In today’s message you’ll find:
Last Call: Gala ticket sales end Tuesday!
Our Annual Awards Gala is coming up on Saturday, May 11. We have a limited number of tickets left, with Tuesday, April 30 as the deadline to purchase.
→ Get details about the Gala and purchase your tickets here!
This is shaping up to be our biggest and best gala yet. We’re building in more time to connect and visit with colleagues and friends, with a whole new look and feel. The Gala will honour our seven amazing 2024 Award Winners. Plus, we will raise funds to support the cause of our Humanitarian Award winner, the late Dr. Dick Smith, including Our Own Health Centre and Rainbow Resource Centre.
Don’t miss it!
Doctors Manitoba AGM
Members are invited to join us for our virtual Annual General Meeting on May 9, beginning at 5 p.m. The agenda includes:
- Remarks from outgoing President Dr. Michael Boroditsky
- A year-in-review report from CEO Theresa Oswald
- A sneak peak of the new Strategic Plan for Doctors Manitoba
- Unveiling the next President-Elect.
Capital Gains Changes — Physician Impact
In its 2024 budget, the federal government has proposed changes that will increase taxation on capital gains. We’ve heard from several physicians concerned about the change and how it might affect them. Below we share what we know so far and invite you to let us know how this might impact you.
What has been proposed?
Right now, only 50% of a capital gain is taxable. This is called an inclusion rate. The federal budget, if approved, would change this:
- For individuals, the amount of the capital gain that is included for taxation would increase to 66.67%, but only for gains above $250,000. This means nothing changes for the first $250,000 of a capital gain, and only 50% of it is taxed. For any portion of a gain over $250,000, two thirds of it would be included and taxable.
- For corporations – including medical corporations – the inclusion rate increases to 66.67% for all gains. This means there is no $250,000 exemption from the new rule, as there is for individuals.
In other words, this change is effectively a 33% increase in taxes on capital gains for the situations outlined above.
These new rules, if approved, would take effect June 25, 2024. So, any capital gains realized before June 25 would be subject to the current 50% inclusion rate for tax purposes, and not the new increased rates.
You can read a more detailed summary about the proposed changes, and other tax changes in Budget 2024, from our partner, MD Financial.
How could this impact physicians?
We know about three quarters of physicians have incorporated their practice. About a quarter of physicians describe themselves as clinic owners or partners. This has the potential to impact all physicians who have incorporated or own a clinic, as well as those with personal investments or property. However, the tax changes may not affect you every year, but rather only those years where you realize a capital gain.
Brad Bokhaut, a local Chartered Professional Accountant for physicians from Bokhaut CPA LLP, stressed the complexity of the change and encouraged physicians to get personalized advice. “This is really like a Rubik’s Cube, in that there are many case-specific variables to consider before making a decision.” He also pointed out that the “devil is in the details,” as detailed rules of these tax changes have not yet been released, and thus there are many uncertainties remain about how these changes will interact with existing tax rules.
He also emphasized the importance of timing, as the proposed increase to inclusion rates take effect on June 25, 2024. For some physicians, it could be beneficial to realize a capital gain before this date.
Response so far
While initially described as a tax increase on the “ultra wealthy” affecting an estimated 0.13% of Canadians, concerns are emerging that the impact could extend much further than originally described. Earlier this week, several medical associations, including Doctors Manitoba, raised concerns about the proposed changes.
Doctors Manitoba responded in several news stories: “The proposed tax changes came as a surprise and Doctors Manitoba is carefully analyzing how it will impact physicians. Most physicians are not employees, so they have no employer benefits or pension plan. They are on their own, and owning a small medical business is just part of their job and, thus, their retirement plan. A change like the one proposed in the federal budget may have the unintended consequence of making it harder to recruit and retain doctors, and that’s a big concern for Manitoba considering we have a record high shortage of doctors right now.”
