I am a little confused by the mixed messages that the Government is sending about primary care and Family Medicine.
In a speech at the Empire Club on February 2, the Minister of Health talked about the importance of primary care. He bragged about all of the new family physicians and Family Health Teams that the Liberals had put in place since Dalton McGuinty was first elected. He stressed the need to build on past improvements and improve access
That speech taken in isolation, would give me confidence that the Government was headed in the right direction. But of course the speech cannot be considered by itself. It has to be put in context with things that this Government has actually done.
By now most readers will understand that the Government has cut physician’s fees by 2.65% and made other targeted cuts which bring the total cuts up to 4.8%. What some may not realize is that because of the specific targeted cuts, Family Doctors face a total cut of 6%. That’s right; Family Doctors face the biggest cuts in the entire profession. And new family doctors are especially targeted.
I’ve previously documented how severely limiting entry into capitated models of care, ending enrolment fees and ending Income Stabilization for most new graduates will make it almost impossible for new graduates to practice in primary care teams.
In his speech, the Minister talks about moving away from fee for service. I should declare at this point that in my 29-year career, I have practiced in fee for service for exactly 4 years. The other quarter century I’ve spent in practice has been in a capitated team. So neither the Government, nor anyone else, needs to explain to me the benefits for my patients who are lucky enough to be enrolled in a Family Health Team.
Here is where I get confused. The Minister announced the need to move away from fee for service 10 days after his Government announced cuts that will effectively force most new Family Physicians to practice in a fee for service model.
That is the mixed message. That’s why I’m confused.
Actions speak much louder than words, so with great reluctance, I’ll have to ignore the speech and assume that the Government is serious about cutting team based, capitated family practice.
Either that or the speechwriters forgot the read the newspapers.
Scott Douglas Wooder, MD