Health care changes leave out young docs 0
The chief of the Georgian Bay Family Health Team says recent changes to health care in Ontario could jeopardize recruitment of physicians in under-serviced areas.
The applications of three recent-graduated doctors to join the Georgian Bay Family Health Team's have been suspended while the ministry reviews the model of new family physicians joining Family Health Organizations or Family Health Networks.
“The very disappointing thing is that the ministry has gone ahead and done these changes without any sort of consultation with the doctors,” said Sohail Gandhi, one of the doctors who founded the Georgian Bay Family Health Team. “There has been no explanation for what happened and why it has happened.”
Gandhi said a doctor who had been actively recruited for the group practice in Stayner might not receive approval to join the team.
He said a number of family health team executive directors who are members of the Associated Family Health Organization have sought answers from the Ministry of Health, and have all been met with the same standard answers that the model is under review.
“The ministry is currently conducting a review of policies and procedures related to registration of primary care practice groups and physicians in the various primary care physician compensation models. This review will be complete in the fall,” said Sheamus Murphy, the director of communications for the Minister of Health Deb Matthews, in an email to the E-B.
The government has created more than 200 Family Health Teams serving 2.7 million Ontarians, and there are more than 700 group practices including Family Health Organizations, Family Health Networks, and Family Health Groups.
Gandhi said there are two advantages of the family health team models: new doctors get access to older and more experienced physicians, and it allows them to be a part of an allied team of health care professionals. This includes access to nurse practitioners, mental health experts, diabetic councillors and health promotion dieticians.
Without being able to join health teams, new family physicians will have to start practices on their own and communities will need to resort to other non-traditional ways of recruiting them. Gandhi said methods have included building facilities and selling it to physicians at a low cost, or offering physician financial incentives for a signing a set-term contract.
Murphy said doctors can also set up independent practices and bill OHIP on a fee-for-service basis in any community and there are about 3,000 physicians in Ontario who use this model.
As a result of being a part of the health team, Gandhi was able to add 200 patients to his practice.
“It has truly revolutionized family practices. It has truly revolutionized preventive care and it is saving money,” he said. “If 30% fewer people that have diabetes are being admitted to hospital (which is expensive to the health care system) than four years ago, you are saving money out of that pocket.”
Another change that Gandhi is concerned about is making patients with lower back pain pay for X-rays, CT scans and MRIs that would have been covered under OHIP in the past.
According to the Ontario Ministry of Health and Long-Term Care's website, OHIP will continue to insure CT and MRI tests for low back pain when these tests are medically necessary — but X-rays, CT or MRI scans should not be ordered routinely.
“I had to tell patients, 'if you want to get an X-ray you will have to cover it'. There was no leeway time or preparation to tell patients.”
Gandhi acknowledged that cuts do need to be made but he said there have been ideas such as reducing the number of echocardiograms performed. He said there were guidelines being developed to determine when one is required.
“All that got dumped and they said this is what is going to be done.”