Strength through the storm Dr. Adam Kassam, OMA President
This week brought a fresh round of uncertainty for society and our profession. The emergence of the Omicron variant, unfortunately, brings flashbacks of last year when morale among doctors and the public plumbed new depths.
Like many of you, I have felt the emotional turbulence with the news of this emerging virologic threat. At a time when we were all hoping to be able to reunite with family and friends over the holidays, I find myself cancelling get-togethers, while focusing on reducing my exposure budget and adjusting to the possibility of new restrictions.
I share the concern about being able to care for patients in a timely way, while grappling with the new urgency of immunizing communities with a third dose of the vaccine. I worry about the impact of curtailing “non-essential” care, which we know is essential. I spend time thinking about physicians holding on by a thread and yet another ask of our colleagues to do more with vanishingly less.
And while I reluctantly accept the jarring nature of this new, but familiar, reality, I am comforted by knowing that we are fundamentally in a better position than we were 12 months ago. We have effective vaccines and emerging data suggesting that three doses provide good protection against severe disease. We have antivirals that have shown to be successful in limiting the course of the disease. We have now become experienced in adjusting to changing public measures, and our ability to co-operate and collaborate across the health-care sector should give us confidence to be able to fine-tune our approach in the weeks ahead.
Through it all, you have stood tall and strong. You have weathered storm after storm. You have risen to every occasion. And are being asked to do so again. You have shown selfless leadership in the face of the greatest challenge of our time.
And I stand shoulder to shoulder with you. In those trenches, donning that PPE, with you. It is your example of service, courage and compassion that continues to give me confidence about the future.
It is with this spirit of optimism that I still believe 2022 will be better than 2021.
With gratitude,
Adam
Important update on negotiations Dr. Paul Conte, OMA Board Chair
I encourage you to read this month’s board report, which contains an important update with respect to the Physician Services Agreement and the progress of negotiations. You will also find out more about key committee work underway, an update on relativity, the CEO year-end report and more. Read the December Board Report.
Due to the undetermined impact of the Omicron variant, interim recommendations for the use of PPE were released. N95s are now recommended – along with eye protection, gloves and gown – when providing care to suspected or confirmed COVID-19 patients. Alternatives to a fit-tested, seal-checked N95 are a non-fit-tested N95 or respirator, or a well-fitting surgical mask. We hope to provide guidance for fit-testing sites for community-based physicians when available. These recommendations also apply to staff performing screening or triage functions who are not separated from patients by a physical barrier or who cannot maintain a distance of two metres. Non-fit-tested N95s or equivalents can be provided as alternatives to surgical masks to patients with suspected or confirmed
COVID-19 and their accompanying caregivers. Read the interim IPAC recommendations from Public Health Ontario. Review the OMA Guide to providing in-person care during the pandemic.
New contact management guidance provided. High-risk contacts (based on risk assessment of transmission by public health units) of confirmed cases of Omicron must self-isolate for 10 days regardless of vaccination status or previous infection. If clinical care is compromised due to staffing shortages, health-care workers who are high-risk contacts of Omicron cases may continue to work under self-isolation provided they are fully vaccinated and asymptomatic.
Updated COVID-19 vaccine billing summary.
Our COVID-19 billing summary has been updated to reflect the INFOBulletin released by the Ministry of Health. It notes that all COVID-19 vaccine administration billing codes apply to all COVID-19 vaccines administered in accordance with provincial guidelines, including third and booster doses. Sessional fees H409 and H410 should be billed when administering COVID-19 vaccines in clinics organized by the public health unit or hospital, for example mass vaccination clinics, and require a group number, which is provided by the health unit or hospital. G593 should be billed when administering the COVID-19 vaccine in settings that are not designated by the ministry as a COVID-19 Assessment Centre, such as a primary care office. Read the INFOBulletin. Access the COVID-19 vaccine billing summary.
