Chair's Report - Fall 2024

Dear colleagues,

Now that we are into the final quarter of 2024, I want to share a comprehensive update on some key developments, achievements, and ongoing initiatives that are shaping our field and our organization’s advocacy efforts. For details regarding the newly arbitrated year 1 award and other important economics that affect our specialties, stay tuned for our relentless Dr. Goldszmidt’s tariff report to come mid-November.

Recent Advocacy Efforts Following Year 1 Award
Ontario’s Anesthesiologists, on behalf of all anesthesiologists of Ontario, submitted a formal letter to Dr. Cathy Faulds and the OMA Board emphasizing the urgent need for targeted investments in anesthesiology, especially given the current human resource shortages impacting surgical services across Ontario. Our letter highlighted the importance of non-relativity-based increases, support for Anesthesia Care Teams, and the need for fair compensation adjustments to improve recruitment and retention. Dr. Faulds acknowledged the seriousness of these issues, and we followed up with data to further reinforce our position and ensure that the unique challenges faced by anesthesiologists are prioritized during the decision-making process regarding how to implement the year 1 award. This was further discussed during the chair’s update at our Ontario Anesthesia Meeting. Following her address to our members, several members and executives were able to advocate further to her on this matter.

We remain committed to ensuring that anesthesiologists receive the necessary support to address the current staffing shortages and workload pressures, and we encourage all members to stay involved as these advocacy efforts progress.

Anesthesiology and Human Resources Shortage
The shortage of anesthesia human resources in Ontario is a pressing issue that profoundly affects patient care and surgical capacity. As the demand for anesthesia services continues to rise, our advocacy efforts have never been more crucial. Through our ongoing advocacy with patients, the OMA, MOH and the government, this concern has become a top priority, prominently featured in OMA’s “Stop the Crisis” campaign. This focus was reinforced during the recent priority and advocacy training for OMA physician delegates at Queen’s Park Day.

Ahead of the latest round of mediation on implementation of the year 1 PSA award, we launched an email campaign encouraging our members to advocate directly to their local MPPs for increased investment in anesthesia human resources. This campaign is vital in ensuring that our elected representatives understand the challenges facing our specialty and how they impact patient care across the province. These also build the foundation to allow for fruitful discussions that our executives have had and will continue to have as they engage with MPPs. So far, 61 emails have been sent to MPPs, the Premier and Minister of Health. Thank you to everyone who has already participated; your efforts are making a difference! For those who haven’t yet sent their message, there’s still time! You can easily send an email to your MPP using the link provided in the OMA-issued email sent on October 9. You can also access the letter directly on our website. I encourage everyone to not only send the letter but to share the link with your colleagues, friends, and family members. The more voices that reach MPPs, the more likely we are to create impactful change.

Our advocacy initiatives have taken many forms, including direct discussions with key decision-makers, collaboration with fellow physicians, and public awareness campaigns via social media to educate the community about the critical state of our sector. By actively engaging with policymakers, we strive to ensure that the perspectives and needs of anesthesiologists are acknowledged and that meaningful actions are implemented to tackle this escalating challenge within our healthcare system.

The Role of Anesthesia Care Teams (ACTs)
Another of our key advocacy focuses is the expansion of Anesthesia Care Teams. The ACT model is designed to extend the care that anesthesiologists can provide by allowing them to oversee and lead a team of highly skilled anesthesia assistants. This structure enables anesthesiologists to triage patients more effectively, focusing on those with the most urgent needs while maintaining high standards of care throughout the surgical process. By increasing the availability of ACTs, we can significantly improve access to anesthesia services, especially in underserved areas where recruiting anesthesiologists has been challenging. This approach helps to reduce surgical wait times, enhances patient safety and outcomes, and contributes to greater job satisfaction for our colleagues.

With the OMA placing significant emphasis on the anesthesia human resources shortage and recognizing the important work done by our OA executives and members to find sustainable solutions, we were able to engage in a meeting with Health Minister Sylvia Jones at the OMA’s October 21 Queen's Park Day. Along with senior OMA leadership including CEO Kim Moran, President Dr. Dominik Nowak, EVP for Advocacy, Communications and Marketing, Craig DuHamel, and General Counsel, Interim EVP Economics, Policy & Research, Adam Farber, I presented our ACT plan, underscoring the urgent need for investments in anesthesia resources. During the conversation, we highlighted the significant impact that the ongoing anesthesiology shortages have on surgical wait times and overall hospital efficiency. We advocated for strategic investments in anesthesia care teams, emphasizing the role they can play in improving OR throughput and patient care in high-demand areas such as obstetrics and trauma care. Minister Jones expressed genuine interest in addressing the issue, applauded our thoughtful solution-oriented approach and committed to exploring further discussions on the data from previous pilot programs. This meeting marks a promising step forward in addressing our specialty's critical needs.

