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Effects of the anti-inflation program: an open letter to L.C. Grisdale, CMA president Dear sir: It is certainly important that all Canadian citizens obey the laws laid down by our governing body, and I firmly believe that all Canadian doctors can appreciate the peculiar position that the leaders of our medical profession are now placed in because of the anti-inflation program. There is no doubt that we must speak and act like responsible citizens, and I certainly feel that all of us will. I am sure that all of us will do all we can to cooperate with the general intent of your letter of Jan. 14, 1976. However, I ask the profession, yourself, the members of the CMA executive and provincial medical bodies to take a serious look at one sentence in your letter: "The program allows physicians to increase their net income beyond the $2400 limit as a result of increased workicads [my italics]." Horrors! The profession has already been criticized for practising volume medicine. We have read about this in the press. Our patients complain that they must wait hours to see us in our offices and emergency rooms. Medical review committees of our provincial colleges have already established firmly workload limits beyond which physicians become subject to investigation and harassment. And now, Sir, you, in your good office - and with the support of your executive, I presume appear to be supporting the concept of "quantity medicine". Sir, you and your executive should take a firm stand against this. We must practise "quality medicine", not "quantity medicine". Who, Sir, will determine what is "an enriched workload mix... Contributions to the Correspondence section are welcomed and if considered suitable will be published as space permits. They should be typewritten double spaced and should not exceed 1½ pages in length.
providing more demanding, more extensive medical services"? And who, Sir, will be the accountant whom we can expect to retain and who will be an expert in the complex field that has only now reared its ugly head above the surface? I am sure many of us may have problems until experts are found. And what will our enlightened government do with all the funds (I pray to God there will be none) that will be confiscated? Put them back into the pot and give them away? It is my hope that perhaps some of the funds that may be taken from the medical profession in this way, and through the added surtax, could be directed into medical research. There have been numerous letters in the Globe and Mail, written by directors of research programs in university centres, crying out for financial aid. These centres are losing people who have been well trained in research and who are working on important programs. These doctors and young research scientists will soon have to leave Canada and look for greener fields, and most certainly these will be found in the United States. I think at this point our profession should take two stands: 1. We should be fighting for a method of ensuring quality medicine, quality delivery of health care, and not supporting anything that reeks of continuing quantity medicine. 2. We should recommend to the federal government that any funds confiscated in this way, directly or indirectly, should be directed into university research programs. I feel strongly that, when we physicians have to pay our 10% surtax, instead of this money being put into government coffers, we should be able to send it to recognized university foundations, and I ask the CMA md our provincial bodies to lobby for this.
754 CMA JOURNAL/MAY 8, 1976/VOL. 114
STANLEY OLEKSJUK, MD
700 Tecumseh Rd. E Windsor, ON
.
Dr. Grisdale's reply: May I state most emphatically that it was not the intent of the presidential newsletter to promote "quantity medicine" as opposed to "quality medicine". The reference to physicians being allowed to increase their net income beyond the $2400 limit as a result of increased workloads was related primarily to young physicians building their medical practice. I am sure Dr. Oleksiuk would agree that it would have been unfair to restrict the net income increase of such physicians to the $2400 limit. The CMA has emphasized the necessity of the anti-inflation program being devised so as not to discourage increased workload, increased productivity, increased efficiency, and so on, of the medical practitioner. We share Dr. Oleksiuk's concern about the inadequate federal government funding of medical research in Canada. Indeed, in recent years we have made representation to the government on this matter on several occasions. We shall continue to press for adequate funding of medical research in Canada, but we hope that such adequate funding would not depend on the level of the surtax paid by physicians or on funds confiscated by the antiinflation program from physicians whose net income increases beyond $2400 were not the result of increased productivity. L.C. GRISOALE, MD
President Canadian Medical Association 1867 Alta Vista Dr. Ottawa, ON
Antibodies to poliovirus To the editor: In his letter (Can Med Assoc J 114: 412, 1976) referring to our article "Antibody status to poliomyelitis, measles, rubella, diphtheria and tetanus, Ontario, 1969-70: deficiencies discovered and remedies required" (Can Med Assoc J 113: 619,
