A petition supporting Kingston household physician Dr. Elaine Ma gained over 1,000 signatures within the first 24 hours after Dr. Sohail Gandhi posted a hyperlink to it on his well-liked medical blog, JustAnOldCountryDoctor.com.
In a December 3, 2024, blog publish, Gandhi referred to the latest occasions involving Ma, saying, “Last week, the Ontario Health Sector (sic) Appeal and Review Board (HSARB) denied the appeal by Dr. Elaine Ma in her fight against the Ontario Health Insurance Plan (OHIP). At the risk of upsetting Dr. Ma and many (? all) of my colleagues,” he wrote, “that decision actually was legally appropriate. HSARB can’t actually look at whether a case is reasonable or not; their job is to go by what’s written in bulletins/updates.”
Nonetheless, Gandhi made it very clear he believed the case ought to by no means even have appeared earlier than the HSARB: “The real affront to physicians is that it should never, ever have gotten here in the first place,” he wrote. And he ought to know. The “Old Country Doctor” is a former president of the Ontario Medical Affiliation (OMA).
Gandhi didn’t mince phrases in an interview, calling the ruling and the “persecution” Ma has endured “cruel.”
“The militancy of the Ontario bureaucracy leading to this is astounding, and [it] should never, ever have come to this stage. But now that it’s at this stage, the right thing for the government to do is to apologize profusely to Dr. Ma,” Gandhi mentioned. “She’s owed an enormous apology by the health minister and by the premier.”
However, he went on, “I don’t think that’s going to happen. I don’t think that’s in their guts to do so.”
Within the weeks since breaking this story, Kingstonist has despatched a number of questions and requests for interviews to Well being Minister Sylvia Jones, Chief Medical Officer Dr. Kieran Moore, and Premier Doug Ford. Aside from one transient and questionable assertion from a Ministry of Well being staffer that included unsupported claims about Ma “pocketing” among the fee for vaccination clinics, political workers have made it clear they might not enable entry to their superiors, even going as far as repeating the identical statements and noting the Ministry wouldn’t tackle this additional.
“That is just bureaucracy hunkering down. That tells me they realize they’ve screwed up. They want the problem to go away, and they’re hoping it will. They’re hunkering down, saying, ‘Don’t bother us anymore,’ hoping that the problem will go away,” he mentioned.
“They screwed up [and want] to avoid apologizing, which is cowardly on their part. I think that the health minister owes [Ma] an apology. The premier owes her an apology. And, at the very least, they need to acknowledge now that the bureaucrats have got their pound of flesh where they can say, ‘See, legally, we were right. We technically followed the law. But you know what? Don’t bother recouping the funds.’”
The petition talked about above was created by The Ontario Union of Household Physicians founder, Dr. Ramsey Hijazi. Physicians can’t legally kind a union, however this can be a grassroots motion of over 2,100 Ontario household physicians who wish to impact change for a greater, extra sustainable health-care panorama.
Hijazi began the advocacy group in 2023 as a result of he and his colleagues had been pissed off that, regardless of Ontario’s household physician disaster, they weren’t seeing any elementary modifications “to help family docs in family medicine, to recruit docs to do family medicine and to have them stay in family medicine.” He didn’t understand any assist from the federal government of Ontario that might impact change.
So far as the Ontario Medical Affiliation is anxious, Hijazi mentioned, “Although they’re supposed to represent us, they’ve been kind of quiet and absent in their advocacy.”
So when a pal despatched him a Kingstonist article on Dr. Ma’s battle with OHIP, he discovered it “absolutely shocking.”
“First, the government labelled us as ‘health care heroes,’” he mentioned. “But then months later, someone… stood up to take action, to try and help the government and deliver on getting COVID vaccines to as many people as possible through innovative ways, and at the end of the day [the government] punished them for it? It’s shocking.”
“So we started the petition because I feel a duty to try and help [Ma] out,” Hijazi defined. Although he isn’t acquainted with Ma, Hijazi mentioned he admires her efforts throughout the pandemic and acknowledges she have to be beneath an “awful” quantity of stress.
He emphasised that “any OHIP fraud, any kind of trying to game the system, is an absolute no-no. I’m 100 per cent against it. But this is not what this case is about at all.”
Gandhi expressed comparable sentiments in his blog publish: “Let’s be clear about this. There is zero tolerance in the broader medical community for misappropriation of funds/intentionally fraudulent OHIP billing. Zilch. Nada.”
“But,” he pressured, “there is a recognition that the imperfect OHIP billing schedule needs to be interpreted with reason, especially when times are unreasonable —- and what could possibly be a more unreasonable time than a once-in-a-lifetime pandemic?”
In dialog, Gandhi identified, “There’s the letter of the law, and there’s the spirit of the law, right? And the letter of the law is very, very particular. It’s written down. But sometimes, an injustice can happen if you look at just the letter, as opposed to the spirit of the law. And that’s what’s happened to Dr. Ma.”
“And that’s why it’s not just me. Many, many physicians around the country, not just Ontario, have read about this story and are really upset and just furious —- because we’re talking about a situation where the actual spirit of the law, the spirit of being just and fair, has not been followed by the Ontario government,” he mentioned, re-emphasizing that he considers this “an Ontario government problem.”
“Before the government decided to hound Dr. Ma, they would have sent it up the chain of their bureaucrats, right? So it would have gone to the deputy health minister if not the health minister herself. So this is a problem where the government is hounding someone for doing the right thing, if not necessarily by every tiny little technicality. And so this is very, very offensive to me. It’s offensive to physicians.”
