Some thoughts on the Ontario Ministry of Health’s new proposal

Recently, I had the pleasure to discuss with Dr. Joshua Liu regarding his thoughts on the Ontario Ministry of Health’s new proposal for healthcare changes. Joshua was my classmate from medical school, who is the current CEO of SEAMLESS MD (a surgical care App), and has numerous years of experience in healthcare research. He was a Canadian Top 20 Under 20 and Forbe’s Top 30 under 30 (in Healthcare), among many other honours. He also created the SMARTS Network and sat on the board of directors at SHAD Valley. In the pre-medical community, he is known as the creater of, which also featured one of our popular posts,

Joshua has already made a blog post regarding his thoughts at In order to make this issue more aware to a wider audience, especially in the pre-medical community where many are passionate to pursue a career in medicine, Joshua has given us permission to share his thoughts on our blog.

Upon reading the new proposal, Joshua has summarized his thoughts and ideas into the following 3 points:

1. A lack of transparency. This is a 24 page-long document that is mainly filled with fluff, with the central message that the LHINs (Local Health Integration Networks, the regional health authorities in Ontario) should be in charge of home care, primary care, and public health. Let’s forget about the pros and cons about the proposal for a second. This much fluff (over 90% of the document) truly illustrates the intrinsic problem within our healthcare system – a lack of transparency. Perhaps, this should be our top priority in the proposed changes.

2. A lack of direction. Upon reading this document, I never got a sense of what the end goal is after all the proposed changes. There was a clearly a lack of direction, which makes it difficult for our medical colleagues to collaborate with the Ministry to best carry out the changes. Comparing to other provinces in Canada, Ontario probably has the most complicated and fragmented healthcare system, and I hope the proposal won’t lead us in the unfavourable direction.

3. A lack of focus on quality of care. The majority of medical providers are reimbursed by the volume-based funding model (eg. Fee-for-service), rather than changing to a quality-based model (eg. Pay-for-performance). Similar changes have been implemented in the US 12 months ago, where various stakeholders are held accountable to their performances based on public targets.

What’s even more ridiculous? In order to cut down on cost, the government has chosen to impose “clawbacks” on Ontario healthcare providers, while manipulating the public’s trust and perception by stating that Ontario physicians are highest paid in Canada. Well, it would for sure be difficult for the proposal to be implemented when 26,000 Ontario physicians believe it will cut the quality of patient care. As a result, physicians have left Ontario, and even Canada for some, to practice medicine.

Thanks to those who competed in our “Cost of Care” essay competition. The winners will be announced in March 2016.