20 August

Proposed Federal Liberal Tax Cuts – A Patient Perspective

Dear Reader,

I have sought to keep Neurology Centre of Toronto’s (#NCT) social media free from politics; however, the recent announcement by our Liberal Federal government is where I have had to draw the line. This post isn’t about money or people paying their “fair share.” This is about patients. Period.

Recently, Finance Minister Bill Morneau announced a proposal to eliminate tax benefits for small businesses, including medical corporations. Many people don’t know this, but doctors – who are essentially government paid workers without a single benefit enjoyed by those with government positions – rely on incorporating as small businesses to afford the practices they build. These practices, beholden to fees that are regulated and imposed by the provincial governments, strive to support one single mission – the treatment of patients.

A quick Google search will offer many different perspectives from different viewpoints in Canada about the proposed tax changes. I invite you to read all of them and make an informed decision about how you feel regarding this issue. I am not writing to convince you in one way or another whether this is a good decision or not for Canada. I am, however, writing to offer a perspective that is not about money but about what matters to me and to NCT – patients.

The Neurology Centre of Toronto opened in January 2017 in midtown Toronto as a unique community concept in Ontario offering adult and pediatric neurology and neurology-related services, all under-one-roof and outside the traditional place where one would find these services – a hospital. Our mission was designed to consolidate services in one location, bringing the focus of care centered around the patient rather than the institution. I have loved every grueling step of the way in building this from scratch and I take an enormous amount of pride in the hard-working doctors, nurses, administrative staff, volunteers and students of NCT who share this vision and have helped make this vision a true reality. All of you are to be commended and I will take this personal sentence to express my gratitude to all of you. Together, we have treated almost 1300 patients since January.

I decided this morning to crunch some numbers and break down the types of conditions that are actively being treated at NCT. The healthcare team at NCT has diagnosed, managed and/or treated about 50 patients with #Autism, 400 patients with #Epilepsy, 100 patients with #DevelopmentalDelay and #Neurogenetic conditions, 300 patients with chronic #headache & #migraine and 75 patients with #concussion and #post-concussion syndrome. We have seen almost 100 patients under 2 years of age with several as young as few days of age. NCT is growing and our hope is to build on these numbers every year so that those in need are cared for as efficiently and effectively as possible.

The Liberal Government’s proposed tax cuts equate a medical clinic, such as NCT, to any other small business. I would argue that there are incredible differences in equating the two. Other small businesses will likely ride out these tax cuts with one simple response – raise their fees. Doctors, on the other hand, cannot do this. Our fees are regulated by the province which are still being discussed and negotiated as we have not had a contract in place since 2012 and some fees have not been raised since the mid-1990s.

Doctors, such as those at NCT and myself, work day-in and day-out to bring services to patients. We care that all patients of all ages with autism, epilepsy, concussion, or any other neurological disorder are given the opportunity for the best-possible care in order that they may achieve their full potential. You may or may not be affected by the short list of conditions I have mentioned above but, the reality of our existence as human beings, is that someone you know and care for will at one point be affected by a neurological diagnosis that requires the attention and care of a well-trained neurologist.  I worry, deeply, that these proposed tax cuts will make clinics, like NCT, non-viable. I ask you to ask yourselves… then what?

In the end, I only ask that you become informed. Please recognize that doctors are not those vilified in the media as the wealthy who “pay less than their fair share of taxes” such as Julie Dzerowicz, Member of Parliament, Davenport, informed me in her email response after I raised my concerns with her. This is a cruel and unnecessary disparagement of a group of fathers, mothers, partners, and children – just like you – bound by oath and united by a fundamental pursuit and desire to heal and care for those in need.

Above all, we are advocates who stand side-by-side with our patients every step of the way. As the director of a neurology practice that has serviced 1300 patients, I refuse to back down for the 1301st patient and beyond. I refuse to stand idly by while a blind government turns their backs on patients and scapegoats physicians in the process.

If after reading this and gathering more information, you have comments or feedback for Bill Morneau and the Liberal government please visit http://www.fin.gc.ca/activty/consult/tppc-pfsp-eng.asp. You can formally register comments and feedback to this email address: fin.consultation.fin@canada.ca

Thank you for taking the time to read this.

 

Evan Lewis, MD, FRCPC

Director, Neurology Centre of Toronto (NCT)

www.neurologycentretoronto.com

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Assistant Professor, University of Toronto

Early Care Concussion Clinic, Holland-Bloorview Kids Rehabilitation Hospital

Executive – Social Media, Neurology Section of the Ontario Medical Association (#OMA)

 

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