Ontario's doctors, who have been without a physician services agreement for four years, say they have agreed to return to the bargaining table after the incoming Progressive Conservative government reached out to them.

The Ontario Medical Association, which has about 44,000 members, said days that were scheduled for arbitration in July will now be used for negotiation and possibly mediation.

The association said each side still has the option to re-trigger arbitration, but notes the move — which it characterized as an olive branch — is a welcome change in the tone of discussions surrounding the physician services agreement.

"Everyone is feeling cautiously hopeful — I say cautiously because we've been burned by government in the past," said Dr. Nadia Alam, president of the Ontario Medical Association.

Some members of Concerned Ontario Doctors, pictured here, at a news conference in Toronto in April. The group said the Liberal government under Kathleen Wynne created a crisis in health care through years of neglect and mismanagement. (CBC) "We've seen...strong signals from the new government that suggests that they want a different kind of relationship (with doctors) so it makes us hopeful not just about getting a good contract for physicians but actually working on the very real problems in our health-care system."

In a message to its members, the OMA said the Tories, who were elected to a majority earlier this month, would be open to revisiting the negotiations mandate set by the outgoing Liberals.

The document lays out a party's objectives and parameters for an agreement.

"That's a huge step because it means that their vision of what a good deal with doctors looks like is going to be different from what the previous government's was," Alam said.

Forging ahead with arbitration would have run the risk of pushing the incoming government into adopting the position held by its predecessors, she said.

The association won't change its position, however, and the possibility of a negotiated settlement depends on how much the new government is willing to budge, she said.

A view of a hospital hallway. The Ontario Medical Association says the lack of a contract has created an environment 'filled with so much instability and uncertainty.' (iStock) "At the end of the day, the OMA exists to serve and protect its members so that those physicians can do a better job taking care of their patients, especially in an environment that's filled with so much instability and uncertainty (due to the lack of contract)," Alam said.

Negotiators should know fairly quickly if talks are looking up because the issues set to be discussed are "big ticket items" such as the physician services budget and the prospect of a imposing a hard cap on that budget, she said.

"Those big ticket items serve as a really good litmus test of whether or not the government actually changed its negotiations mandate in a substantial way. Their response to those issues will be very telling," she said.

If negotiations go well, doctors could see a contract faster than they would have through arbitration; if not, the arbitration process will be delayed by at most two months, she said.

Doug Ford committed to 'fixing the relationship'

A spokesman for premier-designate Doug Ford said the Tories are committed to working with and listening to frontline health-care staff.

"Doug Ford is committed to respecting Ontario's physicians and fixing the relationship. These discussions are an important first step," Simon Jefferies said in an email.

Last summer, OMA members voted 65 per cent in favour of a deal that sends contract disputes with the government to binding arbitration.

Under the deal, there must first be an effort at negotiation, and if an agreement isn't reached, then the parties try mediation before moving on to binding arbitration.

Doctors voted down a proposal in 2016 that would have increased the approximately $12-billion physician services budget by more than $1 billion but also included $200 million in fee cuts. They dismissed another proposal soon after, saying it was just a rehash of the previous offer.