Years 2-4 of the 2024-28 Physician Services Agreement: What It Means for You
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Dr. Eric Goldszmidt
In September, Ontario’s government announced a new deal with the province’s doctors. Formally known as Years 2-4 of the 2024–28 Physician Services Agreement (PSA), it was reached after months of negotiations, mediation, and arbitration. While all physicians were awarded an increase in compensation, additional targeted investments were announced for a select group of specialties, including anesthesiology.
So, what exactly does this mean for our members and our patients? In a quick Q&A, our tariff chair, Dr. Eric Goldszmidt, explains what comes next.
As our tariff lead, Dr. Goldszmidt oversees the OA’s submissions to the Negotiations Task Force (NTF), which negotiates the PSA. He works with the NTF on proposals specific to anesthesiology and then leads our response to any related implementation issues. This includes all submissions to the physician payment committee for permanent changes to the schedule of benefits. In short, he knows the PSA, the NTF, the PPC, the RAC, and all the many other OMA-related acronyms. He is a one-stop shop for all issues related to anesthesiologists’ compensation and for navigation of OMA business.
Q: What do the results of the Year 2-4 2024-28 PSA arbitration mean for Ontario’s anesthesiologists?
A: There are benefits to anesthesiologists on so many levels.
First, the medical profession was awarded normative fee increases for each of Year 2, 3 and 4 of 2.8%, 2.5%, and 2%. Anesthesiologists will receive a relativity adjusted portion of each of those fee increases. The exact amount is unknown as the formula needs to be decided. These increases are on top of the 5.33% relativity payment that our members already received for years 3 and 1 of the last and current PSAs.
Our section was one of a few chosen to receive additional targeted funding. This funding includes an investment of $60 million into a daily or hourly sessional fee for in-hospital OR/NORA work to support hospital-based anesthesiology and make this type of work more attractive.
Additionally, the Ministry of Health and OMA are forming a bilateral committee to develop recommendations to inform expanding anesthesiologist supervision of anesthesia assistants beyond the current cataract model. This could lead to the expansion of team-based anesthesia care.
These actions are positive steps towards reducing the anesthesia human resources challenges that the province is currently facing.
The Ministry and the OMA are continuing to work on a burden-based on-call stipend system and have new investments to add to it. This new system, which replaces the current one, will recognize our intense on-call burden and should result in an increase over what we currently receive.
Anesthesiologists who work in academic health science centres will see increases to their AFP/APP payments.
Finally, our members, like all Ontario physicians, will see increases to parental leave benefits and the physician health benefit program, as well as a renewed commitment to resolving challenges related to good faith payments and expediting manual review billing processes.
Official Wording
Q: What does this mean for patients undergoing anesthesia care?
A: To start with, you should expect the same world-class care you have always received from our members. Beyond that, we are hopeful that the new sessional fees will increase hospital-based anesthesiologists’ hours, allowing hospitals to maximize the number of cases they can do. This could mean shorter wait times for some procedures.
In the longer term, we might see a further expansion of team-based anesthesia care, which means we should be able to care for more patients than we currently can by working solo.
Q: Do we know any more details about the joint Ministry of Health–OMA committee that will be developing recommendations for expanding team-based anesthesia care?
A: Not yet, but the parties have committed to addressing this expeditiously and will make best efforts to have some recommendations by April 2026. To meet that date, they will have to quickly determine who will be on the committee, which will then consult more broadly with key players and expert bodies.
This committee will require bilateral cooperation and much negotiation as the arbitration board does not have jurisdiction to mandate any outcomes in this area.
Given the amount of implementation work required for this award, I think it is only fair that we anticipate delays. Given how complicated this issue is, this item is one of those that I expect to take longer than intended.
Q: Any other thoughts to share about the arbitration results?
A: I am very encouraged that the government agreed to invest in anesthesiology and look at anesthesia care teams. These were decisions the Province chose to make, not ones forced on it by the board of arbitration.
These results are the product of a lot of hard work and advocacy on the part of Ontario’s Anesthesiologists and the OMA. It’s work that is only possible because our members are choosing to support our section by paying their voluntary annual dues. I encourage all our members to pay those dues. The amount is less than one daily sessional fee that our members will receive next year.
Q: What happens next?
A: There is an awful lot of implementation work that will now take place over the coming year. The sections, OMA, and the NTF will remain quite busy with that before turning their focus to the next PSA, which likely will see negotiations begin later in 2027.
Are you an Ontario anesthesiologist who has questions or comments about the future of team-based anesthesia care/anesthesia care teams? Then attend our virtual town hall, Arbitration to Action: ACT 2025 Member Input and Engagement, on Wednesday, October 22, at 7 pm. Please find the RSVP link in the emails sent to you by the OMA on Wednesday, October 1, and Tuesday, October 14, or email us at info@ontariosanesthesiologists.ca