When physicians communicate with their patients or with each other, absolute honesty is absolutely necessary. It’s part of our culture. Without this belief, it’s impossible to practice medicine.
So when I hand over the care of a patient to another physician, I give plain unvarnished facts. I do not try to skew the truth to make my care look better than it was. It would be unfair to the other physician and to the patient for them to not have all the facts necessary to make good decisions.
Would you rather have a physician say “you have a serious illness, I’m going to get you the best care possible and I will be there for you whether things get better or worse”? Or would you rather have a physician say “don’t worry, everything will be fine”. I would prefer the first approach and out of respect to my patients I try my very best to have that kind of approach.
That is one of the reasons that physicians are flabbergasted by the half-truths that the Government is using when it talks about the cuts it has made to physician services unilaterally.
On February 19 Jeff Yurek, MPP from Elgin-Middlesex-London, asked the Minister of Health to explain about the cuts that his government was making to physician services. I believe that Mr. Yurek is concerned, very reasonably, about the problems his constituents will have in finding a family doctor.
When the Minister replied, “We aren’t cutting health care”, there was a collective gasp from the physicians of Ontario. In fact the Government is cutting $580 million dollars in physician services. When a cut that massive is being made, care is being cut.
The Minister then went on to say that the “fund for physicians specifically is going up by 1.25% next year, 1.25% the year after that and 1.25% the year following”. Wow, sounds great. Sounds like I’m getting a 1.25% increase this year and next and the year after. That is how any reasonable person would read the Minister’s comments. But on Feb 1 2015, OHIP regulations were unilaterally changed and every single physician fee is being cut by 2.65%.
Only a politician can make a cut sound like an increase.
It’s technically true, the government is increasing spending by 1.25% in each of the next 3 years. The problem is that the number of new patients and new doctors and the aging of a population with more and more chronic diseases is driving up costs at a rate greater than 1.25%. So in order to keep growth in the physicians’ budget limited to 1.25%, each physician needs to have his fees cut by 2.65%. Oh and if that cut isn’t enough, they will come back for more through the magic of claw-backs.
I don’t think that Mr. Yurek got a completly honest answer.
What would an honest answer look like? Here is an answer that would gain the respect, although admittedly not necessarily the support, of Ontario physicians
“We have a fiscal problem. We need to balance our budget. I am going to cut doctors’ fees for the next couple of years. We hope to work with the OMA to minimize the impact that this will have on patient care. When times are better, hopefully in the next two years, we will look at the cuts and see what can be done to reverse them.”
That’s how a doctor communicates. With honesty and respect.
Scott Douglas Wooder, MD