The OHIP fee schedule is now 50% of the OMA recommended fee schedule.
A fall of 50% in 45 years of State control.
The Liberal Provincial Govt has cut a further 5% this year.
The Liberal Provincial Govt. has given Diagnostic, Investigation and Prescribing rights to REGISTERED NURSES & PHYSICIAN ASSISTANTS.
The Liberal Provincial Govt . has given PHARMACISTS the right to give immunizations and CHANGE MDs' prescriptions. without consultation
MDs still have to REGISTER DEATHS.
In the mid- 1970s the .slogan of the Left- wing Toronto School of Public Health was "BREAK THE MEDICAL MODEL"
Many Ont. GPs are leaving general practice for so-called "focused" practice known for years in the UK as "GPwSI" GP with SPECIAL INTEREST who often work in Community hospital clinics under the direction of a specialist.
Examples in Ontario
GP-psychotherapy = usually social problems. (Govt does NOT pay CLINICAL PSYCHOLOGISTS who are trained for the job). GP-psychotherapy a useful retirement job for Public Health doctors..Now also called Primary Mental Health care. Cheaper overhead.
SPORT MEDICINE with NON-OHIP physio.
ORTHOTICS ($400 an insole) NON-OHIP
GP-ANAESTHESIA
GP-REFRACTION (NON-OHIP from 20-64y)
GP-HOSPITALIST (NO OVERHEAD)
GP-mainly work in Home for Aged & Nursing Home
GP WELLNESS CLINICS : patient pays $3,500/yr which includes extra services eg Dietitian & Physio).GP does not bill OHIP for patient visits.Favoured by upper-middle classes.. In USA TRIO of INTERNIST + OB/GYN + PAED. often provide PRIMARY SERVICES.
GP in Ontario separating into (NON-OHIP GP) WELLNESS CLINICS for those willing to pay and increasingly RN & PA services for the rest.
Some pharmacy chains offer FREE RENT, STAFF & SUPPLIES to eliminate 40% overhead.(Officially not allowed by CPSO but situation "tolerated")
Rural towns offering FREE HOUSING & OFFICE
A.Franklin
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