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
-
9 Oct 2015
8 Oct 2015
OMA DISTRICT 11 (TORONTO) DIRECTOR OBS/GYN RACHEL ALIZON FORMAN MD (Tor 86) FRCSC(2004)
OMA needs a personable spokesperson.for media appearences.
Tall, stylish, well-groomed Dr Rachel FORMAN, mother of two , is the choice of many OMA members. for President.. Living in Toronto is an advantage.
Tall, stylish, well-groomed Dr Rachel FORMAN, mother of two , is the choice of many OMA members. for President.. Living in Toronto is an advantage.
7 Oct 2015
NATIONAL POST: CPSO drafts patients' Bill of Rights
Doctors object to ‘vague’ patient-first principle in medical regulator’s draft bill of rights
Getty Creative ImagesThe
catalogue of almost 50 patient rights and doctor responsibilities in
the draft Ontario College of Physicians and Surgeons document begins
with relatively basic statements, such as that doctors will “always put
your needs first,” and “treat you with dignity, courtesy and respect.”
(COMMENT: This year's CPSO Pres. CAROL ANNE LEET MD(Queen's 1983) FRCPC(Paediatrics)
Brampton Ont- a Western suburb of Toronto ,near the Int.Airport with 39% South Asian population.)
(COMMENT: This year's CPSO Pres. CAROL ANNE LEET MD(Queen's 1983) FRCPC(Paediatrics)
Brampton Ont- a Western suburb of Toronto ,near the Int.Airport with 39% South Asian population.)
In an apparent first for Canada, the country’s largest medical regulator has drafted a patients’ bill of rights, but some doctors are objecting to its “vague” assertion that patients’ needs always be made paramount.
That and other rights outlined in the proposed Ontario College of Physicians and Surgeons document could create unrealistic expectations, some physicians suggested in feedback on the proposed manifesto.
“A patient reading this could call the college and say ‘My doctor didn’t put my needs first. I needed an hour and only got 10 minutes,’ ” one critic says. “Clarification is necessary.”
One commenter asks if always putting the patient first means “I will open up the office on a day the office is closed to accommodate this patient’s schedule … or bend backwards to accommodate the repetitive verbal abuse at staff by an uncompromising patient?”
Another physician simply called the outline of rights and responsibilities “ridiculous,” and added that it fails to respect medical professionals.
Some medical associations, patient groups and hospitals have created patient bills of rights in the past, but the college’s report would appear unique in that it comes from a body that governs and disciplines physicians.
The three-page list says patients have a right to be treated with dignity and respect, reject certain treatment if they disagree with it, be free of sexual advances and not face requests for personal favours or loans. As part of a professional relationship, patients should not even receive invitations from physicians “to their house for coffee.”
Getty Thinkstock“A
patient reading this could call the college and say ‘My doctor didn’t
put my needs first. I needed an hour and only got 10 minutes,’ ” one
critic says.
While colleges in other provinces have done some work in the area, Ontario appears to be first to release such a document, she said.
“The more information the public has that’s easily understood, the more empowered they are and the less likely it is that someone is going to try to cross those boundaries,” she said.
The document is only a draft now, and may have to be adjusted in response to feedback, Leet said.
The catalogue of almost 50 patient rights and doctor responsibilities begins with relatively basic statements, such as that doctors will “always put your needs first,” and “treat you with dignity, courtesy and respect.”
It goes on to address possible unprofessional behaviour, saying doctors must never talk about their personal problems or sexual activities, ask for money, or make physical contact that is not medically necessary. Another section says doctors must explain the reasons for “physical or intimate” examinations and allow a third party to be present if requested.
A patient advocate said Thursday the document is positive as far as it goes, but neglects the most widespread concerns patients have about poor service.
The statement appears to address almost entirely the kind of serious misconduct the college handles in its disciplinary process, said Sholom Glouberman, founder of the Patients Canada advocacy group.
“It’s all about what doctors shouldn’t do, rather than what doctors should do to improve relations with patients,” said Glouberman. “It says nothing about same-day service, it says nothing about patients being able to access doctors through email, it doesn’t say anything about the doctors being there for the patient.”
Some of the physicians who submitted comments, though, worried about unintended consequences of the rights package, which says patients can contact the college any time they have questions or complaints about their MD.
Others suggest doctors are hampered in offering the “best-quality health care possible” – the second listed right – by the system’s limited resources.
“The (health) ministry keeps cutting our fees and the (college) keeps raising the expectations,” writes one. “Is this dichotomy between resources and expectations sustainable in reality?”
National Post
6 Oct 2015
OMA & Ont Govt impasse on Contract.
A suggested response
"GO LEAN
1) NO appointments. First come... etc. Take a number
2) Only same gender patients . Avoids expensive risk of sex abuse complaints to CPSO. . Chaperone RPN in exam room too expensive.
3) Agency receptionist. Fewer benefits, .Flexibility.. Avoids calculating pay deductions tax etc.
4)
Diversify:Occupational portfolio: Non-OHIP jobs e.g. MPP; Insurance
medicine; Orthotics; Refraction 20-64y; Cosmetic medicine, develop
Medical, Sport and Travel clinics. Non-OHIP Psychoanalysis ;
Manipulation; Acupuncture etc
5) Get multiple provincial licenses for job mobility.
6) Ensure office can be sub-let.
"GO LEAN
3) Agency receptionist. Fewer benefits, .Flexibility.. Avoids calculating pay deductions tax etc.