Validating medical exemptions. To reduce the use of forged doctors’ notes, the Ministry of Health has developed a centralized process to validate medical exemptions. Public health units will review and validate exemptions before entering them into COVaxON so that a QR code will be available to the patient via the provincial website. We have been informed that patients may contact their provider to request their previously issued exemption is sent to the health unit and any new exemptions should be faxed to the health unit. Exemptions that do not meet the requirements will be rejected and the public health unit will notify the physician of the denial and rationale. Physicians will be required to notify patients of rejections. Physicians who feel the rejection was made in error can email the Office
of the Chief Medical Officer of Health at covid.immunization@ontario.ca to request a review of the exemption request. Review the guidance for medical exemptions to COVID-19 vaccination. Access a list of public health units.
Urgent call to vaccinate Ontarians 18 and older.With COVID-19 cases surging due to the Omicron variant, Chief Medical Officer of Health Dr. Kieran Moore is calling on all sectors to vaccinate three million eligible Ontarians 18 years of age and older in the next 14 days. Vaccination of the unvaccinated and under-vaccinated, including children aged five to 11, continues to be a priority. All physicians who have capacity to support the vaccination rollout are encouraged to connect with their primary care health unit contacts by region for more information on how to get involved. We recognize that this request adds additional strain at a time when physicians are collectively exhausted and managing multiple crucial demands as part of the pandemic response. We shared details of this request earlier this week. Read the OMA communication on vaccinating more Ontarians. Access the list of primary care public unit contacts by region.
COVID-19 third-dose recommendation updates.Individuals 18 and older who received their second dose > 84 days (three months) ago are eligible for a booster dose and can book through the provincial portal starting Dec. 20. Individuals who are moderately to severely immunocompromised and eligible for a three-dose primary series may now receive a booster dose (a fourth dose) ≥168 days (six months) after completion of their primary three-dose series. Additionally, there is a preferential recommendation for the use of the Pfizer-BioNTech Comirnaty vaccine for those aged 18 to 29. See updated COVID-19 vaccine third-dose recommendation updates.
COVID-19 vaccine dosing interval for five to 11. An interval of eight weeks between COVID-19 vaccine doses for children aged five to 11 is recommended by NACI and Ontario Ministry of Health. Parents and guardians of children five to 11 may request an interval shorter than eight weeks with informed consent. The Centre for Effective Practice has updated its website with a summary of emerging evidence regarding vaccine dosing intervals and a Q&A about dosing intervals for children.
Review CEP’s summary of published evidence on the risks and benefits of an extended interval and Q&A on pediatric dosing intervals.
Post COVID-19 condition, guidance for primary care. Ontario Health has published a resource for assessment and management of the post COVID-19 condition, which provides details on the common persistent symptoms of post COVID-19 condition and how to assess and manage it. It also reviews considerations for self-management, medications, mental health supports and when to refer to an interprofessional rehabilitation team. Access Ontario Health’s guidance for post COVID-19 condition.
Resource for testing for COVID-19 in your office.A guide to offering lab-based PCR testing for COVID-19 has been created by the OMA, for community-based physicians who are interested in providing this service in their offices. The guide includes who should be tested, PPE requirements, preferred specimen types, preparing and shipping specimens, reporting requirements, notifying patients of their test results and billing. Offering testing for lab-based PCR in your practice remains voluntary. Access the testing guide.
Access to rapid tests and PPE. Access to free rapid tests and PPE remain available through the province for use in your practices. Rapid antigen and rapid molecular tests are available to order. Any positive cases from the molecular rapid test, which can be used for diagnosis, must be reported to the PHU. All rapid tests are considered medical devices and must be approved for use by Health Canada.
UpdatedCOVID-19 literature summaries. The OMA collection of summaries of COVID-19 literature from peer-reviewed journals has been updated since it was last shared in November. Access the updated COVID-19 literature summaries.
COVID-19 vaccination data entry. If you are vaccinating your patients with the COVID-19 vaccine, you must enter the data in the COVaxON system. You cannot send the data from your electronic medical record system to COVaxON or the provincial clinical viewers. If you need help with the COVaxON system, OntarioMD can help. Contact OntarioMD if you need support with the COVaxON system.
