Posted on August 11, 2016

Terence Corcoran (National Post): Ontario’s minister of monopoly

Ontario’s minister of monopoly

Terence Corcoran | August 11, 2016 | Last Updated: Aug 11 12:01 AM ET


This coming Sunday, Ontario’s doctors will meet and vote on a proposed compensation agreement between their ersatz union, the Ontario Medical Association, and the Wynne Liberal government. It is shaping up as one of the most important events in the modern history of health care in the province.

The new agreement, known as the Physicians Services Agreement, has been superficially portrayed in the media as just another typical labour skirmish over cash between greedy overpaid medical millionaires and do-gooding politicians protecting the public good and the sanctity of universal health care.

Similar confrontations have been raging since the 1980s when the OMA was transformed into a mandatory Rand Formula organization and doctors lost the right to practice outside the system. But this year could — or should — be different. The Sunday vote is much more than a simple decision on whether doctors — along with nurses the only people in the $50-billion government-funded system who actually deliver health care directly to patients — will be paid more or less over the next four years. The answer is less, but that’s not half the story.

The new compensation agreement (negotiated in secret unbeknownst to members before it was announced by the OMA in July) is the high-profile tip of a giant low-profile health-care menace known as Bill 210, legislation that bears the unbearably cute title “The Patients First Act.” The objective, officially, is to improve primary care in Ontario and repair the bureaucratic shambles that currently exists.

Posted on August 10, 2016

Toronto Star: Doctors accuse OMA of pressing members to vote for deal

Doctors accuse OMA of pressing members to vote for deal

Doctors opposed to tentative OMA deal with government step up their fight ahead of Sunday’s vote.

Dissident doctors fighting a tentative contract between the Ontario Medical Association and the government are stepping up their campaign in advance of Sunday’s vote by physicians across the province.

The Coalition of Ontario Doctors held a news conference Tuesday accusing the OMA of trying to “railroad” members into passing the four-year deal with an “aggressive” effort.

“They’ve hired a pricey Bay Street PR firm,” said Dr. David Jacobs, a Toronto radiologist speaking for the coalition.

“It’s been a very one-sided push. We’ve been subjected to telemarketers, robocalls . . . we’re not quite sure why they’re pressing so hard.”

OMA president Dr. Virginia Walley said the association — which recommends members accept the deal as the best bet to avoid more unilateral cuts by the government — wants to make sure physicians are “fully informed” on the details.

“I believe our members will see the merits,” added Walley, who said the contract is the best doctors can hope for while the OMA goes through the court system in a bid to win binding arbitration for future contracts.

The coalition said the OMA is “trying to ram the deal through in the middle of summer vacation” and repeated warnings that the budget for paying physicians won’t keep pace with inflation and population growth.

“This will require physicians to ration care,” Jacobs said, calling for “full funding of growth in the system.”

He also voiced concerns that doctors, whom he acknowledged “make a good income,” will be squeezed on their fees, making it more difficult for them to pay overhead costs for rent, nurses and other staff in their offices.

The coalition maintains the OMA ignored the direction of its members in not getting the government to agree to send the contract dispute to binding arbitration.

Progressive Conservative Leader Patrick Brown said his party supports the push for binding arbitration, saying doctors are “essential workers” like police and firefighters whose contracts go to third-party arbitrators if an impasse is reached in negotiations.

“All options should be on the table . . . including binding arbitration,” Brown said in a statement.

Posted on August 9, 2016

The Globe and Mail: Coalition of Ontario Doctors urges colleagues to reject deal with province

A coalition of Ontario doctors is stepping up its campaign to reject the tentative four-year agreement between the government and the Ontario Medical Association, charging the deal is vague and could result in cuts higher than the $200-million already laid out in it.

The coalition doctors, who are urging their physician colleagues to vote down the deal, are trying to push this message in these last days before a critical meeting Sunday. They say that patient care will be compromised…

Click here to read the full Globe and Mail article.

Posted on August 5, 2016

National Post: Terence Corcoran: Judge rules OMA ‘sneaky’ in bid to have doctors ratify deal with province

The Ontario Superior Court of Justice invalidated the OMA proxy form, concluding it needed to be re-issued with fairer and more balanced language. The the Court released the ruling on Thursday contains hard language raising questions about the OMA’s tactics.

Click here to read the National Post article.

