(Most doctors must pay their overhead including office space and staff wages out of their income.) Across the country, average income was 5-per-cent higher than in the previous year. Increasingly, though, doctors are earning their pay in ways other than the traditional fee-for-service model, in which a doctor sees a patient and bills for his or her time and expertise. So-called alternative-payment methods have skyrocketed in recent years, and last year accounted for 28.7 per cent of the $22-billion provincial and territorial governments paid out to doctors. A decade ago, alternative payments made up just 11 per cent of physician income. Its a big, big shift, and I think for the better, said Scott Wooder, president of the Ontario Medical Association, which negotiates physicians pay with the province. These alternative payments include straight salaries, compensation in which physicians are paid a fixed sum per patient on their roster, and hourly or daily wages. Sometimes remuneration is a blend of fee-for-service and an alternative payment. Ontario doctors have been embracing alternative payments in greater numbers since the 1990s. Almost $3.4-billion, or roughly 35 per cent, of all physician income in Ontario last year was alternative payments. Most were in the form of what is called capitation compensation based on the number of patients on their roster, regardless of how often a patient seeks medical attention. Has service changed? Dr. Wooder, a family physician from Stoney Creek, Ont., said capitation is attractive to doctors because it offers stability. It also enhances care, he said, by encouraging doctors to spend more time with patients because physicians are not getting paid based on how many patients they see. In Ontario, capitation has prompted doctors across the province to combine individual practices into networks of health-care professionals that include dieticians, pharmacists, nurses, and mental-health counsellors.
Migration of doctors to Canada: a word of caution
It is important to send CV to all these authorities seeking information about eligibility for obtaining registration. These regulatory bodies would provide guidelines and steps that are necessary for an individual doctor to follow. This would include information about three exams: Evaluation exam, MCCQE I and MCCQE II. It is important that the doctors should at least complete two exams before entering into the residency training programme. Preparation can be done for the first two exams before migration. Attempting these exams while in the country of origin is also a possibility. Once completed successfully, the next step is application for residency matching programme known as CARMS. References is a big and valuable requirement for success in getting a training slot. Once matched in the programme, the candidates undergo specialty training, pass the specialty exams and are eligible to apply for Consultant’s position in any province of Canada. For senior doctors who have higher qualifications from western countries, they can directly apply for consultant positions once they fulfil the registration requirements. However, there are chances that despite fulfilling the requirement including passing the exams, one may not get a training slot as many doctors in Canada have ended up driving cabs and working as security guards. In the present era, it is important that the doctors intending to immigrate into Canada must equip themselves with English communication and a number of other skills to ensure success in the highly competitive field of medicine. It is also important for the doctors to acquire sufficient work experience, get three solid references, a letter from Dean of the institute from which they graduated. Besides, a personal letter of interest in the field of choice will carry a lot of weight in the selection process. Those senior doctors who are about to retire from teaching positions or are already retired should contact the various teaching universities in Canada with their resume and expression of interest.