Fee-For-Service Family Physician MIG

Annual update

Dear FFS Family Physician MIG members,

We are now looking back on one year since formation of the MIG. Overall, we are very pleased with our reception at the OMA and specifically with our working relationship with SGFP. We have endeavoured to improve representation for FFS family physicians, through participation on committees and other collaboration with SGFP. We are very thankful to the SGFP executive who gave us a one-time grant to help fund our work. The Negotiations Task Force heard from us, MSPC heard from us. OCFP leadership met with us. We have advocated for our members while also offering our perspective and support as FFS FP “boots on the ground” members. Sadly, reminding OMA leadership about the challenges that FFS members face continues to be needed and it remains daunting to address the disparity within family medicine itself.

The negotiations and resultant PSA was an opportunity for significant discussion and participation to advocate for our members. There remains much to be done as the OMA has moved into the implementation phase. As you are all aware, the PSA has several restrictions that are relevant to us:

The MIG has several members who are focused-practice clinicians in areas that have not been granted focused practice designation. A group of these members has been working diligently to advocate for a process for exemptions from the new virtual care regulations. Many of these practitioners provided care to patients across the province, remotely pre-pandemic. The care of their vulnerable patient populations is at risk. It’s also a hardship for the practitioners. In addition, we have requested consideration from the Priorities and Leadership Group regarding change to the Focused Practice Designation process. You may see that on the “idea note page” on the OMA site. We feel that the current process of twice yearly granting of designations, largely to pre-existing focused practice areas, is not supporting our members as well as it could. There are a variety of focused practice areas to whom family physicians regularly refer that remain without official designations, i.e., cannabinoid medicine and transgendered medicine. The virtual care regulations have made this an urgent matter for these physicians.

Members practicing pure FFS walk-in medicine will also have significant challenges under the PSA with COVID-19 restrictions in place. It will be difficult for this group unless they return to full volume in-person care. Virtual care restrictions disadvantage them as well as the rural Ontarians without access to primary care. These members can be subtly disrespected by colleagues, while they work to keep low acuity patients out of our emergency rooms and treat the 1.3 million Ontarians who have no family doctor. Our system does not work in its current structure without walk-in medicine.

For those practising comprehensive family medicine, managed entry to FHO is reopened. We are told that further opening of the FHO model remains a SGFP priority. For now, the small number of spots is very problematic on an individual level. The negotiated restrictions do not seem to match well with the existing office infrastructure in many areas of RIO 0. Small offices and solo doctor practices are particularly affected without a clear path to apply to join FHOs. We have also asked the OMA to work on a program to assist members to form groups with a minimum six physicians and navigate the process. We have tried to put groups who have contacted us together on a small scale and thank those of you who reached out for your participation in that. Visit the managed entry page. We remain interested in hearing from members affected by the managed-entry restrictions, as well as from those of you who do have success. Please reach out to share your experiences, challenges and wait times at ffsmigdocs@gmail.com.

We are anticipating vacancies in the MIG’s executive in the coming weeks. We welcome expressions of interest from members who wish to step forward to advance the MIGs work.

Wishing you all a wonderful summer!

Warm regards,
Your MIG executive
Drs. Levitan, Brooks, Lajeunesse and Suppal

The Fee-For-Service Family Physician MIG gathers to address various issues facing FFS family physicians.