Doctors, province setting agenda for contract talks.

Doctors, province setting agenda for contract talks

The Ontario Medical Association (OMA) says it is finding it easier to deal with New Democrats than with the former Liberal government of Ontario.

Negotiations between the doctors' association and the NDP got underway on Jan. 16.

Paul Rhodes, manager of government affairs with the association, said the new government is more willing to deal with doctors and achieve a better understanding of the health-care system.

"They are more open-minded than the Liberals," he added.

The association's relationship with the Liberals hit rock bottom during the doctors' strike of 1986, and it had never really improved.

"The New Democrats govern, the Liberals ruled," he commented.

The improved relationship exists despite past differences of opinion between the medical association and the NDP, particularly over the issue of extra-billing.

"That is an old issue," Rhodes said.

The province's doctors have been working without a contract since March 31 1988. Contract talks began 18 months ago.

NEW RELATIONSHIP

A spokesman for the office of Health Minister Evelyn Gigantes said the ministry and the government desire better relations with doctors.

"We are hoping that these negotiations will be the basis for the beginning of a new relationship," the spokesman said.

"There is no question that the government needs to work with the doctors to provide for good medical services."

The government's bargaining team is being led by Michael Decter, a former clerk of the Manitoba provincial cabinet. The four-member team also includes an adviser to Premier Bob Rae.

Rhodes explained that the current discussions do not concern doctors' fees.

The negotiations are being held to determine what matters the contract negotiations will cover, how they will proceed and who will be covered by the contract.

"It's a process agreement," said Rhodes.

The previous process agreement was dissolved in 1988 by the former Liberal government.

Rhodes has no idea how long the negotiations will continue before fees are discussed.

One of the goals of the current negotiations is to establish a procedure for the binding arbitration of disputes.

Rhodes said the association accepts binding arbitration as reasonable, noting that it is available to other groups in the health-care system.

In addition, the association wants to be recognized as the official bargaining agent for all doctors in the province and to make the payment of membership dues mandatory.

The association, a voluntary organization, represents 19,000 of the province's 22,000 doctors.

However, an agreement with the province will cover all doctors.

ONLY ONE INCREASE

Since the last contract expired, Ontario's doctors have had only one 1.75-per-cent fee increase. It was approved by the Liberals in 1988.

"The physicians of Ontario have had no negotiated increase since 1987," Rhodes noted.

However, there has been some criticism that doctors are encouraging patients to visit more often so that they can collect more from OHIP.

"That's fallacious," said Rhodes, noting that patients in every province are making more use of the health-care systems.

According to Rhodes, there are several reasons for the increase, including the aging of the population, advances in medical technology, new testing procedures and increased public concern for health.

However, provincial auditor Douglas Archer reported last year that OHIP billings increased to $4.2 billion in 1989 from $2.7 billion in 1986.

Archer speculated that some doctors encourage more frequent patient visits to make up for the loss of extra-billing privileges, which occurred in 1986.

Rhodes argued that if any doctor is intentionally encouraging visits to increase earnings, there is a process to deal with professional misconduct.

COSTS INCREASING

Dr. Bill McMullen, president of the Sudbury and District Medical Society, said the cost of operating a practice is increasing.

In addition, McMullen noted that doctors, unlike other businessmen, are not permitted to pass on the costs of the goods and services tax to consumers.

Doctors must pay considerable wage and insurance costs, he added.

"There have been increases in malpractice insurance, which has grown by leaps and bounds," McMullen noted.

For example, he said that his own malpractice insurance premiums have risen from $325 in 1976 to more than $3,000. "And that's without a claim."

McMullen said that a medical career is becoming less attractive to many young people who take lifestyle into consideration. He pointed out that applications to medical schools have declined.

McMullen said that becoming a doctor means 70- to 80-hour work weeks, no pension plan, no disability coverage, no vacation pay and no paid sick leave.