Posted on July 25, 2016

Coalition of Ontario Doctors Communiqué – July 25, 2016

Physician Coalition Petition Forces OMA to Cancel PSA Voting Referendum

Against significant odds, almost 3,000 family doctors and specialists have signed a petition in a little over two days under section 15.2 of the OMA’s own by-law to oppose the OMA’s effort to rapidly push through an approval of its recently announced proposed PSA that raised multiple concerns among a wide range of Ontario doctors.  The OMA conceded to the Coalition of Ontario Doctors’ legal team late Sunday night that at least 5% of the medical community had requested a general member meeting that required the OMA Board to respond.  As a result, all OMA Council activities are suspended until such time as a meeting is held.  The member referendum and the Council vote will be delayed until physicians have had a chance to discuss the proposed PSA, debate the pros and cons, and have their questions answered.

The Coalition, a group of OMA Sections and physician organizations, representing Family Physicians and Specialists, feel that the OMA’s surprise negotiation process failed to comply with its own commitment to securing binding arbitration (BA) as a necessary requirement to initiating negotiations with the Liberal government.  In addition to its failure to comply with the need for a fair BA process for Ontario doctors and their patients, the PSA was widely seen as being flawed, ambiguous, and the basis for further cuts to health care and under funding to appropriately meet patient care needs.

Today, a judge will be hearing an application for an injunction filed by Drs. Jacobs and Prieditis on behalf of the Coalition, to seek legal remedy and to enforce where necessary such activities and efforts to ensure that both sides of the PSA proposal can be addressed in a fair and transparent manner not previously afforded by the OMA’s process.


Coalition of Ontario Doctors

  • Concerned Ontario Doctors (Family Physicians and Specialists)
  • DoctorsOntario (Family Physicians and Specialists)
  • OMA Section on Cardiology
  • OMA Section on Cardio-Vascular Surgery
  • OMA Section on Diagnostic Imaging
  • OMA Section on Emergency Medicine
  • OMA Section on Nephrology
  • OMA Section on Neuroradiology
  • OMA Section on Nuclear Medicine
  • OMA Section of Otolaryngology, Head and Neck Surgery
  • Eye Physicians and Surgeons of Ontario
  • Ontario Association of Cardiologists
  • Emergency Physicians of Ontario
  • Ontario Association of Radiologists
  • Ontario Association of Nephrologists



Posted on July 21, 2016

OAC President on CTV News Toronto re: TPSA

Earlier today, OAC President Dr. Jim Swan was interviewed as part of a CTV News Toronto story regarding the growing opposition to the TPSA.


To see it, click here:

Posted on June 7, 2016

Ontario Cardiologists Call on Auditor General of Ontario to Investigate Misuse of Public Resources

Toronto (June 7): Today, the Ontario Association of Cardiologists (OAC) issued an open letter to Ms. Bonnie Lysyk, Auditor General of Ontario, calling on her to investigate the provincial government’s spending in cardiac care and report on what the association considers to be a serious misuse of public resources.

According to the OAC, the Ontario government’s unilateral actions of 2012 and 2015 have resulted in a lower quality of care at higher cost and increased utilization. These actions threaten the long-term viability of the health care system.

“These ill-conceived government decisions are endangering lives and the sustainability of cardiac care in Ontario,” said Dr. James Swan, President, Ontario Association of Cardiologists. “The people of Ontario need to be concerned.”

The OAC is urging the Auditor General to focus on two specific areas involving cardiac tests, namely:

  • Inappropriate over-billing for ambulatory cardiac rhythm monitoring tests (e.g. Holter monitors; external loop recorders), which we believe is costing the health care system millions of dollars. OAC urged the Ministry of Health and Long-Term Care to put a stop to this practice in July 2015 but nothing has been done; and,
  • The dramatic rise in commercial cardiac ultrasound services that was fuelled by the unilateral government regulatory change in October 2015 eliminating the requirement for a qualified physician to be present during these services.

“Ontario cardiologists are concerned by these activities, which are resulting in higher costs and lower quality care,” added Dr. Swan. “If not immediately addressed, these activities will wastefully increase the cost of cardiac care while eroding its quality.”

For more information or to speak with Dr. James Swan, please contact:

Media Relations
Dara Willis

Posted on June 7, 2016

Open Letter to Auditor General of Ontario Re: Ministry of Health and Long-Term Care Misuse of Public Resources

June 7, 2016

Ms. Bonnie Lysyk, CPA, CA, LPA, MBA
Auditor General of Ontario
20 Dundas Street West
Suite 1530
Toronto, ON MSG 2C2

Dear Ms. Lysyk,

The Ontario Association of Cardiologists (OAC) is calling on you, as the chief observer of provincial government fiscal accountability, to immediately undertake a review of the Wynne government’s cardiac care spending, through the Ministry of Health and Long-Term Care (Ministry), and to report on what we consider to be the serious misuse of public resources.

