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Locum physician says province owes her $30K for work in northern Ontario

Dr. Christine Hwang runs a family planning clinic in Toronto, and works as a locum in small communities across northern Ontario. She says she might have to stop the locum work because she hasn't been paid in months. (Submitted by Christine Hwang - image credit)

Dr. Christine Hwang says the Ontario government owes her around $30,000 for her work as a locum physician in small northern communities from October to December 2022, and she’s not alone in saying the province hasn’t paid relief doctors such as herself in full.

Hwang runs a family planning clinic in Toronto, where she lives. For 18 years, she has also worked as a locum physician, under the province’s Rural Family Medicine Locum Program, filling in for doctors in rural communities including Gore Bay, Mindemoya, Red Lake and Atikokan.

Hwang said Ontario’s locum program has been a critical part of the health-care system in small rural communities. When physicians in small towns go on vacation, or take time off due to illness or other reasons, they can rely on a locum doctor to replace them for a short time.

Hwang said she loves the work.

“It gives you an experience working with a much broader knowledge base,” she said.

“You manage a lot more. It’s very different from working in a city practice, and that’s why I’ve chosen to continue working in the north.”

I’m literally borrowing money to pay for my life. – Dr. Christine Hwang

When she first started the locum physician work in 2004, Hwang said, the Ontario Medical Association (OMA) managed the program. For the most part, the OMA managed it well, she said.

“In the past I would get paid within four to six weeks of submitting my expenses,” she said.

In addition to her pay, those expenses include flights, car rentals and hotel stays that are necessary when working in communities far from her home.

Due to health-care worker shortages in northern and remote communities, Hwang said, she recently came out of retirement from her work as a locum physician.

Now, the Ministry of Health manages the locum program directly.

Hwang said it took until November for the ministry to pay her for her June 2022 work, and she’s still waiting to get paid for her end-of-year work.

She said she’s also missing payment for expenses she paid out of her pocket to travel to and stay in small northern communities.

“I’m literally borrowing money to pay for my life,” Hwang said.

While she enjoys working in rural medicine, she said it’s not sustainable if she is not getting paid in a timely manner.

“I might need to take a break until I get some money,” she said.

Submitted by Maxime CannonSubmitted by Maxime Cannon

Dr. Gretchen Roedde had a practice in the northeastern Ontario town of Latchford and now works as a locum physician in other small towns across Ontario.

Roedde said she knows another doctor who was recently owed $50,000 for unpaid locum work. Roedde has also faced similar delays.

“I got paid in September for some work that was done in April and some work that was done in July,” she said.

Roedde said the bureaucracy behind the locum program is complicated because the OMA negotiates with the province how much locum doctors should get paid.

“The forms have to go there to request the locum and then they have to come back, and then they have to be approved, and then you submit your mileage claims, and then they have to come out,” she said.

“So I think it’s just quite cumbersome.”

Roedde said she found a “miracle worker” at the Ministry of Health who has helped her navigate the system and get her claims approved directly. But she added the “cumbersome” system and delays are damaging to health care in the north.

Our locums are a lifeline. – Dr. Shawn Minor

The locum program helps recruit permanent physicians in small communities because it gives them some relief and helps prevent burnout.

“The more northern doctors we have, which is what we were looking for, the more they’re going to be able to take paid holidays, which is also a good thing for people to not burn out,” Roedde said.

“And then, hopefully, we can find doctors to come in and fill in for them. But then those doctors need to be paid.”

Dr. Shawn Minor manages a clinic in Atikokan, in northwestern Ontario, where he regularly depends on locum physicians to fill in for colleagues and himself.

“Our locums are a lifeline,” he said.

Minor said a few physicians left his community about a year and a half ago, and his clinic relied heavily on locums at that time.

But in recent months it has taken weeks just to get responses to emails from the Ministry of Health.

“It is now at the point where some locums who are longstanding with our clinic and our community are saying, ‘You know, they’re borrowing money to come and work for us because they’re not being reimbursed for up to five months,'” Minor said.

“In the private sector, not getting paid for five months is unheard of, but of course, this is the public sector.”

Minor said it would help if clinics like his could receive funds from the province to manage their locums themselves.

“I have the administrative capacity in my clinic if someone simply said, ‘Here are the dollars for your locums,’ he said.

“Give the communities the money for locums and let us do the reimbursement because, you know, that would be super easy and it would remove a layer of inefficiency.”

Ministry of Health response

In an email to CBC News, Ontario’s Ministry of Health said 90 per cent of claims from locum physicians were processed in four to six weeks.

“Claims that exceed the four- to six-week window are typically the result of incomplete documentation such as missing expense receipts,” the email said.

The ministry said it has paid out $5 million to physicians under the Rural Family Medicine Locum Program so far for the 2022-2023 fiscal year.

Credit belongs to : ca.news.yahoo.com

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