We, as individuals on the Board of Directors of the Ontario College of Family Physicians, reflect practising family physicians from across the province in various practice models, ages and stages of career and backgrounds. Together, we are guided by our vision that every Ontarian receive high-quality, coordinated, comprehensive, and continuing care from a primary health-care team led by family physicians and supported by an integrated and sustainable health-care system. This statement provides a framework for us to make decisions about what work the OCFP undertakes, and how we will support you as family physicians to do the work you do every day.

We have met as a Board to discuss what we know of the tentative Physician Services Agreement (tPSA) at this point in time and to try and understand what it means for family physicians and family medicine. While many family physicians may be disillusioned, angry, frustrated, resigned or confused by the way the tentative Agreement was reached, we must remember that it is the absence of an Agreement that brought about recent changes that were not informed by physicians. As a Board, we are committed to being part of informing the proposed changes that will impact family medicine and ensuring our members are heard and updated. We remain firm in supporting family physicians to continue to play critical leadership roles as we consider how to improve and sustain our health-care system for our patients today and into the future.

Tentative Physician Services Agreement Debate

Over the last few weeks, the discussion amongst our colleagues has centred on voting 'yes' or 'no' to the tPSA between the Ontario Medical Association and the Ministry of Health and Long-Term Care. The OCFP has maintained for months that the two parties should seek a negotiated agreement and we have respected the OMA's representative rights and their leadership in this regard. While we do not have a role in negotiations, we do have a voice about the importance of family medicine and what is needed to support family physicians to continue to provide high-quality care to patients and their families in communities across this province.

These past several weeks have presented an opportunity to hear more of the concerns of family physicians - about their practices, about Bill 210, about the way in which the cuts have impacted them. Many of you are weighing the pros and cons of the tPSA and have asked important questions during the OMA's town halls and tele-town halls. Many of us will have been part of discussions in our communities and in our clinical settings.

We know that changes are needed in Ontario to strengthen primary care in our communities. The status quo will not move primary care forward without meaningful family physician engagement and participation.

The Pros and Cons of the tPSA for Family Medicine

The tPSA is a high level "framework" agreement, rather than the kind of detailed contract that we may have expected. The framework provides challenges and opportunities. The OCFP has the same information as the membership - that which has been presented and made available online or through town halls. We have assessed and are sharing an outline of the potential pros and cons from a family medicine and primary care point of view, as well as other broad areas of the tPSA.

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Moving Forward

As family physicians, we are used to dealing with uncertainty. It is part of what we do every day in our clinical work. Managing uncertainty is possible in family medicine in part because of the relationships we have - continuous and trusting over time. Managing the current uncertainty in our environment, particularly during this time of primary care transformation, will also be possible with a commitment to rebuilding relationships.

The critical issues in our health-care system that need to be addressed for the benefit of our patients are issues about which family physicians have a deep knowledge, informed by our experience of caring daily for the people of this province. Regardless of the outcome of the vote, we need to find ways to continue to be part of decisions about the system in which we work - the health-care system in which patients receive their health care.

Each of us has to make our own decision about how much risk we are willing to live with, and we also need to weigh this against the benefit of re-building the kind of relationship within which future uncertainty can be managed for the benefit of the patients that we serve. As you consider your decision about the tPSA, we encourage you to consider both the potential risks and opportunities.

Information about the details of voting at the OMA General Meeting of Members will come to you through the OMA. Make your vote count and ensure that you either attend the General Meeting of Members, or entrust your new updated proxy vote to a colleague who can be there in person.

Regardless of the outcome of the vote, the OCFP will continue to engage in important discussions about resourcing our work and shaping primary care, aligned with our vision. You have your College's commitment to support you in your role in practice, in your family medicine leadership roles and in your communities, and to represent your voice in regional and provincial discussions about how to manage our health-care resources more effectively to serve our patients.

Sincerely,
Dr. Sarah-Lynn Newbery on behalf of the OCFP Board of Directors