Our profession has endured a lot. Since 2012, Cardiology has been subjected to attack by misinformation and arbitrary government cutbacks. At every juncture, your association has been there to fight for what is right for cardiologists and their Ontario patients and we have made huge strides. Now, we need to understand the details and consequences of this newly proposed Binding Arbitration agreement before voting on June 17, 2017.
Last year the OAC played a key role in ensuring the temporary Physician Services Agreement (tPSA), which was orchestrated in secret by the Ministry of Health and the past executive of the OMA, was soundly rejected. As part of the Coalition of Ontario Doctors (Coalition) we won the right to Binding Arbitration that we had fought so hard for and now, we need to follow through on very important next steps.
On June 17, 2017, as a member of the OMA you will be asked to vote on a tentative binding arbitration agreement (BA) with the Ontario government. A general meeting has been called for that day to vote on the tentative “framework appendix for negotiations, meditation and arbitration”. The result of that vote will have major implications for cardiology (indeed all healthcare) for decades to come. Let’s make sure we get it right and vote based on a clear understanding of what this vote is all about.
Recently, the Coalition shared the opinion of Mr. Andrew Lokan, a leading constitutional law expert. He assessed the proposed BA in the context of “how this compares with other BA agreements and how well this proposal would work for Ontario doctors”. Mr. Lokan raised 5 key issues that need clarification before OMA members should cast their votes. These issues are:
5 Key Issues that Need to be Answered Before Voting
This BA entrenches the OMA as the permanent bargaining agent for doctors. Usually there is a mechanism to remove and change an agent if warranted, but this is not provided in this BA.
This BA has the OMA taking on a significant role in the healthcare budgeting baseline. Ask yourself first “Could this generate internal conflicts if cutbacks are forced on a particular group “and second, “what current structure exists within the OMA to deal with this?”
This BA envisions mediation and arbitration as a singularity. During the mediation phase, hints may be intentionally (or unintentionally) dropped that later affect arbitration. It’s best to clearly separate the roles of mediator and arbitrator.
This BA talks about the inclusion of specific criteria for arbitration, including the permanent inclusion of income relativity. Giving prominence to income relativity over other issues has the potential to pit one group of doctors against another, which is divisive and unfair.
This BA says “this is good until 2023” which implies the CMPA supplement will most likely be gone after 2023.
Recent OAC Initiatives and Successes
The OAC exists to stand up for our members and to advocate on behalf of Ontario’s cardiac patients. The OAC is you … and it’s your voice and financial support that have allowed us these recent successes.
Protecting Cardiologists While Ensuring High Quality Care for Patients
The Cardiac Care Network’s Echocardiography Quality Improvement (EQI) program underwent significant changes in 2016-17 to its processes, personnel, and documentation.
The CCN required that a “Facility Agreement” be signed by all facility owners as part of the EQI program. The OAC discovered that it contained an indemnity clause that could expose facility owners to significant cost and legal liabilities, should legal proceedings be initiated against the CCN and/or Ministry in connection with the program.
The OAC worked long and hard to improve the Facility Agreement, to protect cardiologists. In March 2017, we were successful in our efforts to have the clause removed. Some further issues still remain that require our ongoing attention and work. OAC is committed to resolving these quickly with the CCN so that OAC members can feel comfortable signing the document and proceeding through the accreditation process.
OAC Members: A Source of Clinical Expertise
New health care technologies can help improve patient care and reduce costs. Awareness of evolving developments and the ability to measure their actual effectiveness against established parameters is critical.
In April 2017, Health Quality Ontario (HQO), an agency of the Ontario Ministry of Health and Long-Term Care, reached out for OAC’s help in conducting a health technology assessment or (HTA). “Remote cardiac monitoring” is a new and potentially useful tool for health care that will be assessed with OAC input that will culminate in a report to the Minister in May 2018. HQO asked if the OAC could provide clinical experts to assist with its review and recommendations concerning the prospect of extending public funding to technologies that remotely monitor pacemakers, ICDs, and cardiac resynchronization device therapies. The OAC welcomes this government outreach and looks forward to having more opportunities to contribute to public policy development and government funding decision-making in cardiac care in the future.
View our newsletter, The Pulse, to learn more about what OAC has done recently to protect health care of Ontarians. Please remember that June 17, 2017 is a pivotal moment for Ontario cardiologists and their patients. Decisions will be made that day that impact the next decade of cardiac care. Please, let’s all add our voices, pay attention to the FINE PRINT and make the right decisions.
James Swan, MD, F.R.C.P.(C) F.A.C.C.
President, Ontario Association of Cardiologists