Effects of the anti-inflation program: an open letter to L.C. Grisdale, CMA president Dear sir: It is certainly important that all Canadian citizens obey the laws laid down by our governing body, and I firmly believe that all Canadian doctors can appreciate the peculiar position that the leaders of our medical profession are now placed in because of the anti-inflation program. There is no doubt that we must speak and act like responsible citizens, and I certainly feel that all of us will. I am sure that all of us will do all we can to cooperate with the general intent of your letter of Jan. 14, 1976. However, I ask the profession, yourself, the members of the CMA executive and provincial medical bodies to take a serious look at one sentence in your letter: "The program allows physicians to increase their net income beyond the $2400 limit as a result of increased workicads [my italics]." Horrors! The profession has already been criticized for practising volume medicine. We have read about this in the press. Our patients complain that they must wait hours to see us in our offices and emergency rooms. Medical review committees of our provincial colleges have already established firmly workload limits beyond which physicians become subject to investigation and harassment. And now, Sir, you, in your good office - and with the support of your executive, I presume appear to be supporting the concept of "quantity medicine". Sir, you and your executive should take a firm stand against this. We must practise "quality medicine", not "quantity medicine". Who, Sir, will determine what is "an enriched workload mix... Contributions to the Correspondence section are welcomed and if considered suitable will be published as space permits. They should be typewritten double spaced and should not exceed 1½ pages in length.
providing more demanding, more extensive medical services"? And who, Sir, will be the accountant whom we can expect to retain and who will be an expert in the complex field that has only now reared its ugly head above the surface? I am sure many of us may have problems until experts are found. And what will our enlightened government do with all the funds (I pray to God there will be none) that will be confiscated? Put them back into the pot and give them away? It is my hope that perhaps some of the funds that may be taken from the medical profession in this way, and through the added surtax, could be directed into medical research. There have been numerous letters in the Globe and Mail, written by directors of research programs in university centres, crying out for financial aid. These centres are losing people who have been well trained in research and who are working on important programs. These doctors and young research scientists will soon have to leave Canada and look for greener fields, and most certainly these will be found in the United States. I think at this point our profession should take two stands: 1. We should be fighting for a method of ensuring quality medicine, quality delivery of health care, and not supporting anything that reeks of continuing quantity medicine. 2. We should recommend to the federal government that any funds confiscated in this way, directly or indirectly, should be directed into university research programs. I feel strongly that, when we physicians have to pay our 10% surtax, instead of this money being put into government coffers, we should be able to send it to recognized university foundations, and I ask the CMA md our provincial bodies to lobby for this.
754 CMA JOURNAL/MAY 8, 1976/VOL. 114
STANLEY OLEKSJUK, MD
700 Tecumseh Rd. E Windsor, ON
.
Dr. Grisdale's reply: May I state most emphatically that it was not the intent of the presidential newsletter to promote "quantity medicine" as opposed to "quality medicine". The reference to physicians being allowed to increase their net income beyond the $2400 limit as a result of increased workloads was related primarily to young physicians building their medical practice. I am sure Dr. Oleksiuk would agree that it would have been unfair to restrict the net income increase of such physicians to the $2400 limit. The CMA has emphasized the necessity of the anti-inflation program being devised so as not to discourage increased workload, increased productivity, increased efficiency, and so on, of the medical practitioner. We share Dr. Oleksiuk's concern about the inadequate federal government funding of medical research in Canada. Indeed, in recent years we have made representation to the government on this matter on several occasions. We shall continue to press for adequate funding of medical research in Canada, but we hope that such adequate funding would not depend on the level of the surtax paid by physicians or on funds confiscated by the antiinflation program from physicians whose net income increases beyond $2400 were not the result of increased productivity. L.C. GRISOALE, MD
President Canadian Medical Association 1867 Alta Vista Dr. Ottawa, ON
Antibodies to poliovirus To the editor: In his letter (Can Med Assoc J 114: 412, 1976) referring to our article "Antibody status to poliomyelitis, measles, rubella, diphtheria and tetanus, Ontario, 1969-70: deficiencies discovered and remedies required" (Can Med Assoc J 113: 619,
