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Ontario Seeks To Slash Radiologists’ Income

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Ontario’s government wants to cut hundreds of millions of dollars from payments to doctors, with some specialties particularly targeted—including radiologists.

Zita Astravas, spokeswoman for provincial Health Minister Deb Matthews, justified the cuts by saying that new technology allows radiologists to conduct 25 to 30 percent more MRI scans in a day than previously. Canada’s national health system works primarily on a fee-for-service basis, with care provided by private entities and the government acting as insurer for most services. So, theoretically, radiologists have been able to make more money by squeezing more paying services into each day.

The Ontario Association of Radiologists says that if the government’s proposed cutbacks become reality, clinics would close, doctors would flee the province, and wait times for services would sharply increase. Ray Foley, executive director of the association, told the Toronto-based National Post newspaper:

They’re basically trying to trash the medical profession, for reasons that don’t make a lot of sense. We think it’s going to be devastating. It’s not going to cause an erosion of patient care; it’s going to create a chasm in patient care.

The government says tight budgets mean everyone has to sacrifice. It has proposed a pay cap for all public-sector workers and wants to freeze physician payments at the current $8 billion over the next two years. Because of new doctors entering the market and an aging population needing increased care, that means less money for each individual physician.

The government also says physician pay has more than doubled in the province since the early 1990s.

Neither the government nor the Ontario Medical Association has revealed specifics of the government’s proposal. However, Foley did. He said the government wanted to cut all radiologists’ fees by 5 percent and stop paying for diagnostic imaging of patients with chronic back pain and ultrasound scans for certain vascular conditions.

He said the government also proposed “clawbacks” of 5 percent on billings of $400,000 to $750,000, 10 percent on billings of more than $750,000 to $1 million, 25 percent on billings of more than $1 million to $2 million, and 40 percent on billings of more than $2 million.

Collectively, the Ontario Medical Association estimates, radiologists in the province would lose $61 million in income.

The Post quoted Mark Baerlocher, MD, as saying the proposed cuts had sparked a “huge amount of anger” in the medical community. Dr. Baerlocher is an interventional radiologist in Barrie, Ontario. He said he received an average of one unsolicited job offer a week from U.S. clinics.

“I’m 33,” he said. “I’m coming out of 15 years of training with a debt of $225,000. If they actually pushed these cuts through, it would be pretty tempting to leave.”

Related seminar: The Business of Radiology


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