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Ontario cardiologists warn of mass exit unless fee cuts halted

Ontario Health Minister Deb Matthews answers question following the Auditor General's special report on Ornge air ambulance operations Mar. 21, 2012 at Queen's Park.

Moe Doiron/The Globe and Mail

Ontario cardiologists are warning that the province could see an exodus of heart specialists if the government doesn't reverse plans to drastically cut fees paid to doctors for medical tests done with their own equipment.

In a survey conducted last week by the association representing Ontario cardiologists, 43 per cent of about 300 physicians polled said they are seriously considering retiring or leaving the province within two years as a result of the fee cuts announced on May 7.

"It's of a magnitude we've never seen before," said Bill Hughes, president of the Ontario Association of Cardiologists. "We only have 450 cardiologists in Ontario. If 50 or 100 or even 30 suddenly are no longer available to practise because they retire early, that's catastrophic," he added. "That's a crisis of access right there."

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While Health Minister Deb Matthews would not comment on the poll results because she hadn't seen the survey, she said she doesn't believe the province will experience a dramatic drop in cardiologists.

"I would like to know from them where, what jurisdiction, they think they could move to where they will do better financially than they do in Ontario," Ms. Matthews said Wednesday evening. "Ontario doctors are extremely well paid, relative to other jurisdictions in Canada and internationally."

Cuts to some fees paid to cardiologists were among 37 fee schedule changes unveiled by the provincial government this month. The changes focus heavily on a relatively small number of high-paid specialists, mostly radiologists, ophthalmologists and cardiologists, who billed $585,348 on average last fiscal year.

The Liberals estimate the move will save the government – which faces a $14.8-billion deficit – $338-million in 2012-13 and $440-million in 2013-14. But Dr. Hughes, a cardiologist in Peterborough, said halving self-referral fees doesn't make sense and will affect doctors' ability to pay staff, rent and stay in business. Why, he questioned, should doctors be penalized for performing necessary heart tests and scans with their own equipment?

The Health Minister said she's open to talking with doctors about changes to the self-referral fee, slated to take effect July 1. She said the government proposed the change because reviews have shown physicians with diagnostic equipment are seven times more likely to refer a patient for a test than those without such equipment.

"We want to do what's right for patients," Ms. Matthews said.

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