Ontario moves to scale back annual physical exams in new deal with doctors

TORONTO - The annual physical by your family doctor will be quicker and involve fewer tests for most healthy adults under a new fee agreement with Ontario's physicians.

The province reached a tentative deal with the Ontario Medical Association Tuesday, worth $11.1 billion a year, that calls for "modernizing" the annual health exam and personalizing it to individual needs to reduce unnecessary tests.

"The annual visits will still be there, you’ll get all the tests that you need," Health Minister Deb Matthews said Wednesday.

"But we are personalizing it so that if you need more tests you’ll get more testing, and if you need fewer tests you’ll get fewer tests."

The fees paid to doctors for physicals will be reduced for healthy adults because their annual visit will take less time on average, said the Ministry of Health.

Family doctors were some of the strongest voices saying a routine health exam should reflect the fact that the needs of patients vary greatly, said Matthews.

"They came forward with this idea that if we actually look at the evidence, maybe we’re over-testing people," she said.

"It’s best for patients."

The New Democrats said they were worried by the vague government language about "modernizing" the annual check up, and complained they couldn't ask Matthews any questions about the OMA deal because the Liberals prorogued the legislature until sometime next year.

"I would have 100 questions if we had question period, so it leaves me with this really uncomfortable feeling that this was a deal that was set to help the Liberal party, not to meet the needs of the people of Ontario," said NDP health critic France Gelinas.

"Was this a deal that was struck so that we show a victory for the Liberals or is this something that was struck so that we truly get the best patient care available?"

The changes to the annual physical mean not all patients will undergo the same tests when the evidence demonstrates it is not of value, but it is a patient’s needs that will determine the type of care a physician will provide, added Matthews.

A recent Danish study concluded doctors should stop offering annual physicals because they don't appear to reduce deaths from cancer or heart disease but can add to stress levels.

Researchers at the Nordic Cochrane Centre in Copenhagen pooled data from 14 studies that included more than 180,000 people who were randomly assigned to a group that was asked to get regular checkups or one that saw a doctor only as needed.

"With the large number of participants and deaths included, the long follow-up periods used, and considering that cardiovascular and cancer mortality were not reduced, general health checks are unlikely to be beneficial," concluded the authors.

The OMA is expected to help find $100 million worth of savings in the health care system to offset an increase in the total compensation package for the 25,000 doctors it represents.

Matthews said doctors are not getting a raise because the $100 million won't even cover the billings of the 600 new doctors who start working in Ontario each year.