Section General and Family Practice - Review of tPSA


By: Dr. David Schiek

The PSA came out of left field, with negligible input from the negotiating committee.
The MOH has written the agreement in their interests. The press release from the MOH and OMA differed significantly. The prior agreement we had with severe flaws lead us the vulnerability we have been subjected to in the past few years. The unilateral actions have been ruthless and not retracted, besides a token carrot of FHO conversion with the basket of services being covered changed in the interim. The New Graduate program was a fiasco and alienated many new doctors. The OMA did not vigorously defend this "program". The MOH has abandoned it's promotion because of how onerous it was. We cannot look at this PSA in isolation of what we have been exposed to. The OMA has been hoodwinked and manipulated and this agreement has enough vague bear traps we will be subjected to once again. There is nothing concrete to ensure the OMA has a right to represent us with any teeth in this agreement. This agreement has no merit -there is reference to have patients seen the same day or the following and work stat holidays. Utilization in this province by patients is 3 times more than similar jurisdictions overseas. This is not being curtailed by any defined metrics in this PSA.

Look line by line at all these items and it is a waste of money to promote a deal that is only for MOH.

Co-management is a euphemism for passively agreeing to caps and of course unilateral controls are no longer needed by such a mechanism. There is nothing to COMANAGE when you are told to how to co-manage. The health minister is ominously suddenly quiet and is waiting like the wolf for little red riding hood to be delivered by the OMA and we once again will be devoured. What a travesty to see an organization represent the MOH in even circulating this agreement and approving it "tentatively" without consultation. This is an agreement that will divide the OMA with specialists targeted moreso who have less representation. This forum is best designed for those of us who want to warn members of the dangers and sending the already heavily broadcasted message here is not helpful as we have no balance in the objective dissection of this agreement by the OMA , which would be transparent and refreshing. Until now I had been one of the more passive members and with the "selling of the deal" by the OMA I am perturbed, and this cooperation with the MOH has made me feel betrayed to put it mildly. I see nothing in this PSA that could be construed as designed in favour of the OMA members. This is being sold as a fear agreement- if you don't agree the beatings will continue. We should not cave into this PSA. The minister needs egg on his face and needs to take responsibility for his attack on his own profession. We all have to make an individual choice and vote accordingly. Only someone battle fatigued could agree to support this PSA.

This PSA should be a battle cry to protect ourselves more and not capitulate.
I have never ever witnessed such a document which such paucity of detail except to state there is nothing beneficial to the members now or in the future. The revised legislation is proposed to be changed- we have no knowledge or assurance on that matter. The unilateral controls can be readily supplanted by the new legislation and therefore of course there is no need for them anymore, especially with the global cap and ill defined fee modernization. To achieve such modernization all fees can be revised- not just ophthalmology as the whipping section to flush money to the rest of members. Exposing minority members to income erosion without representation is not something I believe in. We already had our annual check fee significantly chopped to periodic health exam and the diabetic management fees are all changed also to minimize potential to earn that fee.

These are now entrenched changes that will not be reversed and the fee changes are far greater than the 7% widely reported. Don't forget if you have the energy to work more or have a large roster auditing and practice profiling is in this agreement. Do I need to say more?

The NO vote is not supported to do a road show. The OMA has ratified this agreement and in essence they are selling this agreement to us and are trying not to ram it down our throats as this would backfire. However it is coming on strong, as the OMA board without grass roots input on this agreement should have refused to transmit this agreement with approval- this was a demand of the MOH -so in essence the OMA has become the pawns of the MOH and they cannot see it, out of fear of not placating the members in not presenting some bone. However this bone is not worth transmitting and the members would feel better if they felt their board is not manipulated and we are protected from the MOH bullying. If we are all united- board, council, all sections of members, concerned doctors of Ontario we will be a very strong force to reckon with. We are playing into the hands of the MOH by not being united, as we should be and if all of the above components issued a unifying statement of defiance we would win this battle and certainly not weaken ourselves further by accepting this agreement. There is little need to have the OMA media machine transmit the press release into a discussion forum. I like the analysis of members and there is a YES roadshow , irrespective of what may be said. The messaging is on point and reverts back to the original text of the agreement, which cannot be dressed up to appear better as it is fundamentally flawed. I have tried to see the positive in it and it does not exist. We will ultimately win the battle by not cooperating.

Services need to be provided and we need to be paid for these services and not at discounted rates.