If the PPSA is rejected, what is the alternative?

I have read many articles for many colleagues about the PPSA—Ontario’s Proposed Physician Services Agreement. Everyone explained the contract in a simplest way until it became clear even to those who do not like to read. The vast majority believe that it is not perfect and does not meet the requirements and needs of doctors. Everyone thinks that the Ontario Ministry of Health wants to run the business of doctors. Everyone thinks that linking the signing of the contract to the upcoming elections is unacceptable and reprehensible. Everyone thinks we are in a dark room and we have been asked to write yes or no even if we don’t see what we are signing on. Everyone says that no one cares about doctors and that they are a group that works a lot and earns little and will earn less with time. Everyone wrote about inflation and compared it to the expected and promised increase from the ministry. Read: Dr. Jabir Jassam: How to restore the value of family medicine I have read some great analyses that are rich in examples, evidence and numbers. I know that my colleagues have spent their time and effort writing these articles, and I thank them for what they said and wrote. I saw the courage of some of them writing without hesitation they voted no and others will vote no. The alternative I wish I had read one article or opinion on the alternative. If the contract is rejected, what is the alternative? How we can continue to work, take care of our patients, satisfy our ministry, and keep life beautiful and happy? I believe that as long as it comes to elections, the situation of doctors will not improve, because whoever wants to win will not try to satisfy doctors, but will portray everything as for the public in a simple way. The general public does not care about doctors, their financial well-being or their personal lives because in the end they know that doctors will be present at their workplaces and that they will be able to visit them now or tomorrow. We, the doctors, are now under pressure from the ministry to accept more work for little gain, and the general public who want to see us when they want without considering or caring about what we gain or lose. In the eyes of most people, we are a greedy group that wants a lot of money without working much, and whoever hears this talk from the government will believe it and will be against us. The government asks doctors to be accountable and because it seeks to win an election, it will not ask the same from the general public, even though the doctors are part of these people who will vote for them; a complex equation that requires a long pause and analysis. The matter will become more complicated, and things will reach a dead end, and neither the ministry nor the doctors will be satisfied. The ministry will not give another suggestion, and the doctors will not be able to stop working and the suffering will continue and probably more doctors will cease practicing. Therefore and In my humble opinion. . . I believe that the best available solution which may satisfy all parties—the ministry and the doctors, and will not harm the public—is for each patient to pay $10 or $20 dollars for each visit to a hospital, ER or a doctors’ offices. (Yes, I know: back in the 1980s, the Canada Health Act was passed outlawing extra billing but we need to help the underfunded healthcare system and we can change the act.) I know that this might be an uneasy proposition and if the government imposes it on people, it may lose the election, but it will win in the end a sustainable health system that serves future governments and generations. Dr. Jabir Jassam is a family physician in Ottawa.

If the PPSA is rejected, what is the alternative?

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