Our recent participation in the OMA’s Queen's Park Day emphasized the critical role ACTs play in addressing the healthcare challenges facing our province. During this event, myself along with OA executives including Drs. Soniya Sharma, Stuart McCluskey, Daniel Cordovani, Environmental Sustainability Working Group members, Drs. Anita Rao, Peter Menikefs, David Ohrling and many of our front-line anesthesiologists and FP-A’s had the opportunity to engage directly with MPPs and shared our insights on the ACT model and its potential to alleviate pressure on the healthcare system. We highlighted how ACTs can optimize the use of existing resources and improve patient care, making a compelling case for increased support and investment in this model.

The discussions at Queen's Park were encouraging, as many decision-makers recognized the importance of team-based care in improving health-care outcomes. By advocating for ACTs, we aim to not only address the immediate staffing shortages but also foster a more collaborative and efficient healthcare delivery model across Ontario. Our ongoing advocacy efforts, including face-to-face conversations with key decision-makers and educational campaigns, will continue to emphasize the benefits of the ACT model and the vital role anesthesiologists play in providing high-quality care to patients.

In addition to these efforts, we recently engaged in a productive discussion with Matt Anderson, CEO and President of Ontario Health. We look forward to continued dialogue with Ontario Health as we work collectively on this critical shortage which directly impacts our ability to care for our Ontarians.

As we move forward, we remain committed to ensuring that the ACT model is integrated into the broader healthcare strategy in Ontario, reinforcing our dedication to enhancing patient care and addressing the challenges within our specialty.

I would like to take a moment to acknowledge the many anesthesiologists and OA executives, both past and present, who have dedicated countless hours to laying the foundation for our current advocacy efforts. Their tireless work in fostering strong relationships with the OMA, the Ministry of Health, and our patients has been crucial in driving our initiatives forward. Without their vision, commitment, and perseverance, we would not have achieved the progress we’ve made, from securing key conversations with policymakers to advancing the ACT model. Their efforts have set the stage for the meaningful changes we are striving to bring to our profession.

As we move forward, we will continue to build on the strong foundation already established, striving for improved working conditions, fair compensation, and better patient care for all of Ontario’s anesthesiologists. Together, we can make significant strides toward a stronger future for our profession.

Successful Ontario Anesthesia Meeting and AGM, September 2024
I am delighted to share that our September 2024 Ontario Anesthesia Meeting and AGM was a great success. It was wonderful to see so many of you in attendance. We had the opportunity to discuss important updates in our field, share insights on recent research, and socialize with colleagues from across the province. A special thank you to everyone who participated, and for your valuable contributions to our discussions. We were also able to advocate directly with OMA Board Chair, Dr. Cathy Faulds, during which we emphasized the critical needs of our specialty and the need for our voices to be heard in ongoing negotiations. Another particular highlight was the presentation of the Distinguished Service Award to Dr. Jon Hooper, which recognized his exceptional leadership and contributions to the field of anesthesiology, and honoured the fundraising efforts of him and his late wife Sindy towards the research of pancreatic cancer. You can read more about Dr. Hooper. 

As we move towards wrapping this year up, I want to thank you for your dedication and hard work. As we navigate these complex issues, it is through our collective efforts that we continue to make progress. Please feel free to reach out if you have any questions or need further information.

Looking forward to a productive and successful end to the year!

Sincerely,

Dr. Cindy Wang
Chair, Ontario's Anesthesiologists, A Section of the Ontario Medical Association

Chair's Report - Spring 2024

Dear colleagues,

Serving as chair of Ontario’s Anesthesiologists (OA) for the past two and half years has been a privilege, and I am grateful for the trust you placed in me. I am as passionate as ever about the work we do as anesthesiologists, the service we provide to patients and our role across the health system.

Your section is your voice when it comes to negotiations, matters of tariff and compensation, and engaging with system players who influence our work. For that reason, we need a strong OA section. An association that will stand strong in its representation of our interests and the interests of our patients. It’s much more challenging for us to take care of our patients if we don’t feel secure or valued.

Our Vision and Mission speak to this. Our Vision is for anesthesiologists to be leading partners, delivering the highest standards of innovative, safe, and sustainable patient care. Our Mission is to advocate for and represent the best interests of our members and to strengthen our leadership role within the health system. 

I would like to reassure you that the executive understands very well that we are no further ahead in terms of remuneration than we were a decade ago. This is not acceptable. Our primary goal has been to protect your financial well-being, which we understand is our members’ number one priority. As a recent example of our efforts, we recently sent a letter to OMA’s CEO and Board Chair asking them to publicly advocate for increased remuneration for all physicians, including anesthesiologists and to bring attention to the anesthesiologist shortage and the need for further investment in Anesthesia Assistants and Anesthesia Care Teams.

As you know, every four years, the Ontario Medical Association (OMA) negotiates a Physician Services Budget (PSB) agreement with the government. The total amount gets divided amongst all specialties through the CANDI (Comparison of Adjusted Net Daily Income) formula. This has made it impossible for us to make meaningful increases to our billing codes and unit fee, and in reality, we have fallen behind.

