The Ontario Medical Association has announced plans to ask the Supreme Court of Canada to hear an appeal of a lower court decision to make the names of top billing doctors public.

The association, which represents the province’s 28,100 practising doctors, revealed Friday it intends to apply for leave to appeal to the nation’s court of last resort.

“Physician billings constitute private, personal information. Privacy is an important and fundamental right in Canada that is protected by legislation and the Charter of Rights and Freedoms,” said OMA president Dr. Nadia Alam in a written statement.

If such information is to be made public, it should be up to the provincial Legislature to do, she said. Reporting billings without context would provide an incomplete and sometimes misleading picture of physician pay structure.

In 2016, the Information and Privacy Commissioner of Ontario ruled in the Toronto Star’s favour in ordering the release of names of doctors paid the most from the publicly funded Ontario Health Insurance Plan.

The OMA twice appealed — first to the Ontario Divisional Court, then to the province’s Court of Appeal — losing both times.

“It is disappointing that the OMA feels obliged to keep fighting disclosure of the use of public funds,” said Star lawyer Paul Schabas.

“Six judges have now had no difficulty upholding the IPC’s decision that doctor billings to the government are not ‘personal information’ and should be transparent, just as all other government spending, including salaries and consulting fees, are public,” he added.

The OMA’s latest move will prolong what has already been a 4.5-year quest by the Star to end the secrecy surrounding OHIP billings.

The case originated in 2014 when the Star submitted a freedom-of-information request to Ontario’s health ministry for information on top billers.

The ministry responded by providing the medical specialties of most physicians in question and the amounts each received in OHIP payments. But it stopped short of revealing names, saying doing so would be an invasion of their personal privacy.

The Star then launched its successful appeal with the Information and Privacy Commissioner.

The commissioner has placed on hold a separate FOI appeal from the Star for physician-identified billing data on all Ontario doctors.

OHIP payments are not the same as salaries because they are also used to cover overhead expenses, for example, rent, equipment and office supplies.

Taxpayer-funded, physician-identified payments are already public in British Columbia, Manitoba, New Brunswick and the United States.

Doctors who favour transparency have been speaking out more since last month’s dismissal by the Court of Appeal of the OMA’s most recent appeal.

“I don’t think it has any merit and I don’t think the OMA should be spending its members’ money on it,” said surgeon Dr. Lesley Barron, adding that two lost appeals are enough.

If the profession wants to improve the lives and health of Ontarians, it should embrace disclosure and engage in a frank discussion about priorities in health and social spending, said infectious disease specialist Dr. Bryan Coburn.

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“Without comprehensive and accurate public information on how physician billing is distributed and who it is benefitting, how can we have a meaningful public conversation about these trade-offs?,” he continued, noting every dollar spent by government represents a trade-off.

Coburn charged that the OMA leadership is not adequately representing the views of its membership.

“There is a segment of Ontario physicians who I suspect want to keep billing information private because they recognize that many Ontarians, like me, would believe their compensation to be excessive,” he said.

Other doctors have argued that more transparency would help in addressing pay gaps — between and within different medical specialties, and between the genders.

Doctors who specialize in what are known as “procedural specialties” — including radiology, ophthalmology and cardiology — are among the highest billers. Others — such as geriatricians, pediatricians, psychiatrists and family doctors — are among the lowest.

Male physicians, in general, get paid more than females.

The issue of the gender pay gap has recently exploded, particularly on social media. A Texas doctor sparked outrage for opining in a medical journal that the gap is fair because women doctors don’t work as hard.

“The work of women is systematically devalued by our billing system,” said surgeon Dr. Nancy Baxter, noting that the OHIP fee schedule favours procedural specialists, the majority of whom are men.

“In all these negotiations (with the province on fee contracts), it does seem certain specialties have done better. That has persisted because nothing ever seems to be done about it,” she added.

“Getting relativity addressed would in turn help deal with the gender pay gap,” Barron said. (Relativity refers to pay disparity between specialties.)

“It’s better to shine the light of transparency than to be in the dark,” she added.