Ontario Sunshine List: Why aren't doctors on it?

CBC Toronto recently asked for your questions about Ontario's Sunshine List. And we got them. One reader asked: Why aren't doctors on the list?

It's time for the Ontario government to reveal how much individual doctors bill the province's publicly funded health insurance plan, according to one health-care advocate.

Michael Decter, a former deputy health minister and the chair of Patients Canada, said the health-care system would be more open and transparent if the province put billings by doctors on its annual Sunshine List.

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Formally known as the Public Sector Salary Disclosure, the list reveals the names and salaries of public servants who make more than $100,000.

The list includes some salaried physicians, such as those who work in community health centres, but the majority of doctors who bill OHIP are not the list because they are considered independent contractors.

"I think they should be on the Sunshine List. It's a serious omission. Physicians are paid overwhelmingly by taxpayer dollars. Taxpayers have a right to know where their money is going," Decter said.

"This is good public policy and it's long overdue."

Decter said it's "bewildering" that the public knows the top salaries of nurses, teachers, police officers, school board administrators, university and college presidents and hospital employees, among other public-sector workers, but not doctors who bill the government.

The province has the data, he said. "There's no issue with doing it. That information has been collected. But it's not made public."

B.C. and Manitoba have been releasing data annually on billings by doctors for years, Decter said, adding Ontario should have done it when it first began disclosing the names of public-sector employees paid more than $100,000. The Sunshine List was started under Mike Harris's Progressive Conservative government in 1996.

There are 115,431 people on the 2015 list and an estimated 26,000 doctors in Ontario, according to Decter. "Doctors on fee-for-service billing are not on the list. That's a pretty glaring omission," he said.

Dr. Mike Toth, president of Ontario Medical Association, said in an email statement that most doctors in the province are not government employees.
 
"The majority of physicians in Ontario are not employees of the government, but rather independent professionals who, under our system of medicare, bill OHIP for the necessary medical care they provide to patients in Ontario every day," he said.

"I would also like to make clear that the figure often reported as an average physicians' salary is actually referring to OHIP billings, out of which come expenses such as rent for clinic space, staff salaries, supplies and equipment — the kinds of expenses that any small businessperson contributing to any community must pay."

Income considered personal information

Brian Beamish, Ontario's information and privacy commissioner, also issued a statement when asked about the issue.

"Doctors who bill OHIP are not considered public-sector employees of the province but rather independent contractors. Further, our office has traditionally treated doctor salaries as the personal information of physicians and exempt from disclosure," he said.

"Currently, there is an appeal underway in which this traditional approach is being reviewed and a decision should soon be forthcoming."

Provincial Health Minister Eric Hoskins, who was not available for comment on Friday, said last week that the average salary of doctors in Ontario is $360,000 a year and that the province's doctors are the highest paid in Canada. There are no caps on billings by Ontario doctors, he said.

Hoskins blasted what he called "out of control" billing by some Ontario doctors and said it is leaving fewer health-care dollars for other services. The Ontario government sets aside $11 billion a year to compensate doctors.

Under the Public Salary Disclosure Act, organizations that receive public funding from the Ontario government are required to disclose annually the names, positions, salaries and total taxable benefits of employees paid $100,000 or more in a calendar year.