MD earnings up 29 per cent in seven years: new data

Posted on September 30, 2015 in Health Delivery System

TheStar.com – News/Canada – Ontario physicians earn an average of $368,000 annually – the highest in Canada, according to CIHI. Out of that, they pay about 30 per cent in overhead expenses.
Sep 29 2015.   By: Theresa Boyle Health

Newly released data show Ontario physicians continue to be the highest paid in Canada with earnings jumping 29 per cent in seven years to an average of $368,000.

Health Minister Eric Hoskins, who is engaged in a nasty dispute with the province’s doctors over fee cuts, seized on the new numbers — released Tuesday by the Canadian Institute for Health Information — as evidence that the profession is fairly paid.  “I am proud as a government that in the last decade, Ontario has reinvested in our doctors … to the point where they are now, and still are, the highest paid physicians in this country,” he told reporters Tuesday.

The province is unilaterally cutting fees to doctors, represented by the Ontario Medical Association, by 1.3 per cent, effective Thursday. This is on top of a 2.65 per cent fee cut in February, which was also imposed unilaterally.
The OMA is threatening legal action and wants the dispute to go to binding arbitration.

Hoskins maintains the cuts he is seeking are modest.  “It’s an issue of asking our physicians to accept slightly less for the services they provide,” said the minister, who wants to divert the monies into other health services such as home care.

Meantime, the OMA is gearing up for what it describes as a “virtual day of action” on Thursday to mark doctors’ anger over the cuts. It’s asking physicians, patients and supporters to sign up and give it time-limited access to their status updates on Twitter and Facebook so that at 2 p.m. it can send out a single message, en masse, to tell government to stop the cuts.

“It’s a way of using social media to send a message to Premier Wynne to let the government know that they need to put patients first and stop cutting funding to medical care,” said OMA president Dr. Michael Toth.
The OMA has hired the communications company Navigator to help with its social media efforts.

The new CIHI data offers provincial comparisons for average gross clinical payments to physicians for 2013-14. The annual average payment to physicians that year was $336,000.  Out of those earnings, doctors pay overhead expenses such as rent and staff salaries, an amount widely cited as about 30 per cent.  CIHI calculated average payments by dividing the total amount paid to doctors from OHIP ($9.9 billion) by the number of doctors (26,888).

“I think it is very important to have sound and comparable information to help in debates around fee negotiations with physicians,” said Geoff Ballinger, CIHI’s manager of physician information.  (Included in the OHIP calculations are fee-for-service billings, capitation payments, contract payments and sessional fees, as well as salaries of some doctors. Not included are salaries of doctors employed by hospitals or compensation earned by radiologists and laboratory specialists.)

Hoskins has been attacked by physicians on social media over the numbers he has been using to argue that physicians are fairly paid.  But the number he has been citing for average annual compensation — $350,000 — is lower than the new CIHI earnings figure.  His office says he is using numbers provided by Ontario’s Institute for Clinical and Evaluative Sciences, which show that average annual compensation jumped by 61 per cent between 2003 and 2013.

On many tweets using the hashtag #CareNotCuts and on a blog titled Ontario’s Health Care Cuts, doctors argue that Hoskins’ math is wrong.  “Your doctor certainly is not receiving a 61% raise! If anything, her salary continues to get cut,” wrote one blog poster.

Dr. Scott Wooder, a former president of the OMA, explained that demands on physicians are increasing because of the growing and aging population.  “Doctors are working harder. They don’t see working harder as being a raise,” he explained.

The province and doctors spent all of 2014 in contract negotiations, but could not reach an agreement. Ontario’s former chief justice Warren Winkler was brought in as a conciliator and he urged the doctors to reconsider the province’s final offer.  The doctors did not, and the province imposed it upon them anyway. It included an across-the-board fee cut of 2.65 per cent.

The province wants doctors to stay within a budget of $11.6 billion for the fiscal year, but contends they are headed above that amount because of the rate at which they are billing OHIP. That’s why it’s coming back for a second round of cuts.  Hoskins has said the unilateral fee cuts are permitted under a negotiation framework the province agreed to at the insistence of the OMA in 2012.

The OMA points out that in addition to the across-the-board fee cuts, there have been additional cuts in fees that affect some specialties more than others. The organization contends that, in total, the physician services budget has been chopped by 6.9 per cent.

In his conciliator’s report, Winkler recommended creating a task force on the future of physician services in Ontario and a minister’s roundtable on health system transformation.

The Star this week sought permission from both sides to interview Winkler about those issues. Hoskins agreed, but Toth said “the conciliation process is always kept confidential.”

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