Following the release of the Ford government’s “Plan to Stay Open”, we heard from a number of CDM members expressing their concern and outrage.
Canadian Doctors for Medicare Board Members working in Ontario drafted an open letter to the Premier, Minister of Health and Minister of Long-Term Care in Ontario in response to their plan.
While we understand that long-term solutions are required to address the current situation, we also know that some steps can be taken immediately to relieve the strain on our system and improve the care Ontarians receive on a daily basis.
We are calling upon the government to repeal Bill 124 and Bill 7, invest in not-for-profit delivery of care and primary care so that everyone has a patient-centered home, and take adequate measures to control infectious diseases like COVID-19 and Influenza.
The letter, copied below, was sent to the Premiers and Ministers on Monday, October 31st with more than 100 signatures from Ontario physicians and medical students. To download a copy of the letter, click here. To view the original form and sign your name, click here.
Fix Ontario Health Care: An Open Letter to the Premier, Minister of Health, and Minister of Long-Term Care
TO:
The Honourable Doug Ford, Premier of Ontario
The Honourable Sylvia Jones, Minister of Health
The Honourable Paul Calandra, Minister of Long-Term Care
Emergency departments are overwhelmed, facing closures and overcrowding. Hallway medicine has become a daily reality. But the emergency department is just the “canary in the coal mine”, a symptom of upstream dysfunction in our health care system.
We are writing as Ontario-based physicians and medical trainees to express our grave concerns regarding Ontario’s “Plan to Stay Open.” This plan not only fails to adequately address the underlying reasons our health care system is in crisis, it will further degrade a system that is already under-staffed and over capacity. It will further worsen existing inequities and further marginalize our most vulnerable patients.
We understand that the long-term solutions to the current situation will require a prolonged effort. However, some steps can be implemented immediately to improve the care Ontarians receive on a daily basis.
At Canadian Doctors for Medicare, we believe that reforms must be rooted in a commitment to publicly-funded health care.
We call upon your government to take the following actions immediately:
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Repeal Bill 124. While we are encouraged by the commitment to stabilize private nursing agency fees and reduce barriers for the entry of internationally educated nurses, a focus on recruitment alone without addressing retention will perpetuate the revolving door of nurses leaving the system. A recent survey showed that the primary reason nurses are leaving the profession is wage dissatisfaction. An overwhelming majority of nurses (91%) feel they are not being fairly compensated. Repeal Bill 124 immediately and provide all health workers affected by it, including nurses, with fair wages.
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Invest in not-for-profit delivery of care. The evidence shows that outsourcing health care delivery to private for-profit entities results in worse health outcomes at a higher cost to the public. We understand the need to reduce the surgical backlog. Using specialized surgical clinics that can perform a high volume of certain surgeries efficiently may be part of how we do that. However, there is no reason why these centres need to be operated on a for-profit basis, using public funds to pay shareholders or investors. We ask you to commit to focus public investments into health care services that are operated on a not-for-profit basis, consistent with the best available evidence.
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Repeal Bill 7. Sending frail elders and people with disabilities to long-term care facilities without consent is a violation of their basic human rights. Many of these individuals are in the last years - sometimes even months - of their lives. Many require their family members and caregivers to be close by and accessible in order to provide essential care such as feeding, helping to take medications, assisting with translation, and care planning. By coercing patients into long-term care facilities which are not of their choosing or that could be far away from their communities, we will see more suffering, and even premature death, in a population which is already extremely vulnerable. As nearly 100% of older Ontarians wish to receive care in their own homes for as long as possible, we ask for your government to further increase investment in home care which would allow more hospitalised patients to return and even remain in their own homes.
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Invest in primary care so that everyone in Ontario has a patient-centered medical home. Health care systems built on robust primary care have better outcomes, lower costs and better equity. Everyone in Ontario needs a relationship not just with a single family physician, but with a primary care team. Team-based primary care allows patients to access professionals like nurses, dieticians, and physiotherapists to more comprehensively address their health care needs. Improving access to primary care can alleviate strain on our emergency departments by helping to address the root causes of what sends patients to the ER in the first place.
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Take measures to control infectious diseases. The COVID-19 pandemic is not yet finished and we are about to enter influenza season, yet we are significantly lagging on rates of booster and paediatric vaccinations. With yet another wave expected in the fall, we need to take proactive measures to prevent the spread of infectious diseases like COVID-19 and influenza. We implore you to consider not only the individual impacts of increased disease transmission, but also the repeated strain it places on a health care system already in crisis.
We welcome the opportunity to discuss the urgent need for action with you further.