2 Oct 2015
Rise of the GPs who retire in their 50s: Thousands hit £1.25million pension cap, then leave
- Pension changes have made it unprofitable for GPs to carry on working
- 5,117 have left since 2012-13 and the average retirement age is now just 59
- Accountants say the issue is a ‘ticking time bomb’ for GP provision
- More younger doctors are moving to Australia, New Zealand and Canada
Soaring
numbers of GPs are retiring in their fifties because pension changes
have made it unprofitable for them to carry on working, experts warn.
A total of 5,117 have left since 2012-13 and their average retirement age is now just 59, and falling.
Accountants
say there has been an ‘acceleration’ in the numbers retiring in their
mid-fifties in the past 12 months and the issue is a ‘ticking time bomb’
for GP provision.
They
put it down to the Government imposing a £1.25million cap on the amount
all employees can put into their pensions over their careers.
Soaring numbers of GPs are retiring in
their fifties because pension changes have made it unprofitable for
them to carry on working, experts warn
Although
this seems high, many family doctors on six- figure salaries hit the
limit by the time they reach their early to mid-fifties.
This
means there is little incentive to carry on practising, especially if
they are already demoralised by targets and rising patient demand.
Figures
from the NHS Business Services Authority, which oversees pensions, show
that in 2014-15, 1,697 GPs retired. This represents 5.2 per cent of the
entire workforce of 32,628 full-time GPs in England.
The average retirement age was 59.16 but has decreased year on year from 59.46 in 2012-13 and 59.29 in 2013-14.
A
separate Government-commissioned survey of 1,172 family doctors by the
University of Manchester revealed this week that 60.9 per cent expected
to quit ‘direct patient care’ in the next five years. The exodus is
leaving surgeries desperately understaffed, with one in ten GP posts
currently empty.
As
a result, patients are finding it increasingly difficult to get an
appointment and at many practices waiting times are longer than three
weeks. Tim Godfrey, of Bishop Fleming, an accountant specialising in
providing retirement advice to GPs, warned the exodus was ‘pervasive’
across the country.
He
said that in the past 12 to 18 months, the number of GPs taking
retirement in their mid-50s had accelerated and was likely to increase.
He
added: ‘There’s this ticking time bomb of doctors in their early
fifties who were planning to go on a few more years who are now saying,
“Do you know what – 55 comes along, I’m going to be off… This is an
opportunity for us to move on”.’
He
said the NHS was losing their years of experience while surgeries were
being left in the hands of young doctors, fresh out of training. ‘It’s
almost a perfect storm,’ he added.
Accountants put it down to the
Government imposing a £1.25million cap on the amount all employees can
put into their pensions over their careers. Pictured is Britain's
Chancellor of the Exchequer George Osborne
Mr
Godfrey blamed the trend on a new lifetime pension limit of
£1.25million imposed by Chancellor George Osborne in April’s Budget.
This
will be lowered even further next year to £1million as the Government
tries to reduce the amount it pays to pension savers in tax relief.
The rules apply to all employees but only GPs and other high-earning professionals with good pensions are affected.
On
top of the retirement surge, more younger doctors are moving to
Australia, New Zealand and Canada, where they enjoy a better work-life
balance while earning more.
The
combined exodus is leaving surgeries understaffed. A snapshot survey of
549 of the 8,500 practices in England by the Royal College of GPs found
10.2 per cent of full-time roles are empty.
NHS England said there were 5,000 more GPs than ten years ago and the career remained ‘hugely rewarding.
1 Oct 2015
VIENNA DOCTORS" BALL
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24 Sept 2015
GLOBAL NEWS: ROGERS CENTRE BASEBALL PRICES. shows degree of disposable income for playtime
SINGLE SEAT
$425
$80
$50
If Local team,"Blue Jays" goes to World Series: $1400.
Canada Health Act (CHA) forbids an Ontario MD to charge a dollar above the Provincial tariff. Does not differentiate between rent and taxes for an office in Central Toronto business area and a remote Rural practice.. Only Francophone QUEBEC allows private medicine.after the CHAOULLI CASE. Dr Chaoulli & (70y patient) G.Zeliotis vs Quebec 2005 Supreme Court Canada 35
(WIKI) Jacques Chaoulli is a physician best known for launching a Supreme Court challenge against the ban in Quebec on private health care.[1] He has French and Canadian citizenship.
In 2006, he called for further privatization to improve wait times.[4]
He currently serves as a special advisor to the Conservative Party of Quebec.
$425
$80
$50
If Local team,"Blue Jays" goes to World Series: $1400.
Canada Health Act (CHA) forbids an Ontario MD to charge a dollar above the Provincial tariff. Does not differentiate between rent and taxes for an office in Central Toronto business area and a remote Rural practice.. Only Francophone QUEBEC allows private medicine.after the CHAOULLI CASE. Dr Chaoulli & (70y patient) G.Zeliotis vs Quebec 2005 Supreme Court Canada 35
(WIKI) Jacques Chaoulli is a physician best known for launching a Supreme Court challenge against the ban in Quebec on private health care.[1] He has French and Canadian citizenship.
Chaoulli was born in France in 1952 and earned a medical degree from the Paris Diderot University. In 1978, he moved to Quebec to study medical education and earned a Master's degree from Université Laval in 1982. Chaoulli has practiced medicine in Quebec since 1986 and is now a general practitioner in Montreal.[2]
In 2005, Chaoulli launched a court challenge against the Quebec government with the Supreme Court of Canada, arguing the Canadian implementation of publicly funded health care was not effective at delivering an adequate level of care.[1][3] After losing in two lower courts, he won the Chaoulli v. Quebec (Attorney General), the Supreme Court's decision on the case, causing a change in the Quebec government's policy on wait times and privatization.In 2006, he called for further privatization to improve wait times.[4]
He currently serves as a special advisor to the Conservative Party of Quebec.
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