Many medical specialists may leave Canada's richest province, Ontario, after an expected rise in malpractice insurance premiums of up to 45% comes into force. The steep increase in insurance fees could have a “significant impact” on the profession's ability to continue to provide certain medical services, warned H Ronald Wexler, president of the Ontario Medical Association.

In a message to members, Dr Wexler said that “high risk procedures such as obstetrics, orthopaedics, and neurosurgery” would be particularly vulnerable. Dr Wexler further estimates that from 2001, “average Ontario dues will increase by 45%” and those in Manitoba, Saskatchewan, and Alberta will increase by 11%. “Ontario has a significant shortage of physicians …