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Ontario doctors stand firm against government

Doctors rejected the government's latest proposals for reform in a province-wide referendum, and some started refusing to accept new non-emergency patients in protest. Last week the health minister asked the College of Physicians and Surgeons to discipline such doctors, but the college refused.

Dr Gerry Rowland, president of the Ontario Medical Association, applauded the college's stand. "The best way for the minister to ensure patients receive quality medical care is not by threatening or legislating doctors into submission but by working with doctors to find fair and reasonable solutions in the best interests of our patients," he said. "I urge the minister to focus his attention on the fundamental problem facing our patients--the chronic underfunding of medical services."

Dr Helen Gordon, president of the college, said in a letter to the minister that the college's decision was a result of a "real concern for the long term effects that misusing the regulations of the college in this way would have on the important principles of self government, accountability, and autonomy."

The latest proposal by the government is to pay the doctors 97.1% of the fees that they are allowed to charge for approved services rather than the 90% that they had been paying--reducing the "clawback" from 10% to 2.9%. The government also agreed to restore the subsidies that it had been paying for premiums on malpractice insurance, which it had suddenly stopped paying last year.

The sticking point for the medical profession, however, was the government's proposal that doctors could not claim fees from the provincial insurance plan if they opened a practice in an area that was considered to have too many doctors already. Doctors saw this as an unacceptable restraint on their independence and rejected the whole plan.

The Ontario Medical Association has launched a radio campaign to gain public support for its action.--DAVID SPURGEON, medical journalist, Quebec

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