IMR Press / EJGO / Volume 27 / Issue 1 / pii/2006114

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Original Research

An analysis of alternative funding for physicians practicing gynecologic oncology in Ontario, Canada prior to 2001

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1 Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
Eur. J. Gynaecol. Oncol. 2006, 27(1), 61–64;
Published: 10 February 2006

Objective: To consider the policy issue of physician reimbursement by examining the events that preceded the Ontario Gyneco­logic Oncologists moving from a fee-for-service environment to an .alternate payment plan in 2001. Methods: The sources of information included a literature search, reviewing Canadian newspapers, interactions with key leaders in the field (Ontario Medication Association, University physicians), and meeting minutes from both university and provincial groups considering alternate payment plans. Results: The problem for Ontario Gynecologic Oncologists involved the goal of providing excellent clinical care, undergraduate and postgraduate education, research and administration in the midst of problems with recruitment, retention and remuneration. Multiple causes for this problem included limitations in health care spending and a fee for service payment schedule that did not ade­quately reimburse complex care. This funding problem got on the agenda as a result of a front page article in the national newspa­per and letters of concern solicited from local members of the provincial parliament. The policy formulation needed to account for alternate financial options and the roles of institutional structures such as the universities, Cancer Care Ontario and the Ontario University Health Science Centers. The influences on the evolution of the new funding policy included the actors, their interests, the values, research on the topic and institutions. Conclusion: The tensions between the goal of excellence in care, education, research and administration and difficulties with recruitment, retention and reimbursement, led the Ontario Gynecologic Oncologists to seek an alternate mechanism of reimburse­ment from the fee-for-service model.

Physician reimbursement
Gynecologic Oncologists
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