Ontario physicians have been struggling in general over the past several years as they have gone without a Physician Services Agreement with the Ministry of Health since 2014. In June of 2017, members of the Ontario Medical Association voted in favor of a binding interest arbitration framework. Arbitration was triggered by the OMA May 24th, 2018, while still dealing with the Wynne Liberals.
The lack of a shared view about how medicine in Ontario should move forward between the government and the physicians of the province has led to a great deal of acrimony and has affected rural and remote medical practice within the province. Burnout levels are high, and there have been no fee changes (except for unilateral cuts) for the past four years. This puts an extra burden on us smaller providers to continue to keep up with the costs of providing brick and mortar, traditional care (including skyrocketing electricity prices in rural Ontario since the privatization of Hydro One) but at the same time being unable to be paid in keeping with inflation to keep their practices open. Numerous examples of closures in smaller areas have been seen over the past four years, including the loss of many specialists to urban contraction, who had been operating satellite clinics in smaller centers to assist with patient travel. We will see what the future holds in health care in Ontario as negotiation begins with the Ford Progressive Conservatives.
The opioid crisis that is become extremely evident over the past ten years has also not left Ontario unscathed. Like our western province counterparts, we have seen the rise of synthetic fentanyl hitting the streets, even in our rural and remote locations. There is no cohesive opioid strategy in Ontario, and Local Health Integration Networks have instead been tasked with trying to assess and institute measures that deal with the opioid crisis. This has largely been put in place without physician input due to the acrimonious relationship between physicians and the Ministry of Health.
A large coup of the Society of Rural Physicians this year was our role in addressing the College of Physicians of Ontario original document regarding change of scope of practice to work in a rural emergency room. Along with the College of Family Physicians of Canada, we were able to persuade the College of Physicians and Surgeons of Canada to amend their original public document to be less deleterious to rural communities, who rely tremendously on competent family physicians to keep their emergency rooms operating fully. Read more about this here.
There are lots of things to advocate for within rural and remote medical practice within Ontario, and we gladly welcome new members and their input to help continue to address these issues. Please contact us for more information on how you can become involved.