Before, during and after the pandemic, the government has cited many reasons for not being able to pay doctors more. Budget pressures are not going away. If we rely only on the OMA for our increases through negotiation, the next decade does not look much better for us. We must actively hold the OMA to task on representing Anesthesiologists and specialists and for us to consider exploring ways outside of the OMA to influence the government.

When I wrote my first Chair’s Report in the fall of 2021, I expressed that we could not afford to be overlooked or be an afterthought when policy decisions are made that impact our ability to carry out our work. The players in the system need to recognize who we are and appreciate our value for us to be able to effectively fight for the monetary and non-monetary resources we need. To set us up for success and achieve our goals, we felt that it was important to focus on and strengthen five areas: Section Governance, Tariff and Compensation, Advocacy and Engagement with key Health System Players, Patient Care and Member Services, and the Ontario Anesthesia Meeting (OAM).

I will briefly summarize the progress we have made in each of these areas over the last couple of years.

Section Governance
- Strengthened executive leadership by recruiting members-at-large to represent diversity in practice and geography to complement the elected executive.
- Solidified oversight of policies and processes and embedded executive leads into our operations.
- Through the Beyond the Mask Campaign, we have attracted many volunteers to our working groups and committees.
- On-boarded Stephanie Field, our Executive Coordinator, and created an annual work calendar to ensure consistency in our workflow.

Tariff/Compensation
- Advocated for fee increases and stressed the increased burden on physicians during Negotiation Task Force (NTF) meetings.
- Submitted strong and strategic proposals to the Physician Payment Committee (PPC) based on member feedback.
- Responded successfully to multiple threats to our funding allocation from other groups related to the most recent PSB. One brief example is when Anesthesiologists practice and submit billings for subspecialty work such as Critical Care, Chronic Pain or Interventional procedures, the funding for that work comes from the anesthesia funding envelope. When those subspecialties propose an increase in their fees, it negatively impacts our funding distribution. We were able to successfully limit the impact on our allocation on several occasions.
- We provided feedback to the Relativity Advisory Committee (RAC) to limit the effects of relativity adjustments against us.

Advocacy and Engagement with Key Health System Players
- Successfully advocated within the OMA for the expedited re-establishment of the Surgical Network as an avenue of advocacy for perioperative services.
- Advocated within the OMA on matters important to Anesthesiologists including compensation and expansion of Anesthesia Care Teams as a model of care.
- Re-booted the Beyond the Mask campaign to increase our profile within the health system.
- Hired part-time administrative support, Lindsay Kneteman, to assist with communications and social media presence and engagement.
- Various aspects of our work have garnered media attention on TV, radio and print on several occasions. Media is starting to reach out to us directly on issues related to anesthesiology.
- Significantly increased our interactions with MPPs and government staff across many issues including:

Brought attention to the critical Anesthesia Health Human Resource (AHHR) issues via the AHHR Working Group, which brought together anesthesiologists across the province to create a Position Paper and Background Paper highlighting Anesthesiology as a medical role and to advocate for maintaining a physician-led model of care.

Mobilized quickly and collaborated with the government during the height of the pandemic when we had regional shortages of epidurals and other equipment, to ensure that our members had the equipment needed to provide care.

Participated in budget consultations with Finance Minister Peter Bethlenfalvy.

Promoted the need for more Anesthesia Assistants and Anesthesia Care Teams and conveyed our suggested solutions to the surgical backlog.

Advocated for a series of changes to advance Environmentally Sustainable practices.

Patient Care
- Leveraged our expertise to provide advice on patient care (specifically the opioid epidemic, epidural catheter shortages, anesthesiologist shortages, and sustainable anesthesia care).
- SolvingPain.ca, which launched in June 2021, continues to feature evidence-based pain management best practices for over 50 common surgeries. The site aims to reduce the escalating opioid and pain management crisis in Canada through safer opioid prescribing practices and better pain control practices.
- Our Anesthesia Health Human Resources working group developed our Position Statement: Anesthesia Human Resources and a Background Paper, which as mentioned previously have attracted media and political attention.
- Our Environmental Sustainability Working Group has:

Developed new Environmental Sustainability resource pages on the OA website to guide implementations in hospitals.

Contributed to the first-ever environmental guidelines in the CAS Guidelines to the Practice of Anesthesia.

Collaborated with CASCADES on their Sustainable Perioperative Care Playbook.

Presented to several hospital groups on eliminating desflurane and greening the OR.

Developed a Circular Economy position statement, which garnered political and media interest.

