Editor's note: A group called "Concerned Ontario Doctors" is holding a rally in Whitby Saturday to show the public "exactly what these cuts mean". The group is a physician-led grassroots advocacy group of over 11,000 members.
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It's been a year since negotiations between the Ontario Medical Association and the Ministry of Health broke down and funding for physician services was cut. Although each cut has been incremental, the total sum has amounted to an average loss of 30% in practice revenue. Because most physician offices operate as small businesses, the inevitable consequence of such a drop in revenue has forced physicians to resort to cost-saving measures to keep their clinics afloat – as is patently obvious in the attached map.
On a local level, preliminary surveys of physicians in the Whitby-Oshawa riding bear out the fact that the Liberal cuts to physician funding are having far-reaching repercussions on practices in the community and the local Lakeridge Health hospital. Both family doctors and specialists were surveyed about practice impacts in the last few months and here are some of the highlights:
- 66% of respondents are reducing staff hours or laying off staff.
- 62% are reducing services offered or office hours.
- 52% are halting plans to open new clinics or offer new services.
- 74% are closing clinics, relocating or retiring earlier than planned.
- 96% are experiencing physician burn-out. One respondent even stated, “I feel so demoralized that I would like to get out of the medical profession entirely.”
These responses are not isolated to Whitby-Oshawa. Clinics and hospitals across Ontario are struggling from chronic under-funding of the system.
Another stark example of the cuts is occurring within downtown Toronto, usually considered a resource-rich city. Dr. Zahra Bardai, a family doctor in Toronto, notes that obstetricians at downtown hospitals have been forced to cap their access to “20 new pregnant patients per month.” In comparison, normal obstetric practices can accommodate twice that number, sometimes more. Frontline family physicians like her are now struggling to get care for their pregnant patients.
Dr. Bardai states, “my referrals are being declined forcing redirection and delay in care, thereby violating the safe, equitable, efficient, effective timely care dimension of medicine."
“Even though obstetricians are available and hospital resources are available, the fact remains that the Ontario Liberals have deliberately underfunded the healthcare system in a thoughtless effort to control their budget. They have placed a hard cap on healthcare funding." said Dr. Kulvinder Gill, co-leader of Concerned Ontario Doctors.
Similarly, patient care is sacrificed for the bottom-line in the world of joint replacement surgery. In the Sault Area Hospital (SAH), patients have found that wait-times have grown exponentially longer since November 2015. The problem according to Dr. Darren Costain, an orthopedic surgeon at SAH, is that the funding for medically necessary hip and knee replacements has nearly run out. With over one hundred elderly patients on the list as of January 2016, the group of 6 orthopedic surgeons have been told that collectively, they are allowed no more than 4 hip replacements and 40 knee replacement until April 2016. Normally, each surgeon books 15-30 joint replacements per month. These surgeons now find themselves in an untenable position: for patients with booked surgeries, they have to tell them that they will have to be rebooked for the spring; for patients in pain and immobility waiting for an initial consult, these surgeons will have to tell them that their wait may stretch beyond 2 years for the necessary surgery; and finally, the surgeons themselves are facing the reality of several months of minimal income while still having to pay for the rising cost of an office, staff, and equipment – not to mention providing for their own families.
These scenarios are playing out across the province. Many orthopedic surgeries have been restricted by lack of funding at Trillium Hospitals in Mississauga and London area hospitals (including Woodstock, Strathroy and St. Thomas); all non-cancer surgeries in London have been rebooked for the next fiscal year; elective cardiac surgeries have been delayed at St. Michael's and Sunnybrook Hospitals in Toronto; and finally, cataract surgeries have been postponed until after April 2016 in Norfolk General (Simcoe County) and St. Joseph's Hospital (Hamilton). This is not because surgeons and hospitals were over-scheduling these medically necessary operations; these ORs were running according to standard hospital-dictated schedule before the closures. Since these surgeries have now been rescheduled for a later date, patients are forced to line up, suffer and potentially die on longer and longer waitlists.
This is the inevitable consequence of low-balling the funding necessary to allow the healthcare system to keep pace with patient need. Unilateral actions like the ones the Ontario Liberals have imposed on the physicians of Ontario are clearly detrimental to patient care and well-being.
“Not since the 1990s have we seen such austerity measures in healthcare – clinics are closing and physicians are leaving. Patients are suffering right now from lack of access to care. Physicians are forced into a Sophie's Choice of caring for their own families or caring for their patients. This isn't safe and it certainly isn't fair,” said Dr. Nadia Alam, co-leader of Concerned Ontario Doctors.
“This Liberal government has cut health care spending by $54 million in the 2015 budget, slashed almost $1 billion from physician services and frozen hospital budgets for the fourth consecutive year. This has resulted in the cancellation of surgeries throughout Ontario, cuts in nursing positions, longer wait times in emergency rooms and very limited access to palliative care. This government needs to start working with our doctors and front line health care professionals to find savings and efficiencies within the system making patient centered care a priority.” stated Ontario PC Health Critic, MPP Jeff Yurek, Elgin-Middlesex-London.
Since its inception in September 2015, Concerned Ontario Doctors, a physician-led grassroots advocacy group of over 11,000 members, has been tracking, verifying and mapping out the growing impact of the Ontario Liberals' unilateral actions. Looking at the latest iteration of the map (attached), it is clear that these cuts have forced physicians to adopt ongoing cost-savings measures like staff lay-offs, service reductions and in worst-case scenarios, clinic closures. This inevitably leads to longer wait-times and less access to care for 1000s of patients across Ontario. This data completely refutes Health Minister Hoskins' erroneous statement that cuts to physician funding will not impact patient care. More information can be found at www.carenotcuts.ca