As reported in the December 2021 Board Report, there is an update to share regarding Physician Services Agreement negotiations with the Ministry of Health. Starting in late November, the OMA Negotiations Task Force (NTF) and Ministry of Health bargaining team entered into intensive mediation. Seven sessions have been held over the last few weeks. There has been progress on many key issues.
As a reminder, mediation was scheduled to end on Dec. 6, 2021. However, given the momentum of these discussions, mediator William Kaplan has directed that the parties engage in further mediation sessions this month and in January 2022 in an effort to reach an agreement. He further directed that the first two scheduled arbitration hearing dates on Jan. 21 and Jan. 25, 2022 be used for mediation. Arbitration dates for February and March 2022 remain in place should that prove necessary.
The mediator, as is usual at any sensitive stage of negotiations, has imposed a blackout, which allows the NTF to only discuss the details of the negotiations with the OMA Board. A similar restriction has been imposed on the ministry negotiators.
The OMA Board has been apprised of these developments, and mediation will continue into January. Members will be kept well informed as mediation progresses. Read the December Board Report.
This last edition of the OMR in 2021 takes a look back in a special Year in Review highlighting the OMA’s advocacy work championing the needs and voices of members, both at decision-making tables and in communities and hospitals; showcasing key activities planned to garner support for the association’s Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care from political parties in the lead up to the 2022 provincial election; an overview of the benefits of OMA membership, and more. Access the Ontario Medical Review online.
Ontario Provincial Framework for Palliative Care.Further to the Compassionate Care Act, 2020, the Ministry of Health introduced the Provincial Framework for Palliative Care on Dec. 15. The framework is intended to support improved, continuous and equitable access to palliative care through a number of settings, among various providers and in support of caregivers and families. To implement the framework, further collaboration will be required from key stakeholders, patients and families. OMA staff are reviewing the framework and will create a plan to further engage our members on how best to ensure our positions and concerns are reflected as discussions on the framework continue over the coming months. Access the Provincial Framework for Palliative Care.
OMA submission on proposed PHIPA regulation. The Ministry of Health has released a regulation for consultation under the Personal Health Information Protection Act
(PHIPA) which would require a health information custodian to provide a copy of the patient’s personal health information in a PDF file if the patient requests access to it in a digital format. The draft regulation proposes that a health information custodian can be exempt from providing personal health information in a PDF file if they can demonstrate that the process will cause undue hardship. The regulation is proposed to take effect on Jan. 1, 2022, if passed. The OMA has submitted a response to the consultation supporting the inclusion of the exemption, calling for the implementation date to be postponed allowing physicians time to adjust their practices to fulfil this new requirement, seeking clarification on how physicians are expected to digitally send PDFs given current
system limitations, and outlining key considerations for future work to enable patient digital access to personal health information. Further details will be communicated to members in the new year.
Exceptional Access Program fax transition delayed.The option to submit Exceptional Access Program requests by fax will continue into 2022. The Ministry of Health had previously communicated that all EAP requests would have to be submitted via the digital EAP platform, Special Authorization Digital Information Exchange (a.k.a. SADIE), beginning Jan. 1, 2022. As a result of ongoing discussions between the OMA and the Ministry of Health, this deadline has been extended in order to give physicians more time to transition away from the fax-based process. SADIE provides a number of benefits, including prompts to complete forms correctly, faster review times and the ability to track progress of applications. The OMA and OntarioMD are informing the ministry’s transition plan and we will share updates as soon as they are
available.
OMA podcast discusses home-care shortages. Ottawa mother Sharon Liff opens up about the challenges of raising a profoundly disabled child and her frustrations with the continued underfunding of home care in Ontario. In this podcast, she shares some of the struggles to provide care for her now 19-year-old son, from around-the-clock feedings to multiple diaper changes and the physicality his care requires. Liff’s story was first published in the fall 2021 issue of the Ontario Medical Review. Access the OMA podcast on home-care shortages. Read the Ontario Medical Review article.