The HSARB determination argues that Ma couldn’t have supervised the variety of college students she used, however each medical doctors expressed that that argument is patently ridiculous.
Gandhi, who taught medical college students for 30 years, defined that supervising medical college students doesn’t imply at all times trying over their shoulders or holding their fingers.
“One of the things that’s really important is to gauge how far along the medical student is in terms of their expertise… You’ve watched them perform a procedure once, twice, three or four times; then, at the end, [you see] that actually that medical student can do that procedure.”
At that time, the doctor supervises at a distance, Gandhi mentioned. Then, “You always have to be available for the medical student, if there’s an issue or a concern. You need to make sure you’re available to help out.”
In Ma’s case, not solely was she available to oversee your entire clinic, however the colleagues she paid and her workers, who had been additionally licensed physicians, had been additionally there to oversee, together with nursing professionals. On prime of all of this, Ma took on all of the legal responsibility for each clinic, so had something injurious occurred, it will have been her accountability, the physician defined.
Hijazi agreed, declaring, “This has very, very significant implications for all doctors practising in Ontario… Family docs are so demoralized working in the system right now, and to have something like this, the decision for the government to pursue this attack on Dr. Ma… an attack on a physician, and her having to fight to get paid for work that was done, is just so demoralizing, and only speaks to the antagonistic relationship the government has with physicians and really has had for a long time.”
Gandhi went as far as to name the case “proof that the Ontario government is unfriendly to physicians” and mentioned that letting the case play out the way it did was “unnecessarily cruel.”
Hijazi reiterated the implications of this ruling and the provincial authorities’s lack of motion on it.
“It sets a really, really dangerous precedent for all physicians in Ontario. I think it’s going to make a lot of physicians question the safety of practising medicine in Ontario as well as taking on learners and training new physicians —- which itself should be a huge concern for not only the general public but even the government, who’s trying to push increased education. This sets a horrible precedent,” he mentioned.
“It sets a precedent for the government to audit anyone on a whim and then use any technicality of language to recoup those billings back, even when it’s beyond reason, like giving vaccines in the parking lot as opposed to in the clinic, in the context of the pandemic. It does not make any sense.”
Gandhi agrees that, throughout a disaster when many are with out household physicians, this determination “paints Ontario in a very bad light.”
“It paints Ontario as a place —- especially in this day and age when so many other provinces cooperate with their doctors on many issues —- where doctors maybe shouldn’t consider setting up shop.”
The identical petition Dr. Hijazi began is being circulated amongst these within the native medical neighborhood, in addition to all through Kingston and the KFL&A area, as native medical doctors rally in help of Dr. Ma.
In an electronic mail to Kingstonist, the native chapter of the Ontario Medical Affiliation, OMA District 7, shared the petition, explaining the collective of medical professionals regionally is aiming to garner greater than 20,000 signatures. The OMA District 7, whose Government Board has voiced opposition to the OHIP’s calls for for reimbursement and in help of their colleague previous to the discharge of the HSARB determination, contains the Leeds and Grenville Medical Society, the Lennox and Addington Medical Society, and the Kingston Academy of Drugs.
Requested why the medical doctors are circulating the petition and why they really feel is it necessary to help Ma, the OMA District 7 Government Board responded with agreed-upon statements. The OMA District 7 Government Board is made up of Dr. Pleasure Hataley (Chair), Dr. Ani Garg (President of Kingston Academy of Drugs), Dr. Veronica Legnini (Previous OMA District 7 Government Board Chair), Dr. Cameron MacLean, Dr. Siobhan Muldowney, Dr. Omar Islam, and Dr. Lysa Lomax. And like Drs. Ghandi and Hijazi, the District 7 Government was direct and didn’t mince phrases.
“As your local community of physicians, we believe the most straightforward resolution to this miscarriage of justice lies in the citizens of Ontario urging Premier Ford and Minister Jones to take action. The government has the authority to overturn the HSARB ruling against Dr. Ma, and we strongly advocate for them to do so,” the native physicians group acknowledged.
“Our concerns are multifaceted, but central among them is that this ruling is rooted in technicalities rather than ethical principles or fairness. While we respect and value the Ministry of Health’s role in safeguarding public funds, extraordinary circumstances — such as the innovative and effective mass vaccination and drive-through clinics organized by Dr. Ma, with full accountability and liability — deserve recognition, not punitive measures like clawbacks or public censure. To penalize such efforts on technical grounds during a global pandemic feels unjust and counterproductive.”
The OMA District 7 Government went on to say the ruling of the HSARB “sets a troubling precedent for medical education in Ontario,” a sentiment of concern Dr. Ma herself pointed to right away following the discharge of the board’s ruling.
“Physicians who supervise medical students assume full accountability and medicolegal responsibility for the care provided under their supervision. If educators are denied the ability to bill OHIP for this patient care, it risks creating an insurmountable disincentive for teaching future healthcare professionals — a loss that would ripple through the province’s healthcare system,” the Government mentioned.
Lastly, the collective of native medical doctors expressed solidarity with their fellow Kingston-based doctor within the face of the pointed persecution towards her, saying, “When the government targets one of us, it feels like an attack on all of us.”
“As Ontario’s physician community, we stand united in our commitment to addressing this issue. We will remain steadfast until this case is resolved in a way that upholds fairness, supports our ability to teach and provide care, and ensures the well-being of the people of Ontario,” the District 7 Government mentioned.
“As such, we urge our community members to sign this petition and to share it with their networks across Ontario.”
With information from Tori Stafford.