Member Services and the Ontario Anesthesia Meeting
- Returned to an in-person OAM and revamped the program to elevate the quality of content presented. In 2023, we had over 100 more attendees than the previous year and one of our largest turnouts ever!
- Ensured geographic representation of speakers from all academic hospitals as well as rural and remote areas.
- Continued to run successful and engaging Leadership Development and Resident Transition to Practice days.
- Updated and promoted the Leadership Development Grant program.
- Continued to highlight the work our members are doing through blog posts.
- Our social media presence continues to grow allowing us to connect to audiences across multiple platforms to highlight the work we do and demonstrate our value.

We have more clearly defined our brand and we continue to raise our profile through public education, social media, media relations, and direct engagement with various health system players, including government.

As an association, we must push ourselves to think differently and consider innovative ways to advocate for additional funding in order to improve our working conditions. Increasing the number of Anesthesia Assistants and expanding Anesthesia Care Team (ACT) models is one avenue we continue to emphasize. Ensuring safe and sustainable work environments with reasonable compensation is key. Many of our colleagues have chosen to retire early or reduce their practice. Fair compensation and a healthy work environment would narrow the HHR gap by reducing attrition of practicing anesthesiologists; this needs to be accompanied by other long-term solutions to stabilize our workforce.

To effectively advocate and achieve these goals, we need your continued support. This work cannot be done without your paid membership support and involvement, ideas, and feedback. We have held our dues at $300 for many years. Raising our fees and increasing the number of members who pay could ensure funding to hire experts, build proposals and help us get them to the right people and tables. If we want to succeed, we must not only pressure the OMA to represent our interests, but we must be effective advocates for ourselves.

As I move into the past chair role, I look forward to what the next executive will accomplish. Once again, it has been very rewarding serving as your chair. I have done everything I can to elevate our profile, advocate for the work we do and position us as leaders. We have set up a solid base. Let’s take what we’ve done and build on it. Let’s think bigger. If you have thoughts or ideas on how we can further succeed, please share them with us.

Sincerely,

Dr. Rohit Kumar
Chair, Ontario’s Anesthesiologists, A Section of the Ontario Medical Association

Chair's Report - Fall 2023

After two years of progress, I’m wrapping up my term as Chair feeling incredibly proud of the foundation Ontario’s Anesthesiologists has built and the advances we have achieved together. 

The OA Executive and I have worked hard to advocate on your behalf, represent your best interests, and empower you as leaders within Ontario’s health-care systems.

We are closer than we ever were to fulfilling our mission to strengthen our role as leading partners, which is important because the challenges today for anesthesiologists and our patients are significant. 

Wait times for surgeries remain long, yet we’re in the middle of a nationwide shortage of anesthesiologists. There is a marked strain on our human resources, with Canada clocking just 11 anesthesiologists per 100,000 people, compared to 23 in Australia, and 21 in the U.S. Three in four anesthesia chiefs across Ontario told us they had staffing challenges this year they couldn’t cover, putting pressure on the anesthesiologists we do have.

That’s why our patients need us to be there for them at Queen’s Park as well as the province’s operating rooms. 

Governance – Anesthesiologists are leading partners

By strengthening our presence within the health system we are establishing anesthesiologists as leading partners.

A key part of that is building a strong voice for our specialty at the OMA, where major strategies and policies for the profession are determined, including future negotiated agreements. 

Earlier this year, I met with OMA President Dr. Andrew Park to discuss ways the OMA and OA can support one another. There are opportunities for you to ensure our voices are heard and drive our most important issues forward as well. We have continued to form deeper relationships with government in order to ensure that your work is understood and valued appropriately. 

OMA elections will be held in the coming months and, under our membership organization’s new governance structure, all Executive positions are up for election. Nominations are now open and voting will take place early in the new year. 

Your voice can make all the difference. If you are passionate about the direction of Ontario’s Anesthesiologists and want to help advance our interests, I strongly encourage you to put your name forward. The supports you need are in place to help you. Reach out if you want to discuss the role you can play in advocating for anesthesiologists and our patients within the OMA and beyond.

Member Services – Strengthening our brand and our growing our team 

We continue to have significant support from our membership, growing in strength to more than 800 paid members. Section fees matter because they provide the financial support required to help us speak up within our authority as one of the largest medical specialities in the province. Help strengthen our collective voice by becoming a paid Section member.

Our Leadership Development Working Group is empowering each one of us as leaders inside and outside the health-care system. Our Leadership Development Grant program continues to offer financial support to those who want to pursue formal leadership training.

Members benefited from virtual leadership coaching sessions and our 2023 OAM Leadership Development Day provided us with training on advocacy, social media, and government relations.

The Anesthesia Chiefs Resource Hub has been updated, providing even better practical support and materials online to new Anesthesia Chiefs. 

We are telling our story and engaging in public and government dialogue in a more strategic way, raising our profile in the news and on social media.

Our ideas to address the shortage in our profession have earned national media coverage. This summer, we had a conversation with patients and government through several print, radio and TV interviews focused on the shortage of anesthesiologists, the impact on patients, and potential solutions.  

