Doctors in Canada Launch Strike : But Ontario Province Walkout Causes Little Disruption

A general strike by Ontario doctors protesting government efforts to limit their fees began Thursday, but the walkout received only lukewarm support from the province’s 15,000 active physicians.

The Ontario Medical Assn., which organized the strike for all medical services except emergency care, had said earlier that support by 50% to 55% of the association’s member doctors would mean success, but officials refused Thursday afternoon to say how many physicians had actually walked out.

Unofficial surveys by news organizations indicated that fewer than 50% of the doctors refused to see patients. The strike was the first indefinite work stoppage by Canadian doctors since a 1962 walkout in Saskatchewan.

Provincial government officials said that disruption of hospitals and other medical facilities was minor, an assessment supported by reports from hospitals that said emergency facilities were only minimally affected.

The medical association called the walkout when a two-day strike last month failed to bring about any modification of Ontario Premier David Peterson’s plan to end so-called extra billing, the practice of charging patients more than the pay schedule allowed under the national health insurance program.

Peterson introduced legislation to end overbilling after the federal government said it would reduce payments to any province that allows doctors to charge more than insurance payments. Ontario was penalized $30 million in 1985 and will lose almost $40 million this year if the extra charges are continued. Only two other provinces now permit overbilling.

Under the Canadian system, nearly all medical and hospital costs are paid for by government insurance programs with only about 5% of all doctors charging more than the insurance payments.

The medical association said the issue is not money but the professional freedom of doctors to deal with their patients without government intervention. Ontario Minister of Health Murray Elston has said that doctors really only want the freedom to “pick the pockets” of patients.

Doctors Are Divided

The divided response to the strike call indicated a serious split among Ontario’s doctors, the highest paid in Canada with an average income of more than $90,000 a year. The May walkout resulted in about 75% support, but surveys by several newspapers early this week indicated at least half of the province’s physicians did not agree with a long-term stoppage.

Dr. Ron Gilifan of Toronto told reporters that “it is nonsense” that most doctors support the strike. “Most doctors,” he said, “are rather upset by it.”

Even several doctors who oppose the government’s action said they would continue to work. “I would like to strike,” said Dr. Jean McIntosh, “but I have to take care of our patients.”

Even though the medical association said it could not assess the strike’s impact until Friday at the earliest, the organization’s president, Dr. Richard Railton, indicated through a spokesman that he might call for the closing of hospital emergency services next week on a rotating basis.

“Nothing has changed in our plans,” said the spokesman.

Although the walkout was incomplete, there were enough disruptions to bring 150 complaints of a lack of care to the Ontario College of Physicians and Surgeons, the professional body that supervises and disciplines the province’s doctors.

The group said it intervened in a dozen cases, mostly abortions, and ordered operations. The college also refused to say if it would discipline doctors who refused to care for patients.

There also were reports that the chiefs of staff at 23 of Ontario’s 220 hospitals have resigned in support of the strike and that the abortion review committees at two hospitals have quit.

Ontario government officials refused to say publicly whether there were plans to introduce emergency legislation to end the strike, but privately they said such a bill might be passed early next week if the medical association doesn’t call off the walkout.