The CMA raised concerns too, noting in their statement that the proposed changes could hurt physician recruitment and retention. Doctors of BC expressed similar concerns, noting “the proposed increase to the capital gains inclusion rate adds yet another burden to doctors during a time when our health system and the providers within it are already under constant strain. Our concern is this change could dissuade doctors from opening or keeping their practices as a corporation, which in turn could impact patient care.”
The Ontario Medical Association added they have “already heard from many of its members who have raised serious concerns about how this additional and unnecessary tax will affect their practices.” A physician in Ontario pointed out change “is essentially a retroactive tax on our savings.”
When these concerns were raised publicly, the federal government responded that they are simply asking the wealthiest to pay a little bit more. “We just don’t think it’s right that a student, or an electrician or a teacher be paying taxes on 100 per cent of their income while others have the opportunities to use accountants and pay taxes on only 50 per cent of that income,” Prime Minister Justin Trudeau said.
What do you think?
Doctors Manitoba wants to understand the impact on you. How would an increase in taxes on capital gains affect your practice? Would this impact you every year, or only when you sell or wind up your practice? Please share your views, in confidence, at practiceadvice@doctorsmanitoba.ca.
Cortext Secure Messaging Changes
Many physicians were notified by Digital Shared Services this week that Cortext, the app used for secure messaging between physicians, is being discontinued by its vendor, Imprivata, on July 31, 2024. This came as a surprise to many, especially as the use and reliance on Cortext has increased significantly over the last year.
Doctors Manitoba has raised concerns about this change, and we have been assured that Digital Shared Services is planning to transition physicians to a replacement app for secure messaging before the vendor retires Cortext from service.
We have also reinforced that access to the replacement app should be offered at no charge to physicians. This was something Doctors Manitoba negotiated for Cortext, following a recommendation from our Rural Health Summit just over a year ago.
Stay tuned to our newsletter for updates on the changes to physician secure messaging.
Last Call for Isolation Benefit Claims
This is a final call for claims for the COVID-19 Isolation Support Benefit for physicians. The last day to submit claims is this Tuesday, April 30. To qualify, the first day of isolation must have occurred on or before March 31, 2024. Manitoba Health will not accept any claims from us after the April 30 deadline. You can review eligibility for this benefit and submit applications on our website.
Guidance, Support and Connection
Mentorship provides information and inspires action beyond what you can learn in a lecture hall – even if that action is a wild goose chase on a snowy spring evening.
The quirky scavenger hunt was a feature of the event held April 19 at FortWhyte Alive, hosted by Doctors Manitoba to mark the conclusion of the most recent season of the Mentorship Program that began at the start of the academic year last September.
The program includes attending physicians, residents and medical students, bridging the gap between medical learners and practicing physicians. In addition to connecting within smaller groups of mentors and mentees throughout the year, program participants had the opportunity to come together at a trivia night, soapstone carving workshop, and a board games and paint night.
Last Friday, mentor Dr. Joseph Silvaggio spoke about the people he learned from when he was starting his career. He said he admired them “for the way they interacted with patients and colleagues, and how they were able to balance personal and professional life. Some of them were good at some of these things, some of them were seemingly amazing at all of them.”
“One feature they all had in common was the desire and willingness to take the time to create a welcoming environment where I felt comfortable asking questions, exploring the specialties, and getting involved in opportunities and simply gaining experience. And that’s what I hope we as mentors have been able to share with our mentor groups this year,” he said.
There are more than 325 participants in the Mentorship Program, a collaboration between Doctors Manitoba, the Manitoba Medical Students Association (MMSA) and the Professional Association of Interns and Residents of Manitoba (PARIM), and UGME Student Affairs.
“Mentorship is rewarding from so many perspectives,” said Cynthia Okojie, Doctors Manitoba mentorship and member engagement coordinator. “It’s a source of inspiration, as well as a support system,” she said, adding that students and physicians are in stressful roles with busy schedules. One resident let Cynthia know she has been in the same group since she began her first year, creating relationships that continued through her four years in medical school. Mentorship events provide an opportunity for connection… and joy. “It’s wonderful to see people enjoying a lighthearted moment.”
