Phase II COVID-19 Physician Compensation Structure

Colleagues,

The Negotiations Task Force (NTF) has reached an agreement with the Ministry of Health on a Phase II physician compensation structure in response to the COVID-19 pandemic. The Board, after much discussion, approved the agreement. I will summarize the process, but the full details are here.

To recap, when the severity of the pandemic became apparent, along with the need to reduce non-essential visits and ensure that physical distance recommendations are being followed, the Board and Ministry agreed to Phase I pandemic funding.  Phase I included measures allowing physicians to bill virtually (including telephone codes) for a number of fee codes (and the NTF is working on expanding these), funding for virtual care clinics (thank you to all those who signed up) and funding for the COVID-19 assessment centres (thank you again).

As I mentioned in my President’s Update of March 27, our next steps were to explore changes for those physicians caring for patients with COVID-19 in hospital and supporting  community health care infrastructure. As I mentioned then, time was of the essence, and there would be an immediate solution followed by ongoing discussions. I cautioned that the solution would not be perfect.

As we have all observed, the impact of COVID-19 is now being seen in hospitals and the Ministry of Health came to these discussions focused on ensuring stable physician human resources and a simplified non-fee for service payment structure. This is, in of itself, a goal that the Board supports.  Phase II of this agreement therefore provides primarily simplified non-fee for service payment structures for physicians working in hospitals including in the ICU and on wards and to provide for expanded capacity in some Emergency Departments as well as those doing necessary administrative work.

However, as I have noted previously, community physicians and clinics, whether family practice clinics who see patients, or procedure-based clinics or IHFs, serve an essential role in keeping patients from going to the hospital in the first place.  This agreement sets us up to immediately begin discussions regarding the creation of a COVID19 advance payment plan against future billings, or some other mechanism, to specifically address the short-term need to maintain health system sustainability.

To be clear, while the OMA has agreed to these Phase II changes, the OMA approved them because, as I noted above, they also allow the OMA to urgently advance the interests of community-based physicians in our future dealings with the Ministry. I want you to know that the Board is committed to ensuring that every physician in Ontario is supported during these unprecedented and challenging times.

Practice Impact Survey

What are next steps? To be candid, we now need help from all of you. We need to provide information to the Ministry as to just how big the looming health care infrastructure crisis is. A number of members have sent me information on how many staff they have either laid off, or are planning to lay off, and when they will have to permanently shutter their clinics.

But we need more data. Please fill out the short survey here and give us as many facts as you can about the impact of the present crisis on your ability to maintain your practices and facilities in operation. If you are unable to click the link, please copy and paste the full URL into your browser: https://insights.oma.org/c/a/6IwHYY9KrIL81zTOZ2gDIQ

The more data we have, the more we can persuade the Ministry to recognize that Health Care Infrastructure is under extreme stress, and in many areas, in danger of collapsing. I thank you all for contributing.

Year 2 Retro Pay

A quick reminder to please check your recent RA to confirm that you received your Year II retroactive pay (April 1, 2018 to March 31, 2019). If you have any questions about the amount or the calculation, call the Service Support Contact Centre at 1-800-262-6524 or SSContactCentre.MOH@ontario.ca (with apologies, the incorrect email address appeared in Tuesday’s update).

Financial Relief Programs

I want to encourage all members to review the federal support programs for physicians facing hardship, available here. The OMA hired MNP (one of Canada’s leading national accounting, tax and business consulting firms) to develop this guide for members. The package contains various supports that may be of immediate benefit to you and your practice.

Conversations Around Goals of Care (Advanced Care Directives)

Finally, I want to take this opportunity to remind members that Thursday is National Advanced Care Planning Day.  A day to bring attention to the fact that many people have not had discussions with their families about their wishes should they become critically ill. Many members have requested information on the best ways to have these discussions with patients and family. The OMA Section on Palliative Care and Hospice and Palliative Care Ontario will be co-hosting a Webinar on this important topic. For more information, and to register for this Webinar, click here.

I hope the rest of your weekend is safe, happy, and restful.

Ontario’s Doctors Rock!