Also part of our 2023 Strategic Communications Plan, we are communicating the value and thought leadership anesthesiologists bring to the health-care system through a series of blog posts on issues of significance. Our social media presence continues to grow. We are connecting to audiences through profiles of members who are making a difference across our social media channels. 

Patient Care — Anesthesiologists providing expert advice 

We are meeting our objective to become more engaged with stakeholders by leveraging our expertise to provide advice on patient care.

Our Anesthesia Health Human Resources Group, led by Dr. Monica Olsen, has been weighing in on the anesthesiologist shortage. They’ve advocated for the Anesthesia Care Team, or ACT, model of care to boost our short-term capacity to care for patients by using more physician-supervised anesthesia assistants. In the longer term, they’re advocating for more anesthesia residency positions to increase the supply of anesthesiologists and regional or provincial licensure so anesthesiologists can go quickly to where care is needed most.

Our Environmental Sustainability Working Group, led by Dr. Anita Rao, is positioning us as leaders in the fight against climate change by making anesthesia more sustainable. Through their leadership, we’ve advocated to reduce and eliminate the use of desflurane, started to promote circular economy principles to guide how hospitals buy supplies, and developed environmental guidelines for anesthesia. We’ve collaborated with CASCADES Canada and the Canadian Coalition for Green Health Care to reduce our greenhouse gasses and environmental impact.

Advocacy and Stakeholder Relations — Influencing decisions 

We’re taking our seat at the table and increasing our influence through advocacy and stakeholder relations.

This meant we were front and centre again this year at the OMA’s Queen’s Park Day. 

We’re raising our profile with the OMA and our peer specialities within it. Our advance work meant we had built the relationships we needed to welcome Members of Provincial Parliament following our Leadership Development Day. We are meeting politicians at the Ontario legislature, and in our own communities. We are making connections at the Ministry of Health and strengthening our ties with stakeholders like the Canadian Anesthesiologists’ Society.

And we are using that influence to advocate for our most important stakeholder — our patients. The next round of fee negotiations between the OMA and the provincial government has begun. We must have the personnel and supplies we need to serve our patients and we need to ensure anesthesiologists are compensated fairly and at a competitive rate so we can keep them here in Ontario.

We’re making that case on your behalf.

As your Chair, it has been my privilege to advocate for you and the work we do and to set us up for success.

We have the foundation and tools we need to strengthen our position as leaders.

Now it’s your turn. Take what we’ve done and build on it. Run for a position on the Executive. Join a working group. Be empowered to make a difference.

Because if I’ve learned anything over the last two years, it’s that we can accomplish so much more if we work together. 

Sincerely,

Dr. Rohit Kumar

Chair, Ontario’s Anesthesiologists

A Section of the Ontario Medical Association

Chair's Report - Spring 2023

Taking our seat at the table 

One of the hardest things for any advocacy organization to do is stand out from the noise of the crowd. There are so many organizations — good organizations with good causes — vying for a seat at the table.

Ontario’s Anesthesiologists is breaking through the clutter. 

In the fall, we were at Queen’s Park when doctors met more than three dozen cabinet ministers and MPPs during a day organized by the Ontario Medical Association. We participated in pre-budget consultations led by Finance Minister Peter Bethlenfalvy. We shared our solutions for the surgical backlog and the health human resources shortage. We talked about the opioid crisis and environmental sustainability. We advocated for increased anesthesia assistant training and reducing the administrative burden for doctors.

We earned our audience with decision-makers by working together to raise our profile — at the OMA, in political circles, and in the public domain. 

We are increasing our visibility by telling our story, through public education, on digital platforms and government relations. These important activities exemplify the important role we play in perioperative care and the value we provide.

Together, we are achieving our mission to represent the best interests of Ontario's anesthesiologists and strengthen our leadership role within the health system.

I am incredibly proud of what we have achieved, and of the contributions of our executive, working group volunteers and members. 

I know there is much more to do and I am confident that we have built momentum that will continue to get us closer to our goals.

Governance – Building a foundation for success

We’re putting in place a strong governance structure and building an environment of trust to ensure the interests of all of our members are protected. Supported by this foundation, we can deliver on our strategy to serve the political and economic interests of our members. We can strengthen our reputation as leaders in the future of health care. We can make a positive long-term impact by influencing policy and advocating for our patients.

This year, we have solidified oversight of policies and processes and embedded our Executive leads into our operations. A member of our Executive now leads each working group. Our Treasurer oversees the Resident Subcommittee. Minutes from all working group and committee meetings are shared to ensure our Executive is well informed about section activities.

Our first Leadership Group Coaching Session was held in January, and another is scheduled for May 1. Planning has begun for a Leadership Development Day on Oct. 26 to coincide with the Oct. 27-29 Ontario Anesthesia Meeting and Conference Weekend at the Marriott Downtown at CF Toronto Eaton Centre in Toronto. 

A leadership webinar is being discussed, and a leadership development resource section added to our website. Our Executive and interested working group members have been prepared to talk to the media, as a result of training led by the OMA.

