Doctors providing comprehensive family medicine in Ontario are poised to get a new compensation deal from the province聽鈥 the first revamp of their payment structure in almost 20 years.
The Ford government and the Ontario Medical Association are close to finalizing a deal that will update the compensation model for doctors working in a family health organization, a move that will affect about 6,500聽family physicians in the province.
The proposed deal comes amid a primary care crisis that has left two million Ontarians without a family doctor. Both the province and the OMA say the updated model will encourage more doctors to practise comprehensive family medicine聽鈥 and prevent others from fleeing the profession.
鈥淔amily doctors are going to be better compensated for the work of being a family doctor,鈥 said Kimberly Moran, CEO of the OMA, which represents roughly 43,000 doctors, medical students and retired physicians.
A study published Tuesday found that while there are now more family doctors practising here,
The updated model 鈥 called FHO+ 鈥斅爎ecognizes that practising comprehensive family medicine has changed in recent years, with administrative tasks taking up more of a doctor鈥檚 time. It will allow doctors to bill for clinical and administrative tasks, such as such as charting, reviewing test results and filling out forms.
Currently, doctors are not compensated for most of these tasks and the growing administrative burden聽has led to burnout and pushed a growing number away from the profession. According to the Ontario College of Family Physicians, doctors spend 19.5 hours a week on average on administrative work.
The lack of compensation for this behind-the-scenes clinical administration was among the top concerns for family doctors, Moran said.
鈥淭his model recognizes the additional workload that they鈥檙e carrying,鈥 she said.
FHO+ is an update to the current family health organization model, in which doctors are paid through聽capitation. This means doctors receive payment from the government determined by the number and complexity of patients on their roster. In a family health organization, doctors can also bill OHIP for some services.
In Ontario, about 6,500聽physicians work in a family health organization, according to the OMA. A spokesperson for Health Minister Sylvia Jones called a family health organization 鈥渢he most widely adopted primary care model in Ontario.鈥 Ontario has a number of family medicine payment models, including fee-for-service, which is not a part of the proposed deal.聽聽
Among the updates, the FHO+ model opens additional spaces for doctors to join family health organizations. Both the OMA and the government say this will increase access to comprehensive primary care.
Ema Popovic, Jones’s spokesperson, said in a statement that FHO+ includes bonuses to encourage family health organizations to enrol new patients, while also strengthening incentives for after-hours care, helping more patients get access to their family doctor.
鈥淭he modernized model intends to retain current physicians, attract new ones, increase patient enrolment, and reduce administrative burdens for physicians,鈥 Popovic said. She noted investments in FHO+ will help the province鈥檚 Primary Care Action Plan, which pledges to connect every Ontarian to a primary care provider by 2029.
A queue for 500 openings for a new family doctor in Walkerton leads to elation and
Negotiations between the Ministry of Health and the OMA are ongoing, with arbitration expected to wrap up in the fall. Moran said the arbitrator is working through a few final details, but that the majority of FHO+ has been agreed upon and will go a long way in encouraging family doctors to offer comprehensive, longitudinal care.
鈥淲e believe this will attract more doctors to the profession and lead to more doctors wanting to stay,鈥 she said.
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