Let the light shine on top-billing doctors in Ontario

Posted on August 7, 2018 in Health Debates

TheStar.com – Opinion/Editorials
Aug. 7, 2018.   By

If Ontario doctors were playing a baseball game, rather than fighting for the right to keep the names of the highest-billing doctors a secret, they would have struck out by now.

They lost their argument before an adjudicator of Ontario’s information and privacy laws, and at the Ontario Divisional Court and, on Friday, at the Ontario Court of Appeal.

Still, the Ontario Medical Association and two groups representing specific doctors have one last ball to try and play. Their lawyers could appeal to the Supreme Court of Canada.

But they really shouldn’t.

Ontario doctors should stop opposing transparency and accountability on OHIP billing practices. Opening the system to public scrutiny allows for more informed debate, and can only help build a stronger health-care system.

And that’s good for patients and doctors, alike.

It’s high time Ontario taxpayers had more information about where the $12 billion paid to doctors goes. And this is far from a groundbreaking idea.

British Columbia, Manitoba and New Brunswick already release the names and annual billings of individual doctors. So does the U.S. with its Medicare program.

In Ontario, without comprehensive information, we’re left with general complaints about an underfunded and inefficient health-care system, juxtaposed with the troubling picture brought to light in a health ministry audit four years ago.

How can one doctor bill for 100,000 patients in a single year? Why did the province’s dozen top-billing doctors received payments averaging $4 million apiece, with one billing $7 million?

Just as worrisome, the audit found a handful of doctors allegedly charged for “services not rendered,” billed for procedures that cost more than they should, and charged for services judged to be “medically unnecessary.” Half a dozen also claimed to have worked 356 days — or more — in that one-year period.

It’s easy to see why incredibly high-billing doctors want to keep their names under wraps. But protecting those who may have questionable billings from public scrutiny only serves to unfairly tarnish the reputations of all doctors.

This whole battle started when the Star challenged a rejection for an access to information request for the names of the 100 top-billing doctors in 2014.

At each stage, judges have sided with the public’s right to know and ruled in The Star’s favour; and the OMA has appealed to the next level claiming it’s “an unjustified invasion of personal privacy.”

Friday’s decision is the latest and, hopefully, last chapter in this saga.

In repeatedly going to bat for these highest billers, the OMA is dragging down the vast majority of its doctors whose billings bear no resemblance to those eye-popping sums.

Indeed, according to the most recent aggregate data published, the average Ontario doctors bills $348,000. And family doctors bill even less at $275,000.

That’s an average, of course, but it’s a figure that would probably surprise many Ontarians who think a medical degree is a fast-track to incredible wealth.

And it bears repeating that OHIP billings don’t actually equal income. Doctors must pay staff salaries, rent, equipment costs and other expenses before they take anything home. The OMA estimates that 30 per cent of the average doctor’s gross pay goes to overhead.

That’s a concept that the OMA believes is too complicated for the public to understand. It has even argued that’s part of why the billings can’t be publicly released.

“This request serves only as a distraction from a bureaucratic and inefficient health-care system which, for the past six years, has failed to put patients first,” OMA president Dr. Nadia Alam said.

The OMA’s solution is for taxpayers to continue to pony up billions in payments — no questions asked — to the province’s 28,000 doctors.

The courts, thankfully, see a broader picture. It’s time the OMA did, too.


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