As physicians and taxpayers, we are turning to you as a measure of last resort, having exhausted all avenues of reasonable discourse with Ministry officials. Our message to these officials has been clear and consistent. The Ontario government’s unilateral actions of 2012 and 2015 have resulted in a lower quality of care at higher cost and increased utilization. These actions threaten the long-term viability of the health care system.

We are asking you to examine two issues involving cardiac tests. These are the most glaring examples of poor management, having been left completely unregulated for decades, despite persistent calls by cardiologists to regulate them.

1. We believe that certain ambulatory cardiac rhythm monitoring tests were, and are being, inappropriately over-billed to OHIP. They have been paid for without question for a number of years, costing the system millions of dollars. This continues despite cardiologists’ urging the Ministry in July 2015 to put a stop to this practice. The government’s inactions have encouraged the proliferation of these inappropriate billings, wastefully increasing the cost of cardiac care while eroding its quality.

2. In October 2015, the Ministry unilaterally decided to waive the longstanding requirement for a qualified physician to be present during the performance of cardiac ultrasound services. Quite predictably, this action has boosted the profits of commercial labs almost overnight. These labs provide services without a physician being present, and without regard to the appropriateness of these tests. Worse still, this Ministry decision has unleashed a flurry of new commercial interests whose sole goal is to drive-up utilization and maximize profits, further burdening the limited provincial health care budget.

The people of Ontario need to be concerned that the Wynne government’s mismanagement of health care is resulting in higher costs and lower quality care. We therefore request that you review these ill-conceived decisions that endanger lives and the sustainability of cardiac care in Ontario.


James Swan, MD,F.R.C.P.(C) F.A.C.C.
Ontario Association of Cardiologists

c.c. Hon Kathleen Wynne, MPP, Premier of Ontario
Patrick Brown, MPP, Leader of the Official Opposition
Andrea Horwath, MPP, Leader of the NDP

Posted on February 25, 2016

2016 Budget Fails to Address Ontario’s #1 Killer: Heart Disease

TORONTO (February 25): The 2016 Ontario Budget, tabled in the Ontario Legislature by Finance Minister Charles Sousa today, revealed that the Wynne government has no plan to fight Ontario’s #1 killer: heart disease. Instead, the government will continue to dramatically underinvest in cardiac care in 2016-17 making it more difficult for heart patients to access timely care wherever they live in Ontario.


“It is clear with this Budget that the Wynne government is more preoccupied with where Ontarians will buy their wine than where and how they will access cardiac care”, said Dr. James Swan, President of the Ontario Association of Cardiologists (OAC). “We question the government’s priorities especially when heart disease is the #1 killer of Ontarians and the financial consequences of ignoring funding for access to cardiac care will cost the provincial health care system millions of dollars,” he said.


Last year, the government unilaterally imposed unprecedented cuts to the Ministry of Health’s physician services budget, wreaking havoc on Ontario’s outpatient cardiac care infrastructure and access to cardiac care. As a result, heart patients now have to wait longer and are more likely to go to hospital for care that they used to receive in the community, which drives up the cost to all Ontarians.


Addressing Ontario’s #1 killer appears to be inconsistent with the government’s singular focus on cost-cutting and revenue generation to fulfill its balanced Budget promise before the next election. “The government is balancing its books on the backs of heart patients and the physicians who care for them,” said Dr. Swan. “Our message is clear: stop playing political games and start investing properly in cardiac care so we can limit the impact heart disease is having on patients and the health care system.”


At pre-budget consultation sessions with the Minister of Finance in January and the Standing Committee on Finance and Economic Affairs in February, the OAC urged the government to make fighting heart disease a priority in the 2016 Ontario Budget by reversing its budget cuts and re-investing in Ontario’s outpatient cardiac care infrastructure. The government has once again ignored the advice of Ontario’s cardiologists.


For more information, please visit:




President, Ontario Association of Cardiologists

Dr. James Swan, 416-487-0054

Posted on February 1, 2016

Submission to the Standing Committee on Finance and Economic Affairs – February 1, 2016 [VIDEO]

2016 SCFEA Pre-Budget Consultations
Presented by:

James Swan, MD, F.R.C.P.(C) F.A.C.C.
Ontario Association of Cardiologists
February 1, 2016