Ontario Radiologists Deliver Important Value to Patients
Radiologists are highly trained physicians who provide the Ontario public with important medical services including the diagnosis of cancer, stroke, vascular conditions, trauma, infectious and inflammatory disease to name some of the leading causes of mortality. Radiologists are at the nexus of the delivery of specialty and emergency care. Primary care depends on timely diagnoses to manage and triage the care of all patients. Diagnostic imaging services (x-ray, ultrasound, mammography, interventional radiology, CT, MRI and PET scanning) have contributed directly to tangible improvements in the health of patients worldwide. Many of these radiology advances have been awarded Nobel Prizes and are commonly seen as among the most important changes to the delivery of health care in the past 50 years. As such radiology is on the leading edge of medical care due to its unique technology focus to deliver a large number of important procedures on a timely basis.
It is not surprising that specialist physicians are well compensated for their medical training taking a minimum of 10 years following under-graduate and often post-graduate training. It is unfortunate that physicians as a trusted profession have been made a target to be vilified for cheap political reasons while ignoring the significant value that every patient place on their care and access to medical experts.
The previous Liberal government used physician compensation in a high-profile‘shame and blame’campaign that repeatedly denigrated hard working Ontario doctors as a tool to stir up angst throughout their prolonged and failed negotiations with doctors. Doctors want to continue to work for the people and provide needed medical care across Ontario. Doctors are not politicians and want no part in the political gamesmanship that is occurring with respect to the misuse of their gross billing data.
We maintain a belief that individual physicians deserve privacy balanced with the public has the right to know how the investment they make into health care is spent. Naming individuals is a breach of personal privacy which benefits no one. These billings are not a doctor’s take-home earnings. This is a fact conveniently overlooked by physician critics. Radiologists have overheads of 70% or higher depending on the nature of their individual practices.
There is a critical shortage of radiologists in Ontario. Radiologists gross billings do not reflect a 9-5 work day. Fewer than 1,000 Radiologists provide 24/7/365 medical coverage for the 13.5 million Ontario patients providing urgently needed emergency diagnoses and the diagnosis and follow-up of the leading causes of death. Gross billings do not provide the necessary transparency to explain that up to 50% of a radiologist’s billings are performed during after-hours periods or that they work in the highest cost areas of medicine (70%+ overhead costs due to the significant technology, specialised space needs and highly trained technical staff and unique supplies). Radiologists provide over 20 million diagnostic services and procedures to a rapidly growing and aging population. The Ministry of Health continues to allow and actively encourage more allied health professionals to order more radiology examinations and then seem bewildered that radiologists have to work longer and harder to keep pace with the demand. The cost of physician services is going up because of more need not an increase in physician fees that have largely remained the same since 2008 or lower as a result of unilateral MOH fee cuts. MOH urges more rapid access to radiology to ease the ER department bottlenecks or increase the number of CT and MRI services to reduce wait times that are already too long and hurt patients.
Arbitrarily choosing a small and statistically invalid number of Ontario’s doctors (100 out of over 35,000 or 0.29%) was designed to create mischief. Doctors are helpless to protect themselves from malicious coverage intended to put them and the medical profession in a bad light.
The Truth about Recent ‘Physician Billing Accountability and Transparency’ Statements
- Comments about the need for physician billing accountability and transparency improperly infers that physicians operate without accountability, even though it is well recognised that physicians are required to meet rigorous standards of accountability and transparency.
- Every medical action of every physician is legislated, regulated and subject to many forms of quasi-judicial and administrative control.
- Physician fees are set by the MOH. They are unilaterally reduced by MOH. Funding levels and payment models are implemented by government. OHIP is solely responsible for paying doctors and already scrupulously audit physician payments. Billing rules are arbitrarily decided by the MOH.
- MOH sees doctors as soft targets that can be put on the defensive through the use of a clever campaign to misdirect public attention away from past MOH failures. Physicians can be accused of inappropriate utilisation even though they do not control demand, and can be blamed for having higher billings when more services are encouraged by MOH and solely approved by OHIP.
- Ontario radiologists are among the hardest working doctors. We provide critical patient care services under difficult circumstances. Almost 50% of our services are delivered after hours on a 24/7/365 basis. We provide well over 20 million diagnostic services to a growing and aging population. We are continually expected to provide more services. We meet shorter reporting turnaround times. We extract greater efficiency from diagnostic equipment to shorten wait times and provide much needed access recognising it means we spend more time working to meet patient care needs of our referring physician colleagues.