We will continue to fine-tune our processes and ensure supports are in place to optimize the contributions of our Executive, working groups, committees, volunteers and members.

Member Services – Building our brand and working as a team 

With more than 1,900 anesthesiologists — 1,474 practicing — Ontario’s Anesthesiologists is one of the largest sections within the OMA. 

Telling our story and engaging in public and government dialogue is key to building our brand. Demonstrating what we do and how it is important for people’s health will ensure we are recognized as partners in health-care transformation. It will help us influence decisions that affect us and the patients we care for.

To promote awareness of who we are and what we have to offer, Lindsay Kneteman, our new Communications and Engagement Coordinator, has begun to implement our 2023 Strategic Communications Plan. You can expect to see a series of blog posts over the next year to help educate the public and stakeholders about the value and thought leadership anesthesiologists bring to the health-care system. Our social media presence will continue to grow and be measured through a more strategic approach to engagement. Because storytelling helps audiences connect more than statistics, we will profile our members who are making a difference across our social media channels including our website, Facebook, Twitter, LinkedIn and Instagram accounts. 

At the same time, we continue to improve our communications directly to you. Member queries are answered promptly. Updates are provided regularly through our quarterly digital newsletters and bi-annual Chair’s Report. The OMA’s new OMA Connect mobile app provides a community for our discussions, event notifications and materials.

Patient Care — An anesthesiologist for every patient

As the voice of anesthesiologists in Ontario we are committed to empowering the practice of anesthesia to deliver the highest level of patient care possible. 

A great deal of it comes down to staffing and how we manage our growing workload. Anesthesiologists are faced with a critical staffing shortage at the same time as the scope of what we are asked to do expands.

Ontario is trying to wrestle with a growing surgical backlog by expanding private clinics, without clear details on how to increase staff or what it will mean for the rest of the system.

Manitoba’s reliance on out-of-hospital surgical facilities to address the backlog has drained anesthesiologists from hospitals and resulted in some hospitals assigning one anesthesiologist to cover two rooms running a general anesthetic by  using physician extenders. The movement towards Certified Registered Nurse Anesthetists providing anesthetics in British Columbia hasn’t gone away.

We are united with the Canadian Anesthesiologists’ Society (CAS) in our position that anesthesia must be led by physicians and that a one-to-one model of anesthesia delivery is the only acceptable kind for deep sedation and general anesthetics. Under the CAS’s new CEO’s strategic plan, they have hired a government relations firm to boost advocacy and establish our presence at a pan-Canadian level. We are building a stronger bridge with this group and supporting this initiative.

Our Anesthesia Health Human Resources Working Group’s forthcoming background paper and position statement will help define us even more clearly as physician leaders of anesthesia care.

Advocacy and Stakeholder Relations — Influencing decisions 

Ontario’s Anesthesiologists were well represented at the OMA’s successful advocacy day in November, where I was one of about 90 physicians who attended more than 40 meetings at Queen’s Park with cabinet ministers and MPPs spanning all parties. 

The shortage of doctors across the system and the surgical backlog emerged as shared priorities and provided an opportunity to build relationships and alignment that yielded further engagement with decision-makers and influencers.

I discussed our SolvingPain public resource to help address the opioid crisis with MPP Michael Tibollo, the province’s Associate Minister of Mental Health and Addictions. A briefing on our environmental work with Mike Shreiner, Leader of the Green party, resulted in a meeting with our Environmental Sustainability Working Group and a commitment to table a motion in the legislature to eliminate desflurane, a strong contributor to greenhouse gas emissions. 

We were front and centre during Ontario’s pre-budget consultations, engaging in a discussion on solutions to the surgical backlog and wait times with Minister Bethlenfalvy and MPPs Nina Tangri, Rudy Cuzetto and Deepak Anand. In a meeting with MPP Stephen Crawford, Parliamentary Assistant to the Finance Minister, we advocated for increased funding to address doctor and staffing shortages, the need for more team-based care, increased funding to train more anesthesia assistants, and ensuring resources to reduce administrative burden so doctors can be doctors. 

We continue to align our advocacy with the work of the OMA, which has asked for our input to ensure our perspectives are reflected in a 2023 update to its four-year advocacy platform, Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care. 

As your Chair, I will continue to represent your interests on every platform, in every venue. We can achieve even more by working together. I encourage you to reach out and get involved in any way you can. 

Sincerely,

Dr. Rohit Kumar
Chair, Ontario's Anesthesiologists
A Section of the Ontario Medical Association

Chair's Report - Fall 2022

Raising our profile, building our influence

When we came together in person at our 67th Annual Ontario’s Anesthesiologists Meeting in September, I took the opportunity to express my gratitude for the care you all provide every day for patients across our province.

I recognized the incredible work you have done before and through the pandemic. Often working under-resourced and understaffed as our work has become more demanding and patients sicker.

