By Dr. Sohail Gandhi, President, Ontario Medical Association
I am proud to be the President of Ontario’s 31,500 practising physicians. I know that making sure every patient gets the care they need, when they need it is every physician’s top priority. We are on the frontlines of the health care system, caring for 340,000 patients every day.
Ontario is undergoing a much needed, and absolutely necessary health care transformation. Our population continues to grow and age and people’s health care needs are increasing in their complexity. All across the province, doctors are working hard to care for more patients and reduce wait times.
Under our health care system, doctors are independent contractors who own their own practices and operate as small businesses. Physician services depend entirely on patient need, and that varies from community to community, specialty to specialty, and physician to physician.
Doctors bill for patients they see, procedures they perform, and in some cases, the tests they interpret. It is important to note that the amount a doctor bills is neither their salary nor their take-home pay. Physicians must pay for the costs of operating their practices, from staff, to rent, to medical and office supplies. These expenses take up a significant proportion of billings, in some specialties up to 50%.
There are also many different models for practices. Some are small and have limited staff while some have a much larger team of several types of health professionals including: physician assistants, nurses, nurse practitioners, technicians and medical assistants. Expenses and volumes of patients seen would be very different depending on the operating model.
A physician’s annual gross billing amount reflects demand for treatment. The more patients need services, the more OHIP is billed for those services. This demand may be intensified in remote and rural locations where there are limited medical resources. In fact, many physicians in underserviced communities may work 7 days a week to provide the best care for their patients.
It is also important to note that Ontario continues to have a lower number of physicians than most other jurisdictions in the world. We currently have 2.6 physicians for every 1,000 patients, whereas Germany has about 4 physicians for every 1,000 patients. This means that our physicians have to see more patients (and thus bill more) to help keep the residents of Ontario healthy.
The OMA supports greater transparency of physician billings. But this should include appropriate context for the public and be governed by an Act of Legislature as it is in other provinces. The real value in greater transparency is to show how much patient demand there is for services. Looking at a select 0.3% of physicians will not do this.
Ontario’s doctors are working with the government to fix our health care system, solve critical issues like hallway medicine and deliver the high-quality care our patients deserve. Part of this work is to recognize the value of services patients need and how those services are provided. We will continue to do this work with the government going forward.
Each and every billing submitted by a doctor means that one more patient has been treated and one less patient is waiting.
Ontario’s Growing & Aging Population = Increasing Demand for Services
visits to specialists last year
total physician visits last year
1 Diagnostic Radiologist
for every 12,170 Ontarians
for every 22,490 Ontarians
for every 29,020 Ontarians
1 General Surgeon
for every 16,520 Ontarians
1 Family Physician
for every 1,445 Ontarians
Sources: Ministry of Health and Long-Term Care, 2017
OMA Department of Economics, Policy & Research
The Economic Contribution of Ontario's Doctors
Ontario's doctors treat 340,000+ patients per day
of funds that doctors receive
from OHIP billings (the government)
are spent on running their clinics:
ONE doctor contributes to 4 or more full-time jobs in their community
pay for and contribute to Ontario's economy
full-time jobs created
GDP in Ontario's
municipal, provincial, and
federal government taxes