As a Family Doctor, Ontario’s Fee Cuts Make Me Want to Quit

In Commentary, Opinion by Ming Yu2 Comments

I graduated from family medicine residency in Ontario three years ago. I’ve spent the last two years building up a family practice serving an underserviced population of non-English speaking new immigrants, as well as patients from about three to four local family physicians who quit prematurely due to burnout. At least weekly I work one night until 12 a.m. to review labs and update my patients’ records, filling out disability forms and advocating for my patients by arranging home care. I make house calls after my clinic days for elderly patients, I do skin biopsies, freeze actinic keratoses and perform incision and drainages in clinic to save my patients the wait to see a dermatologist or a trip to the ER. Our clinic has worked hard to recruit GP psychotherapists, dieticians, ear-nose-throat surgeons, audiologists and even addictions services to help serve our patients better.

Up until now, I have really enjoyed working as a family doctor, getting to know my patients and I take their trust and confidence in me very seriously. Up until now, I have not complained about my work keeping me away from my two young children or taking mountains of unpaid paperwork home to do late into the night after they have gone to bed, but I am getting weary.

Fee cuts for Ontario physicians

The Ontario government is cutting fees for doctors. It’s been happening since 2012 and it’s getting worse. Now there will be an unknown amount of government “clawbacks” (retroactive fee cuts) next year where I may not be paid for up to two and half months. In my weariness I see now why the other community physicians have quit out of fatigue, frustration or anger. I see all of these sacrifices I’m doing to help my patients at the expense of my personal and family life being devalued.

I’m driving an econo-box car and live in a 65-year-old semi-detached bungalow, paying my mortgage and saving up for my children’s education just like most of the population. Much of my income goes to the College of Physicians and Surgeons of Ontario, insurance, the College of Family Physicians of Canada, continuing medical education courses and books, my accountant, my office overhead, disability insurance, saving for a few weeks of unpaid vacation, and saving for my retirement because I have no pension to depend on.

Still, I’m being portrayed as some sort of greedy, wealthy money-driven elitist who can absorb a string of fee cuts over the past two years and also be responsible for paying back extra money spent to care for our provinces’ growing and aging population — neither of which are under my control.

Ask yourself this: Do you have to pay back part of your salary because your employer is poorly operated and losing money? Do you have to start saving six months in advance for potentially not being paid two and half months and not being told exactly how much until only months before you’re getting the cuts?

I hope you all have great family doctors, but be wary. The quality of care you have come to expect is going to be a distant memory in the near future if things don`t change. I’m seriously thinking about quitting — and I know I’m not the only one.

Frontdoor 2 Healthcare

Frontdoor2Healthcare, founded by Dr. Edmund Kwok in 2012, provides editorial and commentary on issues affecting Canadian healthcare from the emergency department’s “front door” perspective. Frontdoor posts allow for open sharing of the diverse opinions and perspectives of emergency physicians from across the country.

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