For a peek at an event, view our Instagram reel of the evening at FortWhyte Alive.
Interested in becoming a mentor or mentee? Don’t miss out on the benefits for both physicians and medical learners. Register here or reach out to Cynthia at cokojie@doctorsmanitoba.ca .
White Out Night Out!
Over 700 physicians entered to win two tickets to Game 2 for the Winnipeg Jets playoff series, courtesy of Doctors Manitoba. Congrats to Dr. Marcus Blouw, who sent us this selfie from his winning seats from Tuesday’s game. Go Jets Go!
Fantastic Physicians
Interlake-Eastern RHA recognized Dr. Eric Stearns and Dr. Greg Pinniger with physician emeritus awards. As he prepares to wrap up a career that spans more than four decades, Dr. Stearns expects that 2024 will be his final year of practice. Looking back, there’s much that he’s enjoyed over the decades. “You can’t beat delivering babies, and I also love to teach,” he said. “And to go out with this award is awesome. It’s the highlight of my career. It really tops it off. This is amazing to me.”
Since 1992, Dr. Pinniger has served as a physician in Manitoba with four years in Killarney and 26 years at Stonewall Medical Clinic, along with work in the surgical intensive care unit at Health Sciences Centre.
Looking ahead, he hopes other new physicians might pursue a similar path in rural general practice. “I hope that rural and family medicine can one day recapture the attention of new medical graduates and entice them into a rewarding, challenging career — one where they can grow professionally and personally and one where they can feel truly needed by those that they serve.”
You can read the full story here.
Health System Updates
eConsult Reminders and Updates
Electronic consultation (eConsult) services continue to expand in Manitoba, with over 950 primary care providers now using BASE or Store and Forward eConsult tools. There are 93 specialty services available.
New specialty services added to BASE eConsult since January include:
- Obstetrics and Gynecology – Abortion Medication, AND, Managing early Pregnancy sporadic loss (non recurrent loss)
- Pediatric Endocrinology and Metabolism
- Pediatric Nephrology
- Psychiatry – Adult NHR (Northern Health Region)
For a complete list of available eConsult specialty services see the eConsult Quick Reference Guides at Training — MBTelehealth, eConsult (BASE) List of Specialties and eConsult (Store and Forward) Referring Guidelines.
In over 70% of BASE eConsult cases an in-person visit is not required to answer the eConsult and provider feedback has been excellent. From primary care providers:
- “Thank you for your prompt, concise, specific response and guidance. I will pursue these recommendations with patient next attendance.”
- “This was extremely helpful. I’ve never initiated treatment for PD before, but she would benefit from a trial while awaiting neuro appt. Thank you so much!”
For more information on eConsult including how to register, visit Digital Shared Services eConsult site.
Specialists and Primary care providers are now remunerated for eConsult with fee for service billing codes. Providers are to bill MB Health directly using the tariff codes 8628 for referring providers, and 8627 for specialists providing service on either the BASEä or Store and Forward eConsult services.
Primary care providers using BASE™ eConsult are reminded to accept the specialist’s recommendations and complete the close out survey at the end of every eConsult. This allows the specialist to view billing information on the completed PDF transcript.
For more information on billing, check out our billing advice article or contact us at practiceadvice@doctorsmanitoba.ca.
Vaccine Reminders
After May 1, 2024, COVID-19 immunizations will not be broadly available until the Fall 2024 COVID-19 Immunization Program. This change will minimize the impact of getting a late vaccine dose in the spring that could affect eligibility in the fall. Latest information on eligibility is found here.
Public Health also issued a reminder that the current order survey for COVID and flu vaccine is scheduled to close for the season on April 30 at midnight. You can order doses, if needed, before that deadline using Public Health’s order form.
Further information is available in this memo from Public Health.
Immunization Awareness Week
In his National Immunization Awareness Week statement, Chief Provincial Public Health Officer Dr. Brent Roussin said it is “a time to consider how easy or difficult it is for Manitobans of all backgrounds, means and locations to get vaccinated. Addressing health inequities is an important part of our work in public health and we are grateful to the many partners, community leaders, governments and other stakeholders who work to address systemic racism and inequality that affect access to immunization and other health care.” You can read Dr. Roussin’s full statement here.
