Doctors association could turn into union
Ontario health minister warns OMA must be willing to accept public sector rules
If the Ontario Medical Association (OMA) insists on binding arbitration, the government is open to recognizing it as a public sector union — but that would mean doctors’ earnings would be made public and their tax breaks slashed, Ontario’s health minister warns.
In an open letter sent Thursday to Dr. Virginia Walley, president of the OMA, Eric Hoskins also drew attention to growing divisions in the profession.
Doctors voted down a tentative deal with the province almost two weeks ago. It would have seen the physician services budget grow by 2.5 per cent annually to $12.9 billion by 2020.
A majority of doctors didn’t like the deal, in part, because it didn’t give them the right to binding arbitration to resolve contract disputes.
“If the OMA’s insistence that it be awarded the right of binding arbitration that we have provided to other public sector unions is so great that it is willing to be reconstituted formally as a union and accept all the obligations that other public sector unions have adopted — including withdrawing objections to salary disclosure that all other government unions are subject to and relinquishing the rights of members to incorporate individually — the government would be open to that discussion,” Hoskins wrote.
Doctors want the right to binding arbitration to resolve the impasse, but the government refuses to turn over total control of what amounts to 10 per cent of its overall budget to a third-party arbitrator. It is willing to consider a form of binding arbitration with parameters — for example, a cap on the annual budget for doctors.
The OMA is appealing a recent decision by the province’s privacy commission that would require the health ministry to make doctors’ OHIP billings public. The decision stems from a request for disclosure made by the Star more than two years ago.
Doctors are worried their billings would be misinterpreted as salaries when the monies are also used to pay for large overhead expenses — rent and equipment, for example.
Hoskins seems to be saying that doctors need to decide whether they want to continue to be treated, for the most part, as independent contractors, or whether they want the benefits of being in a union. By incorporating individually, physicians get significant tax breaks.
The OMA is the professional organization that represents Ontario’s 42,000 physicians, including retirees and students. It is also recognized by the province as the bargaining agent for doctors.
Hoskins wrote that the splinter group, Concerned Ontario Doctors, “which appears to speak largely for high-earning specialists and who believe there should be no constraints on their income,” is increasingly vocal in suggesting it now represents Ontario’s doctors.
If that’s the case, does the OMA agree with their recent proposal to delist services, expand the use of walk-in clinics and reform payments to “disadvantage family doctors and other underpaid physicians in favour of high-billing specialists,” the minister asked.
Walley issued this response: “The Ontario Medical Association has received a reply from the minister of health to our request for a meeting between the minister, the OMA and the premier to discuss the next steps for binding arbitration and a path forward. We are currently reviewing his letter and will issue a response.”
Labour lawyer Steven Barrett said Hoskins took an “unnecessarily inflammatory and provocative stab” at Walley and the profession by sending the letter.
The government should give the OMA time to get its house in order following the defeat of the deal, he said in an email response to questions from the Star.