Final call to nominate a colleague for an OMA award.The OMA Awards are a great way to recognize excellence among medical students, residents, physicians and community leaders for their outstanding contributions to health care in Ontario and the greater medical profession. Nomination deadline is Friday, Dec. 31. Nominate a deserving individual for an OMA Award.
OMA remembers deceased physicians. Earlier this year, the OMA launched an online space for loved ones to post information about a deceased physician that includes details about their career and other memories, allowing members to learn more about a colleague’s professional and personal contributions. Newly posted obituaries have recently been published on the OMA’s website. View the OMA’s In Memoriam web page.
OntarioMD announces new CEO.OntarioMD Board of Directors is pleased to announce the appointment of its new CEO, Robert Fox, effective Jan. 10, 2022. Rob has been a leader in health-care technology for 25 years. During his well-established career, he worked at TELUS Health, Cisco Systems and St. Michael’s Hospital, where he led key technology and infrastructure projects. OMD staff look forward to Rob’s outstanding leadership and experience to advance OMD’s strategic priorities, expand existing capabilities and build new proficiencies that best serve Ontario’s physicians. Read more about OntarioMD’s new CEO.
Learn about candidates, last call for OMA committees. Thank you to all who have stepped forward in the 2021-2022 OMA elections! Nominations are now closed. Those seeking an elected position should have received a status letter this week outlining next steps in the process. Please also take a moment to register below for the upcoming president-elect town hall on Jan. 5, from 7-8 p.m. We will be sharing more details about the event early in the new year.
The 2022 voting and membership renewals periods are being combined this year. To make things easier for members, you will be able to vote and renew your membership at the same time, starting Jan. 10 until Jan. 31. Membership renewal will continue until March 31.
Third year of pandemic explored. On Tuesday, the OMA hosted its Ask Ontario’s Doctors media briefing “What to expect in pandemic Year 3.” OMA President Dr. Adam Kassam was joined by Dr. Onil Bhattacharyya, chair in family medicine research and director of the Institute for Health Systems Solutions and Virtual Care at Women’s College Hospital, Dr. Alison McGeer, infectious disease specialist and senior clinician scientist at the Lunenfeld-Tanenbaum Research Institute of the Sinai Health System, and Dr. Ripudan Minhas, Women’s and Children’s Health Program at St. Michael’s Hospital, to discuss what the “new normal” might look like and how we can protect ourselves and support our children during the third year of living with COVID-19. As a result of
the briefing, Dr. Adam Kassam spoke to CP24 and Global News Radio and, on Tuesday night, Drs. Kassam, McGeer and Bahattacharyya participated in a panel presentation on CP24 TONIGHT LIVE. Topics from the briefing and quotes from all panellists were also included in the Queen’s Park Today daily newsletter. Watch OMA’s Ask Ontario’s Doctors media briefing. Access the OMA’s top media coverage.
Dr. Paul Healey, co-founder of the Physician Financial Independence online community and a member of the Advantages Retirement Plan™ Investment Committee, addresses topics ranging from how to use your money to achieve happiness, costly investment mistakes and the impact of fees in the Financial Checkup Roundup – Physician Financial Independence podcast series. Listen to the Physician Financial Independence podcast series.
Save with Fiat Chrysler. OMA members are eligible to receive up to an additional $2,000 off on the purchase of a new Fiat Chrysler Automobile. Savings can also be applied to eligible Chrysler, Jeep, Dodge and Ram vehicles. Learn more about the Fiat Chrysler discounts.
Easy upgrades to increase value of home. Planning to sell your property? OMA Insurance shares five simple upgrades to help maximize the value of your home without breaking the bank. Get tips on how to increase the value of your property.
OMA News returns in 2022: Today’s edition of OMA News is the final one for 2021. We return with our weekly wrap up of important news and information benefitting physicians and their practices on Friday, Jan. 7, 2022. If there is important news or information to share in the meantime, we will share through an OMA News Alert.
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