions, it certainly will enter the equation.

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I'm curious as to your views. I'm not from Ontario but would not consider practicing there in view of the latest developments. Of course, we don't know what other provinces might eventually come up with to save money.

 

Far too early in the game. Just staying informed. OMA is pretty powerful - this is not going to just go through without massive . I don't see parallel changes in the provinces out west. That will cause a rapid migration of physicians both west and south, leading to significant shortages in Ontario. Population will rage and beat down McGuinty and his mouthpiece, Matthews.

 

This whole thing started because of rampant tax cuts to appease the population in re-elections. Health care spending has only gone up 1% of the GDP over the last 20 years. Tax cuts are THE primary reason for our budgetary issues, not health care spending. While I agree a freeze is in order given the recessionary climate, slashing left, right and center is not the answer - especially when it is clear they have not thought it out.

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Far too early in the game. Just staying informed. OMA is pretty powerful - this is not going to just go through without massive . I don't see parallel changes in the provinces out west. That will cause a rapid migration of physicians both west and south, leading to significant shortages in Ontario. Population will rage and beat down McGuinty and his mouthpiece, Matthews.

Yeah, I'll reiterate what I've stated in other threads. I am in favor of certain cuts in billing e.g. cataracts. Honestly, 10% seems kinda low considering the procedure now takes 1/8 of the time. Now I know how to make a ton of money when I graduate (invent some procedure that takes a very very long time, then magically come up with new technology that shortens it considerably, only take a 10% pay cut).

 

I could see changes like this being made in other provinces. However, cuts to already lower paid specialties on average like family med might be harder to push, and I don't see those sticking around (if that one comment is correct) unless McGuinty manages to persuade the other provinces to follow suit. Otherwise they might try it for a couple years, then realize all their GPs are leaving for other provinces and reinstate the original billing amounts.

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Yeah, I'll reiterate what I've stated in other threads. I am in favor of certain cuts in billing e.g. cataracts. Honestly, 10% seems kinda low considering the procedure now takes 1/8 of the time. Now I know how to make a ton of money when I graduate (invent some procedure that takes a very very long time, then magically come up with new technology that shortens it considerably, only take a 10% pay cut).

 

I could see changes like this being made in other provinces. However, cuts to already lower paid specialties on average like family med might be harder to push, and I don't see those sticking around (if that one comment is correct) unless McGuinty manages to persuade the other provinces to follow suit. Otherwise they might try it for a couple years, then realize all their GPs are leaving for other provinces and reinstate the original billing amounts.

 

self-referral cut was pretty stupid and smart at the same time.

 

Essentially, 2 GPs can refer their patients to each other instead of self-referring -- problem avoided?

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self-referral cut was pretty stupid and smart at the same time.

 

Essentially, 2 GPs can refer their patients to each other instead of self-referring -- problem avoided?

I'm sure someone would notice if that kept happening between the same 2 GPs. But I was referring more to some comment in one of the many Globe and Mail articles on this topic, someone actually quoted it in one of the (also many) threads about the topic on this forum. Basically some guy claiming to have inside information said that the next step in this plan is to focus on cutting family doc pay further which would apparently result in about a 50% net income for most.

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I've also heard that the plan is to eventually remove fee-for-service, essentially making all doctors employees of the state who are paid an hourly wage.

 

As stupid an idea as that sounds, I'd actually love to see it happen in at least one province, as a kind of social experiment. Sometimes I just like to sit back and watch the world burn.

 

That wouldn't be so bad as long as they got all the other benefits of public service i.e. pension, health, etc.

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That wouldn't be so bad as long as they got all the other benefits of public service i.e. pension, health, etc.

 

I still don't like the loss of independence. Ultimately the government will start asking doctors to do things in particular ways that potentially you might not agree with. We serve our patients first and foremost.

 

Also I am just imagining the general slow down in things if everyone was on salary :)

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self-referral cut was pretty stupid and smart at the same time.

 

Essentially, 2 GPs can refer their patients to each other instead of self-referring -- problem avoided?

 

No self-referral means the same group. So a cardiologist that refers a patient for an echo at the same institution will be considered "self-referral". I think that's true even if it is a different institution, although not 100% sure about that one.

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No self-referral means the same group. So a cardiologist that refers a patient for an echo at the same institution will be considered "self-referral". I think that's true even if it is a different institution, although not 100% sure about that one.

 

That will certainly have to be straightened out. Didn't the OMA send a notice a few days ago regarding them contacting the government for clarification of the term "self-referral".

 

If they decide to say that referring to another specialist within your specialty is a self referral and the second person only gets paid half for the consult expect the following example to be the new standard.

 

Cardiologist #1 (who is an expert in say arrhythmia, but does not do interventional) decides that his/her patient needs a pacemaker.

 

Old way: Refer to interventional cardiologist. Pacemaker inserted. Patient happy.

 

New way: Send letter back to the family doctor saying patient needs a pacemaker. Family doc sends a second referral to the interventional cardiologist. Second cardiologist then books the patient as a new consult. Sees the patient as a new consults. Schedules pacemaker. Completes pacemaker. Patient happy, but has been waiting extra time and possible deteriorated.

 

So basically all that has been done is we have increased wait times and cost the system extra cash. Awesome.

 

If they are saying you shouldn't refer patients to equipment you privately own, well that's a different, and slightly more reasonable debate.

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