Family health networks in Ontario

I wish to point out 2 areas of concern relating to an otherwise interesting analysis of Ontario's plan for primary care reform.1

First, the statement that the Ontario Medical Association (OMA) “developed a contract setting out terms and conditions for joining an FHN” (family health network) creates the impression that the OMA alone was responsible for developing these contracts, but the OMA collaborated with the provincial Ministry of Health and Long-Term Care to develop the FHN templates.

Second, the last paragraph states that FHNs “must also negotiate internal governance agreements that set out schedules for extended office hours and on-call services.” In fact, the FHN templates set out minimum governance requirements. In many instances, physician groups will already have in place associateship or partnership agreements, which can be modified to accommodate the FHN agreement. The actual “negotiations” for suitable governance do not involve the ministry but are part of the physician group's transformation to a new structure. The FHN templates permit the province's Family Health Network to obtain copies of internal governance documents and to then request changes if it determines that the governance structure does not meet the requirements of an FHN agreement. Whether this will actually occur remains to be seen.

Robert L. Lee Legal Counsel to Ontario Medical Association Toronto, Ont.