Signatories
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Melanie Bechard, MD MPH - Chair, Canadian Doctors for Medicare, Pediatric Emergency Medicine, Ottawa
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Hasan Sheikh, MD, CCFP-EM, MPA - Vice Chair, Canadian Doctors for Medicare, Emergency and addiction medicine physician, Toronto, University of Toronto
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Danyaal Raza, MD, CCFP - Past Chair, Canadian Doctors for Medicare, Family Medicine, Toronto, University of Toronto
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Amit Arya, MD, CCFP (PC), FCFP - Canadian Doctors for Medicare board member, Palliative Medicine, Toronto, Assistant Clinical Professor, McMaster University
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Nili Kaplan-Myrth, MD, CCFP, FCFP, PhD - Canadian Doctors for Medicare board member, Family Physician, Ottawa
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Joel Lexchin, MD, CCFP(EM), FCFP - Canadian Doctors for Medicare board member, Emergency physician, Toronto, University Health Network
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Yipeng Ge, MD - Canadian Doctors for Medicare board member, Public Health Resident Physician, Boston MA, Harvard University
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Bernard Ho, MD, CCFP(EM) - Canadian Doctors for Medicare board member, Emergency Medicine, Toronto
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Devon Wilton - Canadian Doctors for Medicare board member, Medical Student, Hamilton, McMaster University
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Andriy Katyukha, MD - Canadian Doctors for Medicare board member, Internal Medicine Resident Physician, Toronto, University of Toronto
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Jasmine Gite, MD - Canadian Doctors for Medicare board member, Family Medicine, Hamilton
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Sandy Buchman, MD CCFP (PC) FCFP - Palliative Care Physician, Toronto, University of Toronto
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David Fisman MD MPH FRCPC FCAHS - Internal medicine, Toronto, University of Toronto
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Suzanne Shoush, B. Eng, MC, CCFP - Family Physician, Toronto, Indigenous Health Faculty Lead, DFCM, University of Toronto
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Gordon Guyatt, MD, FRCPC - Internal Medicine, Hamilton, Distinguished Professor, McMaster University, Order of Canada
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Ritika Goel, MD MPH CCFP - Family Physician, Toronto, University of Toronto
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Naheed Dosani, MD, CCFP(PC), BSc - Palliative Care Physician, Toronto, Assistant Professor, Department of Family & Community Medicine, University of Toronto
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Samir Sinha, MD, DPhil, FRCPC - Geriatrician and Professor of Medicine, University of Toronto
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Nanky Rai, MD MPH CCFP - Family Physician, Toronto, Parkdale Queen West Community Health Centre
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Samantha Green, MD, CCFP - Family Physician, Toronto, University of Toronto
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Abdu Sharkawy, MD FRCPC - Infectious Diseases Consultant, Toronto, University Health Network, University of Toronto
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Edward Xie, MD MSc CCFP(EM) - Emergency Physician, Toronto
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Maria del Junco,MD - Family physician, Toronto
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Cathy Vakil, MD, CCFP - Family doctor (retired), Kingston, Queen's University
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Catherine Oliver, MD - Family physician (retired), Toronto
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Raymond Viola, MD, CCFP - Palliative care/primary care, Kingston
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Pat Smith, MD, FCFP - Family Medicine, Dundas, McMaster University, Hamilton Health Sciences
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Beverley Jackson, MD, CCFP - Family physician, Toronto
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Jesse McLaren, MD, CCFP(EM) - Emergency physician, Toronto, University of Toronto
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Abeera Shahid, MD candidate - Medical student, Ottawa, University of Ottawa
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Paul Das, MD, MSc, CCFP (EM) - Family Medicine, Emergency Medicine, Toronto University of Toronto
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Isser Dubinsky, CCFP(EM) - Emergency physician, Toronto, U of T
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Gail Graham, MD FRCPC FCCMG - Medical Genetics, Cumberland
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Rachelle Sender, MD, CCFP, FCFP - Family Medicine, Hamilton, HHS
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May Cohen, CCFP - Family Physician (retired), Toronto, McMaster University
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Deborah Copes, MD - Family Medicine (retired), Toronto
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Nancy Olivieri, MD, FRCPC - Professor, Pediatrics, Medicine and Public Health Sciences, Toronto, University of Toronto
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Ginny Edwards, MD,FRCPC – Psychiatry, Toronto
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Christina Mills,MD FRCPC- Public Health, Waterloo
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Rahel Ahmed, MD - Family medicine, Scarborough
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Wendy Reimer, MD - Family Physician, Kitchener
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Marcella Jones, MD, MPH, CCFP-EM - Physician, Emergency and Family Medicine, Toronto
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Laura Pellow, MD, CCFP - Family medicine, Waterloo
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Rebecca Hicks, MD, CCFP - Family physician, Toronto
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Mark Cornfield, MD FRCPC – Psychiatry, Port Rowan
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Claire Heslop, MD, FRCPC - Emergency Medicine Physician, Toronto
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Amna Majeed - Medical student, Toronto, University of Toronto
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Vanessa Redditt, MD - Family Physician, Toronto, University of Toronto
