The Newfoundland and Labrador Medical Association (NLMA) and the provincial government continued to argue opposing points publicly Monday in a dispute about a two-tier system for salaried medical specialists, still with no resolution in sight.
Health Minister Jerome Kennedy told reporters at Confederation Building Monday he met with Eastern Health president and CEO Vickie Kaminski earlier in the day to discuss recruitment plans to fill positions being vacated by disgruntled salaried specialists.
“Ms. Kaminski should be in a position a little later on in the week to discuss exactly what Eastern Health will do,” Kennedy said.
On Friday, the NLMA confirmed 13 salaried specialists were resigning, effective Feb. 4, 2011, including 12 from Eastern Health and one from Western Health. The number has since grown to 14, with Dr. Joan Quinn, a psychiatrist with Eastern Health in Carbonear, also tendering her resignation.
NLMA president Dr. Patrick O’Shea said Monday family doctors like himself are worried the resignations will cause longer patient wait times.
“Patients are already today, this morning, in my office starting to wonder what’s going to happen with their referrals,” O’Shea said, noting some have already been waiting six months and, if their appointments are after February, they may have to join another long wait list for another specialist.
Describing the resignations as “devastating,” O’Shea said, “There is no question that these resignations will further destabilize an already fragile system.”
As for the province’s plans to begin recruitment efforts immediately to fill the vacancies, O’Shea said he doesn’t believe that’s very realistic.
O’Shea said the health authorities have been trying to fill specialist positions for quite some time now and they’ve been constantly understaffed.
Kennedy said over the last two to three years, the province has recruited more than 50 new physicians, with about 25 to 30 specialists, which indicates recruitment initiatives, such as bursaries and retention bonuses are working.
Finance Minister Tom Marshall also disputed the NLMA’s claims that filling the vacancies will be a difficult task.
Marshall said when doctors apply for salaried specialist jobs, they normally ask whether they’ll be paid the same as everyone else in Atlantic Canada, rather than ask, “What’s the guy down the hall receiving?”
When negotiations with the NLMA began, the goal was to reach Atlantic parity, Marshall said, pointing out that the latest offer has addressed that.
The thorny issue, however, is that about 60 pathologists and oncologists who were given 35 per cent pay increases in 2008 will still be paid higher than 150 other salaried specialists.
O’Shea said the current base pay for the larger group of salaried specialists is about $180,000 a year, while the base pay for pathologists and oncologists is about $255,000. Government’s offer would raise the regular salaried specialists’ annual base pay to about $239,000 and the pathologists and oncologists base pay to about $276,000.
Kennedy said at least seven of the salaried specialists who are resigning also receive stipends above their base salaries for clinical work or for teaching at Memorial University.
Singling out Dr. Julia Trahey, an internal medicine specialist and clinical chief of quality assurance with Eastern Health, Kennedy said she’s paid a $95,000 stipend in addition to her base salary.
Kennedy said if government gives in to the demands of the resigning specialists, another group of fee-for-service specialists could demand the same, but there’s only so much money to go around.
Fee-for-service specialists, who are paid for their services but without a base salary, are being offered a 10 per cent increase.
Kennedy said salaried specialists don’t have to pay overhead costs like the fee-for-service specialists, they receive 10 weeks of guaranteed holidays a year, get pension benefits and the same medical and dental benefits as everyone else who works for government.
During the NLMA news conference, O’Shea also suggested the province’s liberation therapy clinical trial for multiple sclerosis patients could be in jeopardy with the resignation of neurologist Dr. Mark Stefanelli, director of Eastern Health’s MS program.
Kennedy, however, said Monday this is news to him. He said Stefanelli emailed his associate deputy minister Thursday, confirming that there would be a meeting on Nov. 16 with MS patients and indicating that he would continue with the observation study, no matter what.
Kennedy said if anything has changed, he’s not aware of it. He said some salaried specialists who are resigning may be staying in the province as fee-for-service specialists.
“So, whether or not they’re all leaving or just leaving their salaried positions, I don’t know that,” Kennedy said.
The NLMA board of directors plan to meet tonight to review government’s latest offer before sending packages of information to members for a vote around the middle of this month.
O’Shea couldn’t say Monday whether the board will make a recommendation to NLMA members on how to vote.