PULSE N EWS Physician billing highest in , lowest in

In 2001/02, family physicians Information (CIHI). erage of $240 096 per physi- who billed at least $60 000 re- Average gross payments to cian, and lowest in Quebec at ceived, on average, $67 910 less all physicians who billed at least $179803. in fee-for-service payments $60 000 were reported as To estimate income, an than specialists, according to $221 901. Overall, billings were adjustment for practice overhead the Institute for highest in Ontario, with an av- is needed. According to the CMA 2002 Physician Resource Questionnaire (accuracy rate of Physicians’ average fee-for-service payments1 ±1.9%) the average overhead for and estimated net income2 physicians who were primarily fee-for-service was 35% of gross Average FFS payments 350 000 earnings for family physicians, Estimated net income (FFS) 300 000 27% for medical specialists and 250 000 33% for surgical specialists. When the overhead estimates 200 000 are applied to the CIHI gross 150 000 billings, estimated 2001/02 aver- 100 000 age net incomes (before taxes) 50 000 from fee-for-service payments 0 were $124 103 for family physi- cians, $167 750 for medical spe- Family cialists and $209184 for surgical Medical Surgical physicians specialists. Net income is esti- All specialists All physicians specialists specialists mated at $183 775 for all special- 1 Physicians who received more than $60 000 in fee-for-service (FFS) billings, 2001/02, Canadian Institute for Health Information ists combined and $148 674 for all 2 Based on 2002 Physician Resource Questionnaire, CMA physicians. — Lynda Buske, Asso-

DOI:10.1053/cmaj.1040208 ciate Director of Research, CMA

WAITING TIMES ’s 22-month wait for an MRI is “almost criminal” says radiologists’ association Saskatchewan is under fire for lenges right now,” said Nilson. by operating them on evenings having the longest waiting time “If you have an emergency sit- and weekends. He said his goal in the country for a diagnostic uation, you can get an MRI is to cut the waiting time to 6 MRI — a whopping 22 months. right away. That is how our months, and he consider The Canadian Association of system works.” buying a fourth MRI this year. Radiologists (CAR) describes He said only elective proce- Saskatchewan’s NDP gov- the situation as “almost crimi- dures, including follow-up ernment has steadfastly refused nal” and warned that the MRIs for cases already diag- to allow private MRI , could face legal action nosed, wait longer than about 7 fearing it would create 2-tiered from patients. “Denial of care is months. health care. a violation of the Health About 4500 people are now That may be put Act,” said chief Dr. waiting for an MRI in to the test as the Muskeg Lake Normand Laberge. “To use an Saskatchewan. The province First considers a expression, they are getting has 3 MRI machines, but a 1999 health with an MRI ma- away with murder.” CAR report estimated at least 5 chine on reserve land in Saska- “Waiting a year for a diagno- are needed to meet the needs of toon. First are self-gov- sis of MS is the difference be- 1 million people. erning and not bound by the tween quality of life and death.” “The challenge for us is that , so the clinic Saskatchewan Minister of doctors are finding more and could offer private MRI services. Health agreed the more effective uses for MRIs,” “It’s the perfect solution to a wait is too long, but denied it is said Nilson. He said the first problem that shouldn’t exist in hurting patients. priority is to make more effi- the first place,” said Laberge. —

DOI:10.1053/cmaj.1040237 “We’re having some chal- cient use of the existing MRIs Amy Jo Ehman,

776 JAMC • 2 MARS 2004; 170 (5)