OSA Communique - 2019 - A Year OF Change For Ontario Physicians

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 Summary of OSA Activities Occurring in December 2018

  • OSA Board meets weekly in person and/or via teleconference discussing and deciding key matters of importance to OSA specialists

  • Meeting being scheduled with Health Minister Christine Elliott re: OSA separate representation

  • OSA Governance Sub-Committee struck to create a transparent organisation that represents OSA members equally and respects minority rights of small specialists

  • Several OSA Board resolutions passed unanimously include: 

    • Ensuring each OSA specialty is represented on OSA Board

    • De-Randing for all OSA members

    • Approval of RBC’s OSA life/disability/critical illness insurance program to replace OMA’s

    • Releasing RFP for other ancillary insurance and financial services

    • Affirmation on key positions re BA, separate representation and de-Randing (below)

  • Creation of OSA organisational structure to initiate engagement of senior legal negotiators, corporate lawyers, economic advisors/analysts and OSA CEO/staff, etc.

  • Strategic alliance with Canada’s largest financial institution to meet critically needed insurance services

  • February 1-2019 roll-out of the OSA RBC life/disability/critical illness/business overhead replacement program to facilitate specialists transferring from OMA programs on a competitive to significantly less expensive on a package basis avoiding rebates

  • Individual physician ownership of your insurance plans without risk of losing important coverage irrespective of your membership status

  • January 2019 RFP be issued to leading insurers seeking more competitively priced health, medical, travel, dental, wealth management, private banking, leasing and other commonly required financial services

  • Pending review and approval of other RBC no medical life/disability/critical illness/long-term care insurance coverage for specialists, spouses, etc. beyond the Phase 1 OMA replacement program

  • Review of other non-financial services needed by OSA members

  • Deployment of government relations program introducing OSA to legislators and MOH officials

  • Ongoing communications to keep OSA specialists and other Ontario specialists abreast of developments

  • Maintaining a respectful relationship position with the OMA during and after the formation of the new OSA organisation to optimise the overall bargaining position and profile of all Ontario physicians with the request that it will be reciprocated (see position on interim OMA membership reminder in this communiqué).

  • Affirmation that OSA will outsource for the best available expertise to avoid creation of an expensive bureaucracy and other overheads to control cost of voluntary OSA membership fees

OSA Positions on Binding Arbitration, Separate Representation and De-Randing

The formation of the Ontario Specialists Association is well under way.  There has been a tremendous amount of good will as OSA specialists firmly endorse it as their legitimate representative to negotiate on their behalf. Other supportive specialists have contacted the OSA about joining.

This kind of success entails change, and we all know change brings uncertainty and fear. The OSA change is no different with many comments and statements being made since the successful referendum.  While most comments are accurate, there have been some that have confused the purpose and position of the OSA.  An example is the unwillingness to recognise that the OSA now represents ~20% of Ontario’s specialists after only 3 months since its inception.

Why was the OSA formed?

  1. There continues to be serious governance problems at the OMA and an intractability to appropriately and equitably represent minority interests.  Despite several efforts, the expected changes have not materialised following the overwhelming rejection of the OMA’s 2016 tPSA proposal.  These include the failure to ensure wide ranging OMA governance reform and the execution of an impartial forensic audit.

  2. The OMA’s untested relativity model is widely recognised as being irretrievably flawed.  Instead of quickly fixing a recognised problem it has instead created the conditions that have set section against section to the benefit of the MOH.  The failure to manage this crisis has been worsened by a series of flip-flops.  Efforts to find a better way like the proven American RVU approach have been rebuffed without material explanation.

  3. The needs of family physicians and specialists have changed significantly such that no one organisation can reasonably meet their different interests and requirements.  This is a fact of how medicine has evolved, and our organisational capability has not kept pace.  It was not a surprise that an OSA would emerge.  It is important now that both the OMA and the OSA mutually respect the existence of each other, as we have pledged, in order to meet the quite different needs of our respective physician members.

What is the purpose of the OSA?

  1. To create an organisation that has a transparent, accountable and ethical governance structure that fairly and equitably represents the unique needs of specialist physicians irrespective of their size and area of medicine, while advancing the health care needs of their patients in a manner that has been overlooked far too long.

  2. To negotiate with the Ontario government in a results-oriented and commonly aligned manner that is premised on ensuring meaningful change and improvement for our patients while ensuring respect for Ontario specialists.  To repair the damage that has occurred to specialists over the last decade in an environment of trust recognising that it will take time to accomplish what both sides seek.

  3. To obtain separate representation now to ensure that the OSA is the sole representative of those member specialties in a separate negotiation.  This requires legislative change to the Representational Rights Act.  We do not seek to interfere with the rights of the OMA to represent those physicians who freely elect to remain with the OMA.

  4. To end the application of mandatory OMA membership by ending the randing of doctors who are members of the OSA via a legislative change in the Ontario Medical Association Dues Act.  It is the business of other physicians who are members of the OMA to decide what they believe is best for them and the OMA with respect to Rand membership.

  5. The OSA has written to both the Ontario Health Minister and the Arbitrator and specifically asked that the OSA’s involvement in the OMA binding arbitration process be paused until the legislative changes to the Rep Rights Act and the OMA Dues Act are amended in the Ontario legislature. We have not in any way abandoned BA rights for OSA members.  Likewise, we have not sought to interfere with the OMA’s involvement in the current binding arbitration process as has been incorrectly suggested.

  6. Our priority it to secure legislative change to make the OSA the recognised negotiation entity for OSA specialists only and to ensure that separate negotiation representation, a separate binding arbitration process and de-randing rights be accorded to the OSA that recognises the uniqueness of our collective specialty care services to patients.

  7. To negotiate a fair agreement with the Ontario government and to retain all of the other attributes and protections that have previously been negotiated for all doctors, including current and future OSA members. This includes binding arbitration rights as a cornerstone element to ensure fairness and equity between Ontario specialists and the Ontario government when needed.

 OSA Receives Reply Letter From Ontario Health Minister

 The OSA has received a response from the Health Minister this week recognising the emergence of the OSA and has committed to meeting in January to discuss our representation request and need for self-determination.  The important building block work of the OSA Board continues. 

Questions Re 2019 OMA Membership Renewal Notices

OSA specialists are receiving 2019 OMA membership renewal forms and have sought our advice regarding whether they should renew in view of the recent successful endorsement of self-determination by eight (8) specialist sections representing over 3,000 doctors. Our advice is that members should continue to protect their interests by renewing OMA membership on a monthly basis only.  This will permit OSA members to end OMA membership once separate representation and negotiation rights have been recognised by the Ontario government.  There may be other reasons why some specialists may need to maintain OMA membership.  The most notable reason is their OMA insurance if it is determined that their age or health status makes that a relevant factor. 

If you have further questions, please email them to the OSA at info@specialistsontario.com