The association representing Ontario doctors says a proposal from the provincial government to offer advance payments will not be enough to keep clinics open during the COVID-19 pandemic.

The provincial government is offering clinics monthly payments to cover the loss of revenue from lower patient volumes and increased costs for personal protective equipment.

"Ontario will be providing advance payments to doctors, to be reconciled against future earnings, in order to ensure stability of physician services as we continue our battle against COVID-19," says a statement from the Ministry of Health.

The advance payments would equate to 70 per cent of a clinic's average income, and they'll be expected to repay that money over a five-month period beginning in November.

Dr. Sohail Gandhi, president of the Ontario Medical Association, says clinics need grants rather than loans, because doctors will not be able to make up for the deficit when the pandemic ends.

"I don't believe the people who made the proposal are aware of the fact that there's no catch-up in health care," said Gandhi.

"If you're a family doctor and you were seeing 30 patients a day, you can't see 60 patients a day to catch up, it's just inhumane to make people work those kinds of hours six months from now."

He says the most financially feasible option for many clinics will be to shut down during the pandemic because of the overhead costs of staying open.

"That would be a disaster in the making for patient care," said Gandhi.

In Mississauga, Ont., Dr. Sohal Goyal says he's already seeing patients coming in from other cities because they can't find clinics that are open in their community.

The family doctor says he's decided to keep his clinic open through the pandemic to serve the community, but says his clinic isn't coming close to covering the costs of operating.

Goyal says the problem has been compounded by the skyrocketing cost of PPE.

Goyal said surgical masks cost nearly 10 times more now than they did before the pandemic and gloves are four times the price.

'we're scrambling to get supplies'

He's also had to scavenge for hand sanitzer and face shields at local businesses.

"We're scrambling to get supplies for our patients," said Goyal. "I'll go home tonight and I go on the computer, I go every day looking for gloves, masks and gowns."

The Ontario government's proposal for advance payments to doctors has not yet been finalized and still has to be negotiated with doctors, the OMA said.

Gandhi said the proposal also doesn't address the issue that doctors will not be paid for virtual appointments for months because the government's computer system isn't ready to process new billing codes for the virtual screenings.

The provincial government has said the new billing codes have to be used so that the province receives valuable data about the use of online appointments, but the OMA has said a work-around is available.

However, the OMA says that a tracking code can be added to existing billing codes so that they can be paid sooner while the government still receives data.

The province has said the soonest that doctors will be paid for virtual appointments done now is in June.

"We've already seen clinics close," said Gandhi, saying clinics need help sooner. "This is going to add a significant added backlog to our healthcare system in the coming months."