Ontario's addictions doctors reach deal with province over pay for virtual care
CBC
Ontario's doctors have reached a deal with the province over how much addictions physicians will be paid for virtual care after they raised an outcry over previously planned changes they said would have put 30,000 patients at risk of losing lifesaving opioid treatments, The Canadian Press has learned.
Details of the deal were not available but an internal email from the Ontario Medical Association — which represents the province' doctors — to addictions physicians said the agreement would resolve concerns that a drastic cut in funding for virtual care could leave patients without access to treatment.
"An agreement in principle between the Ministry and the OMA bargaining teams has been reached," Dr. Chris Cavacuiti, who leads the OMA's addictions section, wrote in the email sent late last week that was obtained by The Canadian Press.
"The final outcome will result in the status quo for our practices in terms of delivering and billing for video services."
The issue arose after the Ministry of Health and the OMA, which represents the province's doctors, reached a "physicians services agreement" in February, part of which dealt with upcoming changes to Ontario's virtual care program.
At the time, both sides agreed to hammer out details on lingering issues, one of which was the unintended consequences of the changes.
The changes were to take effect Oct. 1 but were delayed to Dec 1. because the province could not make the necessary computer system changes in time.
Addictions doctors said the agreement would cut a $15 virtual care premium paid to doctors per virtual visit.
They argued that meant many physicians may no longer be able to afford to provide treatment for those needing certain opioid therapies.
The doctors emphasized that the main issue was many in the field rely heavily on treating hard-to-reach patients through virtual means, particularly for opioid agonist therapy that involves getting patients on methadone and buprenorphine treatments, which help curb relapses and avoid overdoses.
There are about 600 addictions doctors who specialize in that therapy — about 200 of them use virtual care.
Internal Ontario Medical Association emails and documents obtained by The Canadian Press show that by early September, the province refused to make any exceptions to the physician services agreement for addictions doctors,
"The OMA has repeatedly advised the ministry that proceeding with [the physician services agreement] implementation as scheduled, without addressing these unintended consequences, would adversely affect access to equitable health care and the well-being of several vulnerable cohorts of Ontarians," association board chair Dr. Cathy Faulds wrote in an email on Sept. 7 to members.
Addictions section head Cavacuiti, who declined to comment when contacted, wrote on Sept. 20 to his colleagues saying that the changes meant about 30,000 patients who rely on virtual care for opioid agonist therapies were at risk of losing to the treatments.
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