It’s important to talk about the many ways anesthesiologists bring comfort and peace to those who need it most - on every platform, in every venue.

Because by raising our profile, stakeholders within the OMA, government, and other areas of the health-care system will pay attention to us when we speak.

By telling our story and implementing our new Strategic Plan, we are positioning anesthesiologists within the OMA as trusted advisors, allowing us to influence policy and advocate for our patients.

Here are a few highlights of how we’re building influence:

Governance - Building strength in leadership

We’re building a network of leaders to represent your interests, and putting in place the financial foundation, processes and structure to deliver on our strategy.

Our executive has been strengthened through the leadership of doctors from all over Ontario; Dr. Druvtej Ambati of Smiths Falls, Dr. Vatsal Trivedi of Mississauga, Dr. Sarah McIsaac of Sudbury and Dr. Amanda Jasudavisuis of Kingston.

We have attracted a diversity of volunteers to our working groups and committees. And we’re working on strategies to empower all our members with the skills and tools to shape the future of health care and our field.

Together, we successfully responded to multiple threats to our funding allocation from other groups related to the most recent Physician Services Agreement, and we have and will continue to advocate for billing-related changes to benefit our profession.

Member Services - Bringing us together, telling our story

In September at the Ontario Anesthesia Meeting, we renewed our friendships, learned from each other, and harnessed our collective power through our first in-person annual conference in two years, and plans are underway for next year’s meeting.

We have defined our brand, and are raising our profile through public education, social media, media relations and government relations. Join our conversation on Facebook, Twitter, LinkedIn, and Instagram, and see the updates we’ve made to the SolvingPain.ca website.

We have communicated more to our patients and the public about who we are, what we do and why it is important for their health.

And we have improved our communications with you about our advocacy on your behalf. See our past Newsletters.

Leveraging all the channels available to us helps us to be recognized as valued partners and patient care experts. That means we will be more likely to have a seat at the table when important decisions are made that affect us directly.

Patient Care - Advocating for patients

We have become more engaged with stakeholders, providing them with expert advice on patient care.

Through our Environmental Sustainability Working Group, we have advocated to provincial and federal ministers for less medical waste and less use of high contributors to greenhouse gas emissions. We’ve created an online resource page for those interested in improving sustainability in their own hospitals.

We’ve advocated for patients and our own well-being by bringing more focus to the critical staffing shortage that’s contributing to the surgical backlog and burnout in our profession.

The Anaesthesia Health Human Resources Working Group brought together anesthesiologists from across the province and collaborated with the Canadian Anesthesiologists Society to define our medical role and advocate for a physician-led model of care.

Through the Clinical Advisory Committee and Epidural Catheter Shortage Working Group, we mobilized quickly to engage with the government and ensure we have the materials we need to provide the best care to our patients.

Advocacy and Stakeholder Relations - Building our influence

We have stepped up our advocacy efforts to the government to build our reputation among decision-makers and organized ourselves to be more effective in our negotiations on your behalf.

As our colleagues in other specialties have done, we are building better relationships with the government and stakeholders.

Today, we have a close relationship with the Canadian Anesthesiologists Society and are working together on common issues. And we continue to engage with the OMA on tariffs and compensation and changes to the association’s governance that advantage you.

We’re building momentum, but there is much more to be done. As your Chair, I am committed to setting us up for success.

But we can do so much more by pulling together. If you have any questions or concerns, or if you would like to get involved, please do not hesitate to contact me personally.

Sincerely,

Dr. Rohit Kumar
Chair, Ontario's Anesthesiologists
A Section of the Ontario Medical Association

Chair's Report - Summer 2022

Dear Colleagues,

With summer upon us, I am excited to share the progress we have made in the last few months, what is top of mind heading into the summer and some of what we expect to deliver through the fall of 2022. To keep us targeted in our efforts and representation, this report will once again be divided into four key strategic areas of focus: Governance, Member Services, Patient Care and Advocacy & Stakeholder Engagement.

Governance, Tariff and Compensation

Sound governance is the foundation on which we can effectively represent you. We appreciate that one of our primary roles is to represent your financial interests in the matters of Tariff and Compensation. Earlier this year the Medical Services Payment Committee (MSPC) asked all sections and groups to submit proposals for changes to the Schedule of Benefits to simplify or delete obsolete codes, make intra-sectional relativity adjustments, and fee increases which would be considered depending on the amount of money allocated by the Physician Services Agreement.

Our submission included revenue neutral proposals to address common billing issues such as difficulty in payment for obstetrical care and a code to create a foundation for Acute Pain Services and Anesthesia Care Teams. The OMA has supported these proposals in principle and will discuss them with the Ministry of Health through a newly constituted bilateral committee, the Physician Payment Committee (PPC). We also carefully reviewed all submissions by other groups and provided strong feedback to the OMA-MSPC where payments for the services for anesthesia care would be negatively impacted. We expect continued engagement with the PPC over the summer in these areas.

