By Sohail Gandhi Opinion
Tues., July 9, 2019
The Toronto Star has recently featured a series of articles about doctors’ billings. These articles have raised some questions about the value of services doctors provide compared to the value other health care providers offer.
The Ontario Medical Association (OMA) welcomes and appreciates the value all health care providers bring to patients and the broader health care system. We do feel it is important to point out, as doctors have rightly done, that physicians are the only health care providers who pay their own overhead and staff costs. No other health care provider does.
As the OMA has repeatedly stated, it’s also important to understand that physicians are not government employees. They are independent small business owners. OHIP billings are not salaries. Billings are gross earnings out of which physicians must pay all operating expenses, including office space, staff salaries, medical equipment and more.
The average general family practitioner makes about $380,000 and pays about $120,000 in overhead costs. These doctors also provide emergency, long-term, hospital and delivery care and about $60,000 is compensation for providing these services. All things considered the average family physician makes about $200,000 for caring for about 1,200 patients.
Doctors also provide care for the most complex patient needs. Nurse practitioners for example, do not pay overhead, which would typically average about $100,000 for their services. If overhead were factored in, their total compensation would be closer to $200,000 for 800 patients.
The OMA has also consistently said that if billings are to be disclosed, it should be done by the government in an orderly and consistent way. In 2016, our submission to the Information and Privacy Commissioner stated that, “We thus respectfully submit that the decision to publish physician billing information should not be in the hands of the courts or administrative tribunals, but rather in those of the legislature, which is elected. If the sitting government wishes to pass legislation mandating physician billing disclosure by name, it has the purview to do so.”
The public should absolutely be able to see where their tax dollars are going. Providing the full picture, in an orderly way, will help ensure physician billing disclosure is transparent — and meaningful.
The OMA strongly believes that staying focused on ensuring each health care provider can add their value is far more constructive than comparing doctors’ billings with the cost of other health care providers.
Focusing on how much each health care provider bills or earns without context, and without a broader plan to address system-wide issues, may result in additionally fragmented care and stress on Ontario’s health care system. Ontarians need professional health care providers with a range of skills to help reduce wait times. No health care provider wants to see longer wait times or more fragmented care.
The priority of the more than 31,000 practicing doctors in Ontario is the health and well-being of every resident in the province. Ontario’s doctors care for more than 300,000 patients every day. They are on the front-line of the health care system, making sure it works for the people of Ontario.
All health care providers offer high quality care to their patients in their own unique ways. Doctors, nurses, nurse practitioners and many other professionals are equally committed to the health and well-being of patients and work together to deliver the best care possible, as one integrated team.
The government of Ontario is currently leading significant health systems transformation, which will help further integrate health care providers. The OMA knows that collaborative, integrated, team-based care, where every health care professional works to their full scope of practice to provide the best standard of care for Ontario’s patients, is the most responsible way forward.
The OMA will continue to work with the Ontario government and other health care providers to fix our health care system and address critical issues, such as hallway medicine, to deliver the safe and high-quality care our patients deserve.
One more patient seen is one less patient waiting.
Dr. Sohail Gandhi, President of the Ontario Medical Association
Used with permission from The Toronto Star, www.thestar.com Copyright The Toronto Star. All rights reserved