09/22/2015 05:34 EDT | Updated 09/22/2016 05:12 EDT

Dear Premier Wynne - Our Patients Need Care, Not Cuts

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I am a family doctor, starting a new practice in Ottawa.

There are 700 patients on the waiting list at the clinic I joined, who are in need of a family doctor. Many of the patients I am meeting have not had a regular physician in years.

Yesterday I saw a 55-year-old woman who felt fine. She had not seen a doctor in eight years. Her blood pressure was elevated, she smoked, and had a family history of heart disease. I will be working with this patient to control her blood pressure (with lifestyle changes and/or medication) and assist her in quitting smoking. Without such interventions she would be at high risk for a heart attack in the future. The price of a few family doctor visits ($33.70 per visit, soon less), or the cost of that patient's yearly capitation amount in a Family Health Organization is minimal compared to the cost of treating an acute heart attack (ER / inpatient stay +/- ICU +/- interventional procedures +/- surgery +/- rehabilitation).

The savings to the health care system by investing in preventative health are huge, and often intangible. I will also be screening this patient for cervical cancer with a pap test (adding $6.75 to my earnings that visit), screening for breast cancer and colon cancer, and recommending vaccinations to help prevent pneumonia and shingles. The burden on the health care system of treating any of those conditions would be much larger than allowing me to help prevent them.

I also saw a 20-year-old girl who has been struggling with depression, anxiety, and addiction for years. She has had two months now where she is sober. She felt she had mostly been self-treating her anxiety with alcohol and was ready to make a change. We had a long session discussing treatment options, and she opted to start antidepressant medications and pursue therapy. We talked about her dreams and career goals, and what steps she could take to pursue them. We also talked about her previous suicide attempts, and emergency supports available should she have those thoughts again. Unfortunately the wait list for psychiatry is long, so I will be following this patient on my own for a while. If this patient is able to stay out of the hospital, stay sober, and get a job that she enjoys, it will be tremendous for our society.

I am not complaining about making too little money.

I am complaining that the Ministry of Health has imposed a unilateral agreement on physicians, rather than working with the Ontario Medical Association (OMA) to come up with a solution for cost-savings. Without input from Physicians, they have instituted cuts, clawbacks, and limits on family physicians entering into Family Health Organizations/Family Health Teams.

This approach is not only short-sighted. It is unfair and insulting to the hard-working physicians of this province. We fear these changes will negatively impact patient care and jeopardize our entire public health care system.

I am a family doctor.

I love my job and am proud of the work my colleagues and I do. We help to prevent acute diseases, manage chronic diseases, manage psychiatric and medical conditions in patients of all ages. We keep people out of hospitals, out of long term care units, out of psychiatric care facilities. I see patients who range from rich to poor. Whether a patient is working a minimum wage job or at a prestigious law office, they are equal in the face of disease, and equal in the face of our health care system. It saddens me to hear about colleagues considering leaving medicine, leaving the province or turning to private medicine because they cannot afford to keep their practices open. Our clinic has been struggling financially and these upcoming cuts seriously threaten the services we are able to provide.

Ontario doctors rarely get angry, Premier Wynne. We rarely speak out on financial matters. Our focus has, and always will be, on patient care.

But this has gone too far. We feel disheartened...we feel ignored.

We ask that the provincial Liberal government go back to discussions with the OMA so that we can all work together to find savings within health care. Those working on the front lines agree that there are inefficiencies in the system, and savings to be found. Physicians want input. We are seeking respect and collaboration from the government, and a fair negotiation process.

Please help us provide our patients with the quality health care they deserve.


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