An Open Letter

Doctors for Responsible Healthcare (DRH) is a new grassroots movement formed by resident and staff physicians in Toronto that aims to change the culture of anger and confrontation that has overtaken much of Ontario’s medical community in the past year. Talk of physician job action and increasing privatization of health care has intensified.

We know that many of our colleagues feel frustrated and fed up by the lack of respect shown to physicians in the last cycle of negotiations with the Ministry of Health. We acknowledge that a fair and just relationship must be solidified between the OMA and the Ministry. But we encourage our colleagues to consider a way forward built on reason, respect, and patient-centred care.

We call for a stand against physician job actions that will jeopardize patient care. We support the concept of job action in general as a tool to protect and promote labour rights; however, we feel that doctors are a uniquely powerful and privileged group in society, and that physician job action cannot be justified if we truly care about putting patients first. We also support a health care system with access based on patients’ needs, rather than their ability to pay.

We need to look to the future and imagine a stronger, more efficient, and more equitable health system, including a just relationship between the OMA and the Ministry of Health. At this critical juncture, we have a chance to breathe new life into a medical system that, with all its flaws, is a testament to who we are as a society. Our guiding principles are as follows, with acknowledgement to the writers of the letter “A Way Forward [imbed hyperlink]” for their inspiration and wording:

1) We affirm the need for a fair and independent process to determine key elements of physician compensation, as is the case in most other provinces. For this reason, we support the universal call across the medical profession for a just and fair process, involving a third party, when necessary, for resolving disputes.

2) We believe that government should commit to adjusting the physician services budget to account for population and demographic changes and net new physicians in the system, with reasonable compensation changes, where justified, from time to time. At the same time, we recognize the obligation of physicians to engage in evidence- based practices and to prudently manage the clinical services we provide so that the physician services budget is responsibly managed.

3) We believe that all doctors should be fairly compensated, but we also acknowledge that technological and other changes over the last few decades have led to circumstances in which the fees for certain services do not appropriately reflect such factors as time, complexity, costs of practice and other clinical measures.Fairness in net earnings across services, disciplines and specialties is essential.

4) We reaffirm – and call on Government and the OMA to reaffirm – commitment to the principle of access to health care based on need, without Ontarians being required to pay out of their own pockets for necessary physician and hospital services. We unequivocally reject proposals from a small number of physicians to charge patients above OHIP payments in order to increase their own incomes (extra-billing) or to charge the sick for access to services (user fees).

5) We oppose any form of physician job action including limited withdrawal of services or ceasing to be part of administrative processes with Government such as the LHINs.




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