Despite beefed up rewards for physicians working after hours and being on call, the deal ratified by Ontario doctors Saturday definitely won\u2019t be the panacea for Northern Ontario health care, two Sault Ste. Marie physicians say.<\/span>\u00a0<\/span><\/p>\n Both Dr. Alan McLean and Dr. Janice Willett say some strides were made in the pact \u2014 reached late last month and ratified by doctors on the weekend \u2014 to mollify overworked doctors in this underserviced region.<\/span>\u00a0<\/span><\/p>\n But because many details remain sketchy, it is practically impossible to give the document a clean bill of health, they say.<\/span>\u00a0<\/span><\/p>\n \u201dFor the first time \u2014 or more specifically this time \u2014 there has been been targeted funds,\u201d said Willett, a Sault gynecologist and District 9 chair of the Ontario Medical Association for northeastern Ontario.<\/span>\u00a0<\/span><\/p>\n \u201dIn other words, they\u2019ve said, \u2018There is a\u00a0problem\u00a0with after-hours workloads with some specialties and getting these people to stay in Ontario,\u2019 so they\u2019ve targeted funds.\u201d<\/span>\u00a0<\/span><\/p>\n The deal provides fee increases for doctors of about two per cent each year over the four years, as well as premiums for after-hours work, being on call, and treating patients over 75.<\/span>\u00a0<\/span><\/p>\n Willett said that for after-hours procedures \u2014 mostly surgical \u2014 physicians will now receive a 40-per-cent premium for work done after 6 p.m., compared to the previous 30 per cent. For treatment performed after midnight, they\u2019ll pocket a 62.5-per-cent premium, compared to the present 50 per cent.<\/span>\u00a0<\/span><\/p>\n \u201dPreviously, we\u2019d just see a\u00a0certain\u00a0percentage go across the board, so they\u2019ve made some brave decisions that may not be politically\u00a0correct\u00a0because the majority of physicians may not be after-hours physicians,\u201d Willett said.<\/span>\u00a0<\/span><\/p>\n \u201dBut I think it\u2019s a step in the right direction and I think we could probably\u00a0build\u00a0on it as long as they don\u2019t\u00a0lose\u00a0the momentum.\u201d<\/span>\u00a0<\/span><\/p>\n The deal also sets the course for primary-care reform in which family doctors would gather into group practices and be paid according to the level of care patients require rather than for each service.<\/span>\u00a0<\/span><\/p>\n The so-called \u201drostering\u201d model is currently being tested and evaluated in seven pilot projects across the province.<\/span>\u00a0<\/span><\/p>\n \u201dPhysicians will be able to look at the evaluation and determine . . . if that\u2019s the type of practice they wish to be involved with,\u201d said Dr. Ronald Wexler, president of the Ontario Medical Association, which represents 24,000 doctors.<\/span>\u00a0<\/span><\/p>\n The government hopes to have 80 per cent of all family doctors involved within four years.<\/span>\u00a0<\/span><\/p>\n McLean, president of the Algoma West Academy of Medicine, said he has doubts about how this model will impact the Sault.<\/span>\u00a0<\/span><\/p>\n \u201dWe already have the Group Health Centre that has clustered a big group of doctors together and there\u2019s no real solid plans for how (the province) is going to do that with the rest of us,\u201d he said.<\/span>\u00a0<\/span><\/p>\n \u201dSo I don\u2019t think that will affect us any time in the near future.\u201d<\/span>\u00a0<\/span><\/p>\n Willett contended that the deal\u2019s authors didn\u2019t pay enough attention to Northern Ontario\u2019s unique health-care situation, including matters that must be addressed if the area is to have any ground to stand on in its ongoing effort to recruit and retain doctors.<\/span>\u00a0<\/span><\/p>\n \u201dThe\u00a0problem\u00a0is that whenever we have a provincial agreement, it gets watered down because the amount has to go across the board,\u201d she said. \u201dThere are still unique solutions to be found for Northern Ontario. Some of these incentives aren\u2019t enough.<\/span>\u00a0<\/span><\/p>\n \u201dIn other words, if the incentive is the same to practise in Chatham, the question is, what is going to make the physician come to Sault Ste. Marie?<\/span>\u00a0<\/span><\/p>\n \u201dSo we\u2019re still not there completely.\u201d<\/span>\u00a0<\/span><\/p>\n She did applaud a plan to review Northern physician recruitment and retention by Nov. 30.<\/span>\u00a0<\/span><\/p>\n A pressing issue for Ontario doctors is the Canadian Medical Protective Association\u2019s decision to introduce a regional rating to its fee structure starting in 2001 for Canada\u2019s 58,000 doctors who rely on CMPA for malpractice insurance.<\/span>\u00a0<\/span><\/p>\n By January 2001,\u00a0certain\u00a0Ontario high-risk\u00a0specialists, such as obstetricians and gynecologists, could be shelling out annual insurance fees as high as $61,000; many now pay $29,000, Willett said.<\/span>\u00a0<\/span><\/p>\n \u201dIt\u2019s not necessarily that the (Ontario) doctors are any\u00a0worse,\u201d she said. \u201dWe seem to be a little bit more Americanized than the other provinces.\u201d<\/span>\u00a0<\/span><\/p>\n According to CMPA figures posted on the association\u2019s web page, the average award or settlement on closed cases between 1989 and\u00a0<\/span>1999\u00a0was $131,000 nationally. The Ontario average of $172,000 during the same period was 31 per cent higher than the national average and more than 156 per cent higher than that of Quebec, whose average award\/settlement was $67,000, about half of the national average.<\/span>\u00a0<\/span><\/p>\n \u201dSome centres are saying, \u2018We can\u2019t accept prenatal patients because I can\u2019t afford my malpractice insurance next January,\u2019\u00a0\u201d Willett said.<\/span>\u00a0<\/span><\/p>\n The agreement reached Saturday states that a committee will be struck to study the matter and by June 15, a report will be presented determining the viability of developing an independent malpractice insurance agency, recruiting a private insurance company or negotiating the matter further.<\/span>\u00a0<\/span><\/p>\n