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MDs question motives, results of vote by specialists trying to break away from OMA

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A group of specialists trying to break away from the Ontario Medical Association is being called out by peers who charge that the discord is all about money.

“They don’t want to be the group that has to give up (some money) for other groups to increase their earnings,” general surgeon Dr. Nancy Baxter said in an interview Tuesday.

“Until the OMA started talking more about relativity, you didn’t hear about these specialty organizations wanting to break away,” continued Baxter, one of many doctors who has gone public with criticisms — many of them on social media — of a referendum the breakaway specialists held last week.

“Relativity” refers to big pay gaps between different medical specialties. The OMA, which represents Ontario’s 31,000 practising physicians in contract negotiations with the provincial government, has struggled recently to develop a recommendation on the issue for an arbitration panel charged with resolving a four-year-old contract dispute.

The stakes in the ongoing dispute are high. The arbitration panel must first determine how much extra money should be added to the physician services budget, which currently stands at more than $12 billion or 10 per cent of the entire provincial budget. The panel must then determine how the extra money should be divvied up between different specialties.

Radiologist Dr. David Jacobs, who is spearheading the breakaway efforts, served as an OMA board member until late September when he resigned and announced the need to form a separate specialist group. In an open letter critical of the OMA, Jacobs noted it was unable to reach a negotiated settlement with the new Ford government and charged its bureaucracy has grown while its accountability has waned.

He said 24 specialty sections recognized by the OMA (there are 49) had shown interest in forming a separate group, writing that they should be able to freely choose who represents them. He called for one bargaining agent to represent family doctors and another to represent specialists.

The timing of Jacobs’ resignation coincided with the release of a report from the OMA’s relativity advisory committee, which recommended narrowing pay gaps between medical specialties. It called for the pay of four top-billing specialties — radiologists, ophthalmologists, cardiologists and gastroenterologists — to be cut by up to 1 per cent annually for 11 years. Money saved would then be redistributed to lower-paid specialty groups.

Essentially, this means high-paid specialties would get a smaller piece of the pie and lower-paid specialties a bigger one.

While the word “relativity” was never mentioned in the letter, there was reference to an upcoming meeting of the OMA’s 250-plus member governing council at which a vote was to take place on whether to endorse the committee’s recommendation to narrow pay gaps. Jacobs, who is also vice president of the Ontario Association of Radiologists, warned the meeting would “further divide” the OMA and said he “cannot be party to this.”

Council members voted almost 80 per cent in favour of narrowing pay gaps.

But in an unusual move, the board then persuaded council to change its decision to one that would see each of the 49 sections make its own pitch to the arbitration panel on how to tackle relativity.

The OMA leadership then came under fire from doctors on Twitter, angry over what they called “copping out” on a difficult issue. Others interpreted the move as a strategic one aimed at weakening support for the formation of a separate specialist group.

Jacobs subsequently revealed the formation of the Ontario Specialists Association (OSA) and invited specialists to vote on a “referendum” in late November to secede from the OMA.

In releasing the results of that vote last week, the OSA issued a news release stating “Ontario Specialist Groups Vote Overwhelmingly to Leave the OMA.” The release stated the majority of voters from eight sections were in favour of separating, but there was very limited information released beyond that.

But upon further investigation by the OMA and others, it was learned that only 10 per cent of specialists and 5 per cent of all doctors voted in favour of a divorce.

The OSA also issued incorrect information, initially stating the majority of otolaryngologists (also known as ear, nose and throat doctors or ENTs) had voted to separate when in fact the opposite was true.

On Twitter, many opposing physicians are calling into question the motives and results of the vote.

Emergency medicine physician Dr. Ian Stiell, referring to why a majority of ER doctors opposed the split: “Emergency physicians are a very poor fit with the Ontario Specialists Association which wants to preserve income for the highest billing specialists without addressing relativity.”

Psychiatrist Dr. Javeed Sukhera: “Shame on (the OSA). Relativity is about valuing each and every physician. It is not about knocking each other down. If we help lift each other, we all win.”

Family medicine resident Ali Damji: “We are in an era where new money isn’t coming to us so we need to redistribute and invest in underfunded areas (primary care, mental health, elderly) … Which unfortunately also means that when we invest in that part of the pie, other parts become smaller. I don’t think doing so in an evidence-based and thoughtful way is a bad thing — and it’s needed.”

Baxter, adding to the growing chorus of female doctors calling for disparity in pay between male and female physicians to be addressed: “We need relativity within and across specialties to address the discrimination experienced by physicians in Ontario. (OSA) needs to figure this out as well.”

Pediatrician Dr. Mo Eltorki, questioning the results of the vote: “Sorry, please elaborate on your definition of success! This does not represent specialties in Ontario, not even close! You forgot to mention the large specialties that refused to split from the OMA: emergency medicine, dermatology, ENT, occupational therapy and plastic surgery.”

Asked earlier if the issue of relativity was behind the efforts of the OSA to separate, Jacobs would only say all doctors are facing fee cuts. He has repeatedly stated the Ford government is receptive to the idea of specialists forming their own organization.

The Medical Post last month quoted an unnamed Ford government source stating that the province would respect the results of the referendum. The source said if a “critical mass” of doctors voted to split, the government would be open to amending legislation to make that happen.

