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“Physicians can’t increase their fees like other small businesses may be able to … What will happen is we will be having discussions with the province to say, somewhere, physicians have to be able to recoup the losses that they’re going to incur to literally run their practices.”

If professional corporations cease to exist in the form that we have now, then obviously we're going to have to explore other options to keep our businesses sustainable. Alberta Medical Association President Dr. Padraic Carr

Dr. Trina Larsen Soles, the Doctors of B.C. president, said the tax breaks have been a factor in their negotiations even though the ability to incorporate there wasn’t initially set up as a concession on fees.

“You negotiate in a particular structure,” she said. “Essentially it is, ‘Well, you don’t need this particular fee increase or that to be funded, because you can incorporate.'”

Alberta Medical Association President Dr. Padraic Carr echoed those sentiments.

“Professional corporations have been factored into our provincial negotiation and our relationships with government and physicians, some of it formally and some of it informally,” he said.

“If professional corporations cease to exist in the form that we have now, then obviously we’re going to have to explore other options to keep our businesses sustainable with the master agreement.”

Health spending is the largest component of provincial budgets, and doctors’ fees make up a big portion of that spending. For example, last year’s $134-billion Ontario budget booked $51.8 billion in health spending, of which $11.5 billion was expected to be physician compensation.

Keeping a lid on fees is a key method by which provincial governments try to control healthcare spending and balance their budgets. However, the provinces would get some increased tax revenue from the proposed changes, which could soften the blow of a fee hike. Other benefits could also be negotiated in lieu of a fee hike to replace the lost tax savings.