Physician billings require proper context

Re OHIP billings need to be transparent, Opinion, April 12 Every day, 300,000 patients are cared for by Ontario’s 31,500 doctors. Patient care is why we all chose medicine.

Last week, the Supreme Court declined to hear the OMA’s appeal regarding disclosing the highest billing physicians by name. Contrary to the Star’s editorial, the OMA respects the decision of the Court.

The OMA’s position from the outset was to balance transparency, accountability and a measure of privacy for doctors. Disclosure will have unintended consequences. Many of us are concerned that any context of how physician billings actually work will be lost against headlines focusing on a handful of physicians at the top of the list.

Doctors are independent contractors who own their own practices and operate as small businesses. Physician services depend entirely on patient need. Doctors bill for patients they see, tests they interpret and procedures they perform. Each billing means one more patient treated and one less patient waiting.

However, the amount physicians bill is not the same as their salaries. Billings are gross revenue from which physicians must pay an average of 30 per cent for staff salaries, office space, medical equipment, electronic health records and supplies.

Many high-demand physicians also hire professionals and assistants so they can see many times more patients in a day than they could on their own.

Now that disclosure is coming, if physician billings are to be published, how should this best be done?

Simply adding physicians to the Sunshine List misses the mark, because physicians aren’t government employees and billings aren’t salaries. Disclosure should be done in a way that makes sense and include billing context. The OMA also suggests that disclosure be done through enabling legislation as in other provinces .

At the end of the day, our patients expect thoughtful, measured conversation from their physicians. So that’s what we’ll provide. Dr. Nadia Alam, president of the Ontario Medical Association