Getting on the Provincial Agenda

An Update from the Ontario Orthopaedic Association

David A. Wismer, M.D., FRCSC
President, Ontario Orthopaedic Association
Toronto, ON

The Ontario Orthopaedic Association (OOA) has been very active the past several months in its quest to improve the economic position of its members and the access to quality orthopaedic care for our patients. Our strategy has been to engage a government relations firm and an economic consultant. This two-pronged approach has been helpful to the OOA in refining its priorities and better positioning our Association for productive negotiations.

We are still early in the process but there are some encouraging signs that our efforts are bearing fruit. The Ontario government has been heavily criticized in the media and public for lack of delivery on pre-election promises and, particularly, for the implementation of a health tax that is to be directed totally to health care in the province.

In order to blunt the sting of the new health care tax, one of the Premier’s budget promises has been particularly helpful to the OOA in opening doors at the Ministry of Health (MOH): “to reduce waiting lists, an additional 2400 TJA will be performed in Ontario this fiscal year.” The complexity in delivering on this promise has been the starting point for our discussions with the MOH.

The OOA has produced a list of needs that is directing our government relations efforts:

1. Increase resources to the OR

• This to help the government deliver on its promise of an additional 2400 TJAs.

• The government has already suggested that some surgical services and procedures (e.g.: ophthalmology) may be moved out of the OR in order to accommodate the increased resources for orthopaedics, however a dedicated funding model may be years away. Protected funding for the cost of implants only may be a temporary, stop gap measure.

• An increase in the consult fee is a starting point here. Currently, Ontario ranks 9^th lowest out of the 10 provinces. A 15.6% increase would only bring Ontario’s consult fee to the national average. There are also some serious issues in intersectional equity, particularly in paediatrics, hand/upper limb and foot and ankle surgical fees. We have presented data to the MOH that shows Ontario has been able to retain less than half of the orthopaedic surgeons trained in the province for the past several years.

• A long-term issue, but one that must be addressed if we are to effectively solve the retention and recruitment crisis.

• We have discussed with the MOH officials the potential solution that exists with physician extenders. The government has been very receptive on this point.

• A dedicated form fee to incentivize the remaining 30% of Ontario surgeons who do not participate in the OJRR.

In a relatively short period of time, the OOA has been successful in raising the awareness of the crisis that exists in our profession in Ontario. This report is very preliminary – I look forward to updating our colleagues across the country on what we learn and accomplish in this exercise and also to hear what other provincial associations are doing to address similar challenges.