I would like to thank Dr. Julian deBacker, the outgoing resident representative on the executive, and welcome Dr. Nicholas Timmerman who joins Dr. Isabel Theberge as his replacement. Our residents in training are our future and we look forward to strengthening our relationship with them. I would also like to welcome Dr. Druvtej Ambati, who replaces Dr. Paul Gill as the FP-A Member at Large. I would like to thank Dr. Gill for his dedicated and passionate service over the past 5+ years. He has not only represented the FP-A perspective but has been a valuable contributor to all matters related to our section.

Member Services

Ontario’s Anesthesiologists is the home base for anesthesiologists across Ontario. We will continue to highlight and provide opportunities for growth in education, research, advocacy, and advancement to elevate our specialty and to ensure our members are set up for success.

Planning for the Annual Ontario Anesthesia Meeting and Conference, to be held September 16 to 18, 2022 at the Westin Harbour Castle in Toronto, is well underway. To help promote a high standard of anesthesia care in Ontario, the meeting will include current and clinically relevant topics, as well as several interactive workshops. In addition, there will be a Leadership and Professional Development Day on September 15, 2022. Past leadership offerings have been very well attended and highly successful, so we encourage you to register early to get one of the limited spots. The complete conference program and registration will be available soon.

We recently helped Cancer Care Ontario promote a webinar on Blood and Albumin Transfusion Rates at the Time of Cancer Surgery across Ontario. Through the fall we are planning more presentations on clinical topics as well as content to promote your financial success, an introduction to social media, media relations, and stakeholder advocacy. Through our Leadership Development Working Group, we are in the early stages of planning small group video coffee chats with health system leaders and influencers to create partnerships and to share our perspectives.

Patient Care

Each day we all intend to provide the best anesthesia care for our patients. To help take us Beyond the Mask, the section is active in other ways to help drive better patient care.

Our Environmental Sustainability Working Group has rapidly grown to over 15 volunteers and is creating an online resource guide for departments and hospitals to incorporate environmentally sustainable perioperative practices within their hospitals. You can visit our website to learn how you can also make a difference. I am pleased to report that members of the Working Group have also met with Federal and Provincial Ministers to promote the inclusion of anesthetic gases in the greenhouse gas inventory. Doing so will require hospitals to track use of inhaled anesthetics and drive sustainable practices.

Health care workforce shortages are negatively impacting patient care delivery. For anesthesiologists this is of particular interest as there is a movement to permit Certified Registered Nurse Anesthetists to provide anesthesia care in British Columbia. Across the country, each Provincial government will be looking to explore their own solutions to a growing surgical backlog and possible anesthesia shortage, both of which have multiple contributing factors. We do not see the cRNA model as a safe or economical option within our Canadian system. Our section recognizes the need to take a proactive approach in addressing this threat to our autonomy and to the safety of our patients. Thus, we have formed an Anesthesia Health Human Resources Working Group consisting of a mixture of academic and community anesthesiologists. The intent is to stay connected, combine our efforts and share resources to counter this movement. This group will explore solutions to ensure a safe and more robust anesthesia coverage across the province. One of the key short-term goals of this group, working closely with the Canadian Anesthesiologists’ Society, will be to create a position statement defining anesthesiology as a medical role and promoting the anesthesia care team model with a physician-led supervisory role.

The SolvingPain website continues to be a valuable resource for anesthesiologists, our other physician colleagues and health-care workers. If you have not had a chance to visit the website, I encourage you to, and to promote its use. It provides evidence-based pain management guidance for pre operative, intraoperative and postoperative care including safe prescribing practices to limit excess opioids in the community.

Advocacy and Stakeholder Management

This spring, we launched the Ontario Anesthesiologists’ Instagram account. Social media is incredibly important in showcasing and promoting the work you do. I encourage you to also follow us on Facebook, Twitter and LinkedIn to stay informed, and to share our posts to amplify our presence.

We have had some early success in engaging stakeholders, including government, through work being done by the Environmental Sustainability and Anesthesia Health Human Resource Working Groups. As our work progresses, we will continue to engage and strengthen those and other ties. To have a voice and to be able to positively influence, we need to be seen, heard and understood. As mentioned, through the fall we are planning opportunities to equip our members with skills and tools to become more influential at all levels of the health-care system.

Our mission continues to be to advocate for and represent the best interests of anesthesiologists, and to strengthen our leadership role within the health-care system. Our vision is for anesthesiologists to be leading partners, delivering the highest standards of innovative, safe, and sustainable patient care.

I will end by reinforcing my commitment to representing you by elevating our voice and promoting our interests. I remain positive and hopeful that by working together and supporting each other, we can accomplish a lot. Please reach out any time with your thoughts and ideas. We value your feedback and suggestions.

Sincerely,
Dr. Rohit Kumar
Chair, Ontario's Anesthesiologists
A Section of the Ontario Medical Association