Practicing in Ontario

Physician practice environments  

In Ontario, physicians practise in a wide range of settings, with many choices to help meet personal and professional goals. Many physicians focus solely on direct patient care while others are partially or exclusively engaged in research, teaching or administrative work, and often a combination of these activities.

Practice environments can include solo or group practices, hospitals, academic research centres, clinics, public health units, community care access centres, private industry, or government. Locations for practice are equally diverse ranging from large urban centres and outlying suburbs to small towns and rural communities. Ontario also has several locum programs available for physicians registered with the College of Physicians and Surgeons of Ontario. Physicians may choose to operate their own office practice or work in a group practice. A group practice may be an administrative group setting with staff or space sharing; or a clinical group setting with patient record sharing, as well as space or staff sharing. Group practices can be single specialty or multispecialty.

Some physicians provide direct care on staff at hospitals or clinics, which can be dedicated to a particular service or specialty. Other physicians work with public health agencies, where they engage in disease prevention and management, health promotion and planning, and needs assessment. At academic research centres, physicians can undertake clinical practice and be involved in laboratory medicine and classroom teaching. Physicians also hold leadership positions in the private sector, and working with government physicians can help to set policy that meets the needs of the population and health care professionals.

Family Physician Practice
Specialist Physician Practice
Locuming in Ontario

Compensation options

Insured physician services are funded from a provincial physician services budget. There are two basic types of physician funding:

• Fee-for-service (FFS): Physicians bill the Ontario Health Insurance Plan (OHIP), which is administered by the Ministry of Health and Long-Term Care, for each insured service rendered. Insured services are set out in the Schedule of Benefits for Physician Services.
• Non-fee-for-service: Physicians enter into a contractual arrangement to be paid through an alternate funding plan (AFP) or other complement-based, salary or blended capitation model. AFPs are amalgamations of clinical earnings for a designated group of physicians who agree to provide designated services. Complement-based models provide for a base payment for a Full-Time Equivalent "complement" in a given community in addition to overhead payments, locum coverage, CME etc. Salary-based models provide a salary for each physician in addition to benefits and other incentives, premiums and bonuses. Blended capitation models include capitation or "per head" payments for providing a basket of services to a roster of patients plus incentives, premiums and bonuses for additional services such as after hours services, hospital, pre-natal, obstetrical and home visit services, preventive care and chronic disease management. In certain selected circumstances, FFS can also be billed.