Ontario doctors warn that patients will have less access to their services because the government is cutting their fees.

The government is chopping fees by 1.3 per cent starting next week to keep the profession within an allotted $11.6-billion budget for the fiscal year.

Dr. Michael Toth, president of the Ontario Medical Association, says the profession is frustrated and some members are talking about leaving the province or retiring early.

“It’s going to affect patients ultimately,” he warned, noting that some physicians will be forced to lay off staff and cut office budgets.

Physicians are venting their anger on social media. On Twitter, hardliners are threatening job action such as a work-to-rule campaign, hour cutbacks and cancellation of flu-shot clinics.

Toth said the OMA, which represents 28,000 members, wants to get back to the bargaining table with government and is considering legal action.

Health Minister Eric Hoskins said he wants to reassure Ontarians that there have been no service cuts.

“My concern is that a perception is being propagated that this will result in more challenging access to primary care providers. The facts simply don’t bear this out,” he said.

Ontario doctors are among the best paid in Canada with average annual compensation of about $350,000, an amount that has grown by 60 per cent over that last decade, Hoskins said. From that, physicians pay overhead costs, such as employee wages and office rent, an amount widely quoted as about 30 per cent.

Hoskins said patients should not be affected over what is a dispute over remuneration: “I have received assurance from the president of the OMA that they will not take action that will impact the quality of care they provide or patient safety. I take him at his word.”

The rift dates back to a payment scheme the government unilaterally imposed last January after a year of negotiations with the OMA ended in an impasse. It included a 2.65 per cent fee cut and a clawback provision that would take effect if doctors’ OHIP billings were taking doctors over their $11.6-allotment.

The fee-for-service payment model allows doctors to control the amount of their compensation. If they see more patients and perform more procedures, they can bill the public insurance plan for more money.

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The payment scheme also includes increases of 1.25 per cent in the physician services budget for each of the next two years. The government said the annual increases are intended to meet a rise in demand from a growing and aging population and the addition of 700 new doctors.

But the OMA contends increases of 2.7 per cent are needed in each of the next two years to keep up with demand growth.

The OMA is lobbying MPPs, holding town hall meetings in communities across the province and staging a virtual town hall with members next week.

Toth argued there is a “power imbalance” with government and called for a neutral third-party to weigh in with a binding decision: “We are looking to resolve this . . . . We think the way to do this is mediation-arbitration.”