Doctors from eight medical specialty groups — who are among the highest paid in the province and are facing the prospect of fee cuts — have voted to break away from the Ontario Medical Association.
The “Ontario Specialists Association” or OSA — as the collective of groups is calling itself — is unhappy with the way the OMA has been representing its members in contract deliberations with the province and wants to negotiate its own deal.
The breakaway specialists also don’t like that many doctors want high-billing specialty groups — such as those in the OSA — to be hit with fee cuts. Lower paid specialties — including psychiatrists, geriatricians, infectious disease doctors and pediatricians — argue that the $12 billion the province pays doctors should be more fairly divvied up.
The $12-billion physician services budget represents 10 per cent of the entire provincial budget.
Whether the province will recognize the OSA is still to be determined.
It is unclear exactly how many of the province’s approximately 31,000 active physicians voted in favour of seceding, but it’s believed to be a small number, relative to the size of the profession.
The news release states: “Voting results by specialty in favour of seceding from the OMA” include the following:
- Cardiac Surgery: 78.6 per cent;
- Cardiology: 84.7 per cent;
- Diagnostic Imaging: 90.5 per cent;
- Otolaryngology: 67.2 per cent;
- Ophthalmology: 90.0 per cent;
- Gastroenterology: 78.1 per cent;
- Nephrology: 63.4 per cent;
- Neuroradiology: 95.9 per cent;
- Nuclear Medicine: 76.7 per cent.
But the actual number of doctors represented by these percentages is not clear.
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Adding to the confusion is that the release states eight major specialist groups want to separate, but the above breakdown refers to nine. There are a total of 38.
The physician spearheading the split, radiologist Dr. David Jacobs, did not respond to emails seeking clarification.
There was much discussion among doctors on Twitter about this Thursday, with many contending the total number that voted to separate is quite small.
However, in an earlier telephone interview, Jacobs said: “We were very happy with the high level of participation.”
One physician tweeted only 5 per cent of all of the province’s doctors voted to secede. The OMA estimates the same.
A source close to the talks, who spoke on the condition of anonymity saying some Ontario doctors have a history of attacking people on social media, estimates only 10 per cent of all specialists (non-family doctors and non-general practitioners) voted yes:
“That is not exactly impressive. Even Donald Trump has a higher favourable rating.”
The doctors and province have been without a contract for more than four years. The contract dispute is now in binding arbitration.
Under a binding arbitration framework that OMA members endorsed, the arbitration panel must consider the issue of relativity. That refers to the big pay gaps between the highest and lowest paid specialty groups.
That would not bode well for the OSA. The government is seeking fee cuts as high as 15 per cent for the top paid specialists. Asked if this is why they want to separate and negotiate their own contract, Jacobs responded:
“The whole organization, if you look at the government’s mandate, is facing the prospect of fee cuts.”
Pressed further on the issue, Jacobs said: “You have my comment.”
One major outstanding question is whether the province will recognize the new association. Currently the province recognizes the OMA as the profession’s sole bargaining agent, essentially its union.
The OSA’s news release said the organization’s next step is to meet with government representatives and persuade them, based on the voting results, to recognize the organization.
Hayley Chazan, press secretary for Health Minister Christine Elliott, said the government plans to seek legal advice on how to proceed:
“As a result of the Ontario Medical Association’s recent referendum outcome, our government will evaluate the impact with respect to the existing legal framework for bargaining agents and will consult with legal counsel to confirm next steps.”
OMA president Dr. Nadia Alam pointed out it was not the OMA that carried out the vote and noted questions have been raised about the results:
“The OMA did not conduct this poll, and we cannot verify its validity. A number of members have raised concerns about voting irregularities. This survey is not legally binding because the OMA’s representational rights are baked into our provincial laws and our Representational Rights Agreement.
“So, we will continue to argue for a good deal for all sections at the arbitration table. This remains our top priority.”
The infighting within the profession is heating up at the same time that the OMA is asking the Supreme Court to hear an appeal of a lower court ruling that would make the names of top-paid physicians public. The Ontario Court of Appeal ruled in favour of the Star earlier this year in a decision that would allow for the release of names.
The Star has been trying to get the names released for almost five years in a quest that started with an access-to-information request to the province’s health ministry. The province’s privacy commissioner and Ontario Divisional Court have also ruled in the Star’s favour.
Theresa Boyle is a Toronto-based reporter covering health. Follow her on Twitter: @theresaboyle
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