Since then, Health Minister Christine Elliott’s office has only said the government is seeking legal advice on how to proceed.

Theresa Boyle is a Toronto-based reporter covering health. Follow her on Twitter: @theresaboyle

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‘Business as usual’ for Dorel Industries after terminating go-private deal

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MONTREAL — Dorel Industries Inc. says it will continue to pursue its business strategy going forward after terminating an agreement to go private after discussions with shareholders.

« Moving ahead. Business as usual, » a spokesman for the company said in an email on Monday.

A group led by Cerberus Capital Management had previously agreed to buy outstanding shares of Dorel for $16 apiece, except for shares owned by the family that controls the company’s multiple-voting shares.

But Dorel chief executive Martin Schwartz said the Montreal-based maker of car seats, strollers, bicycles and home furniture pulled the plug on a deal on the eve of Tuesday’s special meeting after reviewing votes from shareholders.

“Independent shareholders have clearly expressed their confidence in Dorel’s future and the greater potential for Dorel as a public entity, » he said in a news release.

Dorel’s board of directors, with Martin Schwartz, Alan Schwartz, Jeffrey Schwartz and Jeff Segel recused, unanimously approved the deal’s termination upon the recommendation of a special committee.

The transaction required approval by two-thirds of the votes cast, and more than 50 per cent of the votes cast by non-family shareholders.

Schwartz said enhancing shareholder value remains a top priority while it stays focused on growing its brands, which include Schwinn and Mongoose bikes, Safety 1st-brand car seats and DHP Furniture.

Dorel said the move to end the go-private deal was mutual, despite the funds’ increased purchase price offer earlier this year.

It said there is no break fee applicable in this case.

Montreal-based investment firm Letko, Brosseau & Associates Inc. and San Diego’s Brandes Investment Partners LP, which together control more than 19 per cent of Dorel’s outstanding class B subordinate shares voiced their opposition to the amended offer, which was increased from the initial Nov. 2 offer of $14.50 per share.

« We believe that several minority shareholders shared our opinion, » said Letko vice-president Stephane Lebrun, during a phone interview.

« We are confident of the long-term potential of the company and we have confidence in the managers in place.”

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Anglais

Pandemic funds helping Montreal businesses build for a better tomorrow

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Many entrepreneurs have had to tap into government loans during the pandemic, at first just to survive, but now some are using the money to better prepare their businesses for the post-COVID future.

One of those businesses is Del Friscos, a popular family restaurant in Dollard-des-Ormeaux that, like many Montreal-area restaurants, has had to adapt from a sit-down establishment to one that takes orders online for takeout or delivery.

“It was hard going from totally in-house seating,” said Del Friscos co-owner Terry Konstas. “We didn’t have an in-house delivery system, which we quickly added. There were so many of our employees that were laid off that wanted to work so we adapted to a delivery system and added platforms like Uber and DoorDash.”

Helping them through the transition were emergency grants and low-interest loans from the federal and provincial governments, some of which are directly administered by PME MTL, a non-profit business-development organization established to assist the island’s small and medium-sized businesses.

Konstas said he had never even heard of PME MTL until a customer told him about them and when he got in touch, he discovered there were many government programs available to help his business get through the downturn and build for the future. “They’ve been very helpful right from day one,” said Konstas.

“We used some of the funds to catch up on our suppliers and our rents, the part that wasn’t covered from the federal side, and we used some of it for our new virtual concepts,” he said, referring to a virtual kitchen model which the restaurant has since adopted.

The virtual kitchen lets them create completely different menu items from the casual American Italian dishes that Del Friscos is known for and market them under different restaurant brand names. Under the Prasinó Soup & Salad banner, they sell healthy Greek options and their Stallone’s Sub Shop brand offers hearty sandwiches, yet the food from both is created in the same Del Friscos kitchen.

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Downtown Montreal office, retail vacancies continue to rise

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Some of downtown Montreal’s key economic indicators are heading in the wrong direction.

Office and retail vacancies in the city’s central core continued to climb in the fourth quarter of 2020, according to a quarterly report released Thursday by the Urban Development Institute of Quebec and the Montréal Centre-Ville merchants association. The report, whose first edition was published in October, aims to paint a socio-economic picture of the downtown area.

The survey also found office space available for sublet had increased during the fourth quarter, which may foreshadow even more vacancies when leases expire. On the residential front, condo sales fell as new listings soared — a sign that the downtown area may be losing some of its appeal to homeowners.

“It’s impossible not to be preoccupied by the rapid increase in office vacancies,” Jean-Marc Fournier, the former Quebec politician who now heads the UDI, said Thursday in an interview.

Still, with COVID-19 vaccinations set to accelerate in the coming months, “the economic picture is bound to improve,” he said. “People will start returning downtown. It’s much too early to say the office market is going to disappear.”

Public health measures implemented since the start of the pandemic almost a year ago — such as caps on office capacity — have deprived downtown Montreal of more than 500,000 workers and students. A mere 4,163 university and CEGEP students attended in-person classes in the second quarter, the most recent period for which figures are available. Border closures and travel restrictions have also brought tourism to a standstill, hurting hotels and thousands of local businesses.

Seventy per cent of downtown workers carried out their professional activities at home more than three days a week during the fourth quarter, the report said, citing an online survey of 1,000 Montreal-area residents conducted last month.

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