The Ontario Association of Generala Surgeons (OAGS) and the Section on General Surgery are deeply concerned about the access by General Surgeons to the operating rooms of the province, and decreased operating room availability in order that perceived priority targets, such as joints and cataracts be met.
It is our stated position that a general surgeon requires, at minimum, access to the operating room two full days per week for elective procedures (7.5 hrs/day), which may include endoscopy time .
It is our belief that hospitals that do not comply with this standard are in contravention of the agreement (implied contract), which they make with surgeons to provide appropriate resources.
- O.A.G.S. Board of Directors, January 21, 2006
"General surgeons provide essential surgical services across the country. They are in the front line of trauma care and provide care for the sickest surgical patients in the general hospitals. These duties frequently require excessive demands on the surgeon's time." - Canadian Association of General Surgeons (CAGS)
The Ontario Association of General Surgeons believes that general surgeons of this province require relief from onerous call schedules and are entitled to remuneration for being on-call as well. This position statement is specific to the provision of new emergency consultations. It does not relieve the surgeons of responsibilities for patients actively under their care.
The O.A.G.S. agrees with the CAGS position that a maximum 1 in 5 on-call system is reasonable. This maximum should apply to all general surgeons. A surgeon may voluntarily agree to provide more frequent on-call. However, under no circumstances should a hospital administration, board or MAC require a more frequent on-call service.
In some situations, a 1 in 5 on-call service may be too onerous. It is understood that this frequency of on-call should not disrupt the general surgeon's normal daily responsibilities, rest period and non-medical obligations such that the quality of patient care is jeopardized.
Where the general surgery department is unable to provide full coverage for new emergency referrals, then it is the hospital's responsibility for arranging coverage at other facilities.
All general surgeons should receive a retainer fee for being on-call. The surgeon would continue to bill full fee-for-service.
The O.A.G.S. believes that the general surgeons have provided a commendable level of service to the citizens of Ontario for many years. The needs of the general surgeons must be recognized so that the provision of safe, high quality service will not be compromised.
- O.A.G.S. Board of Directors, February 5, 2000
For more guidelines:
Guidelines Advisory Committee (MOHLTC & OMA)