NB: The following is a guest blog, written by the (anonymous) author of the survey I referenced in, “Will the OMA Learn Lessons from OHIPs Latest Attack on Doctors?“. While it’s true these surveys tend to attract negative responses by their nature, the rather large number of respondents (especially compared to some of the OMAs own Thought Lounge surveys), suggests the OMA really needs to pay attention to the extreme dissatisfaction this issue has caused. My thoughts follow at the end.
The purpose of this survey was to highlight to the OMA the need to take this issue more seriously and to outline the impact the delayed payments had on members. The OMA’s response to this has been tepid. At the time the survey responses were collected, the payment timeline for November and December, 2024 retroactive pay was set as November, 2025. This was changed to August, but this does not alter the fact that the MOH has repeatedly delayed payments for physicians over the years.
Even with a signed, public agreement, the MOH has not managed to uphold its obligations, yet the OMA seems resigned, on behalf of its members, to accept whatever delays happen, based on whatever excuse the MOH provides. The members are not the cause of the MOH’s problems, yet they pay, over and over, for these deficiencies.
The survey results are summarized below. As a practicing physician, my time is at a premium, so I utilized AI to summarize the main findings of the survey.
Technology willing, the full survey results are here. Survey Monkey dashboard is here.
AI-Generated Summary of the Full Survey Document:
The survey responses reveal widespread dissatisfaction among Ontario physicians regarding delayed payments, systemic issues in healthcare administration, and inadequate advocacy by the Ontario Medical Association (OMA). Key themes include the impact of late payments, financial hardship and impact to personal finances.
Many respondents reported being unable to meet financial obligations, pay taxes, or fund discretionary purchases due to delayed payments. Some had to take on debt or cancel planned expenses like maternity leave benefits, vacations, or home down payments.
Clinic Operations:
Clinic owners faced cash flow disruptions, inability to pay staff, and delayed renovations. Others mentioned the administrative burden of tracking payments and rejected claims.
Mental and Emotional Toll:
Physicians expressed feelings of moral injury, frustration, and discouragement, with some considering early retirement or leaving the province entirely. The delay has eroded trust in the Ministry of Health and the OMA.
Lack of Accountability:
Respondents described the Ministry as untrustworthy, disrespectful, and adversarial, with unilateral decisions that breach agreements. Many called for interest payments on delayed funds and legal action to hold the Ministry accountable.
Systemic Issues:
Complaints included outdated payment systems, rejected claims, and lack of transparency in billing processes.
Weak Advocacy:
Many respondents felt the OMA failed to advocate strongly for physicians, with delayed and insufficient responses to the payment issue. Some called for legal action, media campaigns, and stronger negotiation tactics.
Loss of Trust:
Physicians expressed frustration with the OMA’s perceived lack of power and transparency, with some questioning the value of membership dues.
Declining Appeal to Practicing in Ontario:
Many respondents are considering leaving Ontario or medicine altogether due to poor compensation, lack of respect, and systemic challenges. Some noted that other provinces offer better pay structures and support.
Family Medicine Crisis:
Respondents highlighted the lack of investment in family medicine and primary care, with concerns about burnout, scope creep, and inadequate funding.
Rejected Claims:
Physicians reported valid claims being rejected by OHIP , causing financial losses and administrative burdens.
Delayed Payments:
Delays in flow-through funding, parental leave benefits, and relativity-based fee adjustments were frequently mentioned.
Outside Use Penalties:
Respondents criticized penalties for outside use, especially when patients sought care elsewhere due to hospitalizations or urgent needs.
Recommendations for Advocacy:
Demand Accountability:
Push the Ministry to honour agreements, pay interest on delayed funds, and improve payment systems.
Increase Transparency:
Advocate for clearer communication about payment timelines, rejected claims, and billing processes.
Strengthen Negotiation:
Take a more aggressive stance in negotiations, including legal action and public campaigns to highlight the Ministry’s failures.
Support Physicians:
Address broader issues like rejected claims, outside use penalties, and inadequate funding for family medicine and specialists.
Conclusion:
There have been severe financial, emotional, and operational impacts of the delayed OHIP payment. There is an urgent need for the OMA to advocate more forcefully with the Ministry of Health to address late payments and systemic issues affecting Ontario physicians. Physicians are calling for immediate action, including interest payments, stronger advocacy, and accountability from the Ministry of Health and the OMA. The dissatisfaction expressed by respondents highlights the risk of losing physicians to other provinces or professions if these issues are not resolved.
An Old Country Doctors Thoughts:
While the above was written by my colleague, my personal thoughts on the survey is that I’m not really surprised by the results. I try to “keep my ear to the ground” so to speak, and there is a broad level of dissatisfaction with how the MOH repeatedly gets away with violating its own signed contracts, and the frankly abject level of incompetence at the MOH. The incompetence is unfortunately, not limited to just their payment systems/processes, but also how they run health care in general.
I’m also not surprised by the negative comments towards the OMA. Admittedly (as mentioned before) these surveys tend to cater to negative responses. However, there is a real sense of defeat on the ground about how physicians are being treated by the current government (protracted arbitration, stupid statements about the family physician shortage, and more). My sense is most physicians are resigned to defeat and are disengaging from health care – which is bad for the whole health system.
It does not help frankly, that a few short days after being told physicians would not get paid on time, OMA CEO Kim Moran was quoted in an Ontario Government News release on Primary Care saying:
“Ontario’s doctors are encouraged by this announcement and look forward to working with government to ensure that every Ontarian has access to a family doctor. We will do everything we can to accelerate this goal by collaborating with Deputy Premier and Minister of Health Sylvia Jones, and the lead of the Primary Care Action Team, Dr. Jane Philpott. It’s a long road ahead but this is a positive step forward to protecting Ontario’s valued health care system.”