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Erin Frotten, MD, CCFP - Family medicine, Hamilton
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Geneviève Rochon-Terry, MD CCFP - Family Physician, Toronto, University of Toronto
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Judith Peranson, MD, MPH, CCFP, FCFP - Family Physician, Toronto
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Liana Kaufman, MD CCFP - Family Physician, Toronto, Unity Health Toronto
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Eileen Nicolle, MD CM CCFP - Family Medicine, Toronto, University of Toronto
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Nicholas Prudhomme, FRCPC - Emergency Physician, Ottawa
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Alice Gray, FRCPC - Emergency Medicine, Toronto
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David Gruber, MD, CCFP(EM) - Emergency physician, Toronto
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Megan Landes, MD - Emergency Medicine, Toronto
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Nisha Kansal, MD, CCFP - Family Physician, Ottawa
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Nena-Rae Watson, MD, CCFP - Family Medicine, Toronto, Staff physician, St. Michael Hospital; lecturer U of T
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Kathryn Dorman, MD MSc CCFP - Family Physician, Toronto, University of Toronto
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Zainab Najarali, CCFP(EM) - Emergency Medicine, Toronto
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Anand Sinha, MD, CCFP - Family Medicine/Palliative Care, Toronto
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Helen Tam-Tham, MD - Family Physician, Toronto, University of Toronto
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Michelle Cohen, MD, CCFP, FCFP - Family physician, Brighton, Queen's University
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Trevor Morey, MD CCFP - Family physician, Toronto
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Semir Bulle, MD - Psychiatry resident, Toronto, University of Toronto
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Gaibrie Stephen - Family Physician, Emergency Medicine, Toronto
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Brooks Fallis, MD, FRCPC - Critical Care Physician, Toronto
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Yoni Freedhoff, MD, CCFP - Family Medicine, Ottawa, University of Ottawa
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Daniel Rosenbaum, MD, FRCPC - Psychiatrist, Toronto, University of Toronto
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Katrina Hui, MD, MS, FRCPC - Psychiatrist, Toronto
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Amanda Rosenblum - Palliative Care MD, CCFP(PC), Toronto, University of Toronto
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Sabrina Lin, MD - Family Medicine Resident Physician, Toronto, University of Toronto
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Rakhshan Kamran, MD/PhD Candidate - Toronto, McMaster University
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Paige Guyatt - Medical Student, Hamilton
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Madeline Rampton - Medical Student, Hamilton
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Emily Koseck, BSc - Medical Student, Kingston
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Sarah Klapman - Medical student, Kitchener
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Rithvika Ramesh - Medical Student, Hamilton, McMaster University
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Yasmin Dini - Medical Student, Hamilton, McMaster University
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SoroushNedaie - Medical Student, Hamilton, McMaster University
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Aravinth Jebanesan - Medical Student, Ottawa, University of Ottawa
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Junaid Ishaq - Medical Student, Hamilton, McMaster University
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Sean Lazaro - Medical Student, Mississauga, McMaster University
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Sophia Zhang - Medical Student, Hamilton, McMaster University
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Karen Zhao - Medical Student, Hamilton, McMaster University
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Victoria Shi - Medical Student, Waterloo
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Omolara Soyinka - Medical Student, Hamilton
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Michaela Beder, MD FRCP - Psychiatry, Toronto, University of Toronto
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Christine Moon, MD-PhD(C) - Kingston, Queen's University
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Kate Reeve, MHSc, MD, CCFP - Family Physician, Toronto
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Rebecca Rajakaruna, MD, CCFP - Family Physician, Toronto
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Austyn Roseborough - Medical Student, London, Western University
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Claudia Gomez, FRCPC - Anesthesiologist, Ottawa
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Ashley Lubberdink, MD, FRCPC - Emergency Physician, Mississauga
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Artin Ghassemian, MD, FRCPC - Hematology, London
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Laura Muldoon, MD, MPH - Family Physician, Ottawa, University of Ottawa
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Mary Boulosm MD - OB/GYN Resident, Toronto, University of Toronto
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Nitin Mohan, MD, MPH - Public Health Professional, Oakville, Western University
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Yasaman Yazdizadeh - Medical student, Toronto
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Oksana Motalo, FRCPC - Hematology, Kingston
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Jill Rudkowski, MD, FRCPC - Critical Care, Hamilton, St. Joseph’s Healthcare Hamilton & McMaster University
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M. Hashim Khan, MBBS, MPH, FRCPC - Respirologist, Toronto
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Sadia Mehmood - Medical Student, London, Western University
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Lauren Welsh, MD, CCFP-AM - Family Medicine, Toronto