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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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Anglais

Nostalgia and much more with Starburst XXXtreme

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Get a taste of adventure with Starburst XXXtreme based on the legendary NetEnt Game. The nostalgic themes are sure to capture fans of the classic version as they get treated to higher intensity, better visuals, and features. The most significant element of the game is its volatility. Patience will not be an essential virtue considering the insane gameplay, and there is a lot of win potential involved. It retains the original makeup of the previous game while adding a healthy dose of adrenaline. 

Starburst Visuals and Symbols

The game is definitely more conspicuous than before. The setting happens over a 5-reel, 3-row game grid with nine fixed win lines, which function if a succession from the left to the right reel is present. Only those players that that attain the highest win per bet line are paid. From a visual standpoint, the Starburst XXXtreme slots illustrates lightning effects behind the reels, which is not surprising as it is inherited from the original version. Available themes include Classic, Jewels, and Space. The game is also available in both desktop and mobile versions, which is advantageous for players considering the global pandemic. According to Techguide, American gamers are increasingly having more engaging gaming experiences to socialize to fill the gap of in-person interaction. Starburst XXXtreme allows them to fill the social void at a time when there is so much time to be had indoors. 

Starburst XXXTreme Features

Players get to alternate on three features which are Starburst Wilds, XXXtreme Spins, and Random Wilds. The first appears on reels 2,3, or 4. When these land, they expand to cover all positions while also calculating the wins. They are also locked for a respin. If a new one hits, it also becomes locked while awarding another respin. Starburst XXXtreme offers a choice between two scenarios for a higher stake. In one scenario with a ten times stake, the Starburst Wild is set on random on reels 2,3, or 4, and a multiplier starts the respin. The second scenario, which has a 95 times stake, starts with two guaranteed starburst wilds on reels 2,3, or 4. it also plays out using respin game sequence and features. The game also increases the potential with the Random Wilds feature to add Starburst Wilds to a vacant reel at the end of a spin. Every Starburst Wild gives a random multiplier with potential wins of x2, x3, x5, x10, x25, x50, x100, or even x150.

The new feature is sure to be a big hit with the gaming market as online gambling has shown significant growth during the lockdown. AdAge indicates the current casino customer base is an estimated one in five Americans, so Starburst XXXtreme’s additional features will achieve considerable popularity. 

What We Think About The Game

The gambling market has continued to diversify post-pandemic, so it is one of the most opportune times to release an online casino-based game. Thankfully Starburst XXXtreme features eye-catching visuals, including the jewels and space themes. These attract audience participation and make the gameplay inviting. The game also has a nostalgic edge. The previous NetEnt iteration featured similar visuals and gameplay, so the audience has some familiarity with it. The producers have revamped this version by tweaking the features to improve the volatility and engagement. 

That is characterized by the potential win cap of 200,000 times the bet. Starburst XXXtreme does not just give betting alternatives for players that want to go big. The increase of multipliers also provides a great experience. If the respins in the previous version were great, knowing that multipliers can go hundreds of times overtakes the game to a new level. 

Players should get excited about this offering. All of the features can be triggered within a single spin. Whether one plays the standard game or takes the XXXtreme spin route, it is possible to activate all of the features. Of course, the potential 200,000 times potential is a huge carrot. However, the bet size is probably going to be restricted and vary depending on the casino. It is also worth pointing out that a malfunction during the gameplay will void all of the payouts and progress. Overall, the game itself has been designed to provide a capped win of 200,000 times the original bet. 

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Anglais

‘We’re back’: Montreal festival promoters happy to return but looking to next year

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In downtown Montreal, it’s festival season.

In the city’s entertainment district, a musical act was conducting a sound check on stage Friday evening — the second day of the French-language version of the renowned Just For Laughs comedy festival. Tickets for many of the festival’s free outdoor shows — limited by COVID-19 regulations — were sold out.

Two blocks away, more than 100 people were watching an acoustic performance by the Isaac Neto Trio — part of the last weekend of the Festival International Nuits d’Afrique, a celebration of music from the African continent and the African diaspora.

With COVID-19 restrictions continuing to limit capacity, festival organizers say they’re glad to be back but looking forward to next year when they hope border restrictions and capacity limits won’t affect their plans.

Charles Décarie, Just For Laughs’ CEO and president, said this is a “transition year.”

“Even though we have major constraints from the public health group in Montreal, we’ve managed to design a festival that can navigate through those constraints,” Décarie said.

The French-language Juste pour rire festival began on July 15 and is followed by the English-language festival until July 31.

When planning began in February and March, Décarie said, organizers came up with a variety of scenarios for different crowd sizes, ranging from no spectators to 50 per cent of usual capacity.

“You’ve got to build scenarios,” he said. “You do have to plan a little bit more than usual because you have to have alternatives.”

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Anglais

MELS new major movie studio to be built in Montreal

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MONTREAL — MELS Studios will build a new film studio in Montreal, filling some of the gap in supply to meet the demand of Hollywood productions.

MELS president Martin Carrier said on Friday that MELS 4 studio construction will begin « as soon as possible », either in the fall or winter of next year. The studio could host productions as early as spring 2023.

The total investment for the project is $76 million, with the Quebec government contributing a $25 million loan. The project will create 110 jobs, according to the company.

The TVA Group subsidiary’s project will enable it to stand out « even more » internationally, according to Quebecor president and CEO Pierre Karl Péladeau. In the past, MELS Studios has hosted several major productions, including chapters of the X-Men franchise. The next Transformers movie is shooting this summer in Montreal.

Péladeau insisted that local cultural productions would also benefit from the new facility, adding that the studio ensures foreign revenues and to showcase talent and maintain an industry of Quebec producers.

STUDIO SHORTAGE

The film industry is cramped in Montreal.

According to a report published last May by the Bureau du cinéma et de la télévision du Québec (BCTQ), there is a shortage of nearly 400,000 square feet of studio space.

With the addition of MELS 4, which will be 160,000 square feet, the company is filling part of the gap.

Carrier admitted that he has had to turn down contracts because of the lack of space, representing missed opportunities of « tens of millions of dollars, not only for MELS, but also for the Quebec economy. »

« Montreal’s expertise is in high demand, » said Montreal Mayor Valérie Plante, who was present at the announcement.

She said she received great testimonials from « Netflix, Disney, HBO and company » during an economic mission to Los Angeles in 2019.

« What stands out is that they love Montreal because of its expertise, knowledge and beauty. We need more space, like MELS 4, » she said.

There is still not enough capacity in Quebec, acknowledged Minister of Finance, the Economy and Innovation Eric Girard.

« It is certain that the government is concerned about fairness and balance, so if other requests come in, we will study them with the same seriousness as we have studied this one, » he said.

Grandé Studios is the second-largest player in the industry. Last May, the company said it had expansion plans that should begin in 2022. Investissement Québec and Bell are minority shareholders in the company.

For its part, MELS will have 400,000 square feet of production space once MELS 4 is completed. The company employs 450 people in Quebec and offers a range of services including studio and equipment rentals, image and sound postproduction, visual effects and a virtual production platform.

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