Kimberly Moran
CEO, Ontario Medical Association (OMA)”
A very well respected physician from another province told me after seeing this: “It’s a bit pathetic. Screw us over and we’ll still be nice to you”. Personally I think Ms. Moran should look up “Stockholm Syndrome“.
I’ve repeatedly said you cannot have a high functioning health care system without happy, healthy and engaged physicians. These survey results suggest that that isn’t the case in Ontario.
justanoldcountrydoctor 
Doctors and the Stockholm Syndrome
by Stephen Skyvington
On August 23, 1973, a thirty-two-year-old career criminal by the name of Jan-Erik Olsson, who had just escaped from prison, entered a bank in Stockholm, Sweden, along with an accomplice, and began firing off his machine gun, announcing to a group of startled bank employees, “The party has just begun!” The employees had sticks of dynamite strapped to their bodies and were held hostage until they were finally rescued five days later.
What makes this story particularly fascinating — to me and to a number of psychologists who’ve studied other hostage-taking scenarios — is the rather shocking and totally unexpected attitude the hostages exhibited following their release. In media interview after media interview, all four of the hostages showed support for their captors and empathized with them. Even more bizarrely, the bank employees were fearful of those who’d come to their rescue, believing irrationally that the robbers were actually protecting them from the police. During a phone call from the vault with Sweden’s prime minister, one of the captives even implored the PM to provide a getaway car so the hostages could leave the bank along with the kidnappers.
“So, what does all this have to do with doctors?” you’re probably wondering.
Good question. Let me try to provide an answer. Having worked closely with physicians for the past thirty years, I’ve come to know how doctors think, behave, and react. Believe me when I say that those who heal us are not like you and me. They’re not motivated by greed or money. They don’t believe in playing politics or getting even. And they most certainly aren’t trying to win any popularity contests by doing the politically expedient thing instead of the right thing. Doctors, for the most part, are solid citizens. We can trust them. We can put our faith in them. And, unlike our elected officials, we can believe what they tell us. But doctors are not perfect … far from it. They’re gullible and easily fooled. Time and time again, they make bad business decisions and often put their faith in the wrong people. Worst of all, they’ll go to almost any lengths to make excuses for those in charge — even when those same politicians are threatening both their livelihoods and their lives.
That doctors here in Canada are suffering from a severe case of Stockholm Syndrome there can be no doubt. To prove this, I’m going to share with you some inside information that’s not generally known to the public. We’re going to have to travel all the way back to 1994 — the year before Mike Harris and his Progressive Conservative Party tried to bring common sense to Ontario. In 1994, Dr. Hugh Scully and a group of prominent Ontario doctors produced a report that called for, among other things, a parallel private health care system. You heard me right. The hybrid health care system that I and others are so vocally advocating for had its beginnings in the Scully Report. As previously mentioned, three months after I began working at the Ontario Medical Association, Harris and his fellow common-sense revolutionaries surprised just about everyone by winning a majority, defeating both the Liberals and the NDP by a wide margin. Within the OMA, there was a great deal of debate as to when would be the right time to present the new premier with his own copy of the Scully Report.
Just as Rome burned while Nero fiddled, however, things were happening behind the scenes, and voilà, before anyone knew what was happening, finance minister Ernie Eves stood in the legislature and introduced the Savings and Restructuring Act — an enabling piece of legislation that would, in effect, give several ministers, including the newly installed health minister Jim Wilson, the right to play God. One thing that’s not generally known is that in the original version of the bill the Ontario Medical Association was going to be legislated out of existence. The new government also stated they would no longer cover any portion of doctors’ malpractice insurance fees.
Following a series of very public skirmishes, including a rather effective job action undertaken by the province’s obstetricians and gynecologists, who refused to take on any more pregnant patients unless the government changed its mind about their malpractice insurance fees, the OMA and the Harris government eventually hammered out a new Physician Services Agreement in 1997 — one that would allow the medical profession to “co-manage” Ontario’s health care system through the Physician Services Committee.
This was it, right there. The moment when things could have gone one way, but instead went the other. Doctors, beaten and abused and obviously worn out, caved in and agreed to help fix health care by co-managing the system. I remember the sense of jubilation inside OMA headquarters. Everyone there — including me, I’ll admit — thought we’d actually pulled off something of a coup. Co-managing Ontario’s health care system. Wow! What more could you ask for — especially if you were a special interest group like the Ontario Medical Association? Unfortunately, as we saw with those Stockholm bank employees, snuggling up with those who may not have your best interests at heart is a poor idea at best and a dangerous one at worst. For not only would the province’s doctors do everyone a huge disservice in the years to come by propping up our crumbling health care system so our elected officials could continue to perpetrate the myth that our country has the best system in the world, they also fell asleep at the switch and failed to realize they were being recruited by the Harris government to weed out fraud — something Jim Wilson was obsessed with. Thus, when the CPSO’s Medical Review Committee began ramping up its activities in 1999, the OMA turned a blind eye to what was going on, assuming that if their partners in managing the health care system felt doctors were guilty of ripping off the system, then those doctors must indeed be guilty.
Stephen Skyvington was the former manager of government relations for the Ontario Medical Association. His book, This May Hurt A Bit: Reinventing Canada’s Health Care System, was published in 2019 by Dundurn Press.
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