Kidney Transplant Record
A record 83 Manitobans received a kidney transplant through the Adult Kidney Transplant Program at HSC in 2023, besting the previous high of 77 set in 2017. Additionally, a record number of Manitobans donated the gift of life to others in need through organ donation last year, with 30 donating organs posthumously. That is significantly more than the previous record of 22, set in 2018. The increased number of transplants was made possible by the HSC Transplant Wellness Centre, which opened in July 2020 and provides enhanced care for living kidney donors, pre-transplant and post-transplant patients and recipients. The $4.5‑million centre, funded by the HSC Foundation and the Manitoba government, has improved care for kidney transplant recipients as well as Manitobans receiving transplants in other provinces.
New Provincial Spine Program
The Manitoba government is investing more than $12 million toward the establishment of a new provincial spine program that will reduce long wait times for patient consultations with spinal surgeons, establish centralized wait lists and co-ordinate complex levels of care across a multitude of care providers, diagnostic imaging and operative resources throughout the province. Three spinal surgeons have been recruited to Manitoba over the past 10 months – two in Winnipeg and one in Brandon. The Provincial Spine Assessment Clinic, which is staffed by physiotherapists in partnership with surgeons, will be incorporated into the new provincial spine clinic.
Dr. Renner Retiring as Internal Medicine Head
Dr. Eberhard Renner is retiring later this spring as Head of the University Department of Internal Medicine and Provincial Specialty Lead for Internal Medicine with Shared Health.
He served in this leadership role for many years, including through significant events such as the push to improve patient flow, the consolidation of Winnipeg hospitals, the pandemic, and the recent change in government. Renner published an op-ed this week explaining his decision to retire, citing concerns about the structure and functioning of the health care system.
ICYMI
Job posting: Physician Data Analyst
100 new doctors in one year. Is it doable?
Gaining More Doctors Requires Team Effort — Read our editorial about how the government could achieve a new record for physician recruitment and retention.
Reminder: Submit your claims to Manitoba Health within six months
Upcoming Events
You can always review upcoming events on our events calendar page.
CFPC Physician Wellness Retreat
The College of Family Physicians of Canada (CFPC) Physician Wellness Retreat May 23 – 26 aims to provide family physicians an environment in which they can learn and apply principles of physician wellness. Keynote speakers include Dr. Jillian Horton and Dr. Catherine Hansen.
Register here.
CMA AGM May 29
This year’s Annual General Meeting for the CMA is special for Manitobans, as CMA President-Elect Dr. Joss Reimer will officially become president. Register to hear from her and other CMA leaders. The CMA AGM will be held virtually on Wednesday, May 29, from 10 a.m. to 2:30 p.m. Meeting information, including the agenda, is available at cma.ca/agm2024.
2024 Canadian Conference on Physician Leadership — May 24 – 25 in Montréal
Lead the change our healthcare system desperately needs! Attend the CCPL2024 in Montréal, where you’ll gain invaluable insights and skills to drive transformation.
View the conference program here. Register now.
Cancer Day for Primary Care
The 16th biennial Cancer Day for Primary Care, a collaboration between the Community Oncology Program at CancerCare Manitoba and the University of Manitoba, is back May 31 as a hybrid event, offering both virtual and in-person attendance options at Theater B, 727 McDermot Ave, University of Manitoba. What sets this event apart is the opportunity for attendees to submit their own cases for discussion by our expert panel. Join us for a dynamic and informative program. Learn more and register.
HPV and Cancer — Interdisciplinary Rounds
Speakers for the June 5 event focused on prevention, treatment and future direction include Dr. Vanessa Poliquin, Dr. Ciaran Lane and Dr. Sarah Kean. Register now.
Doctors Manitoba Book Club
Join us for our Doctors Manitoba Book Club on June 4 beginning at 7 p.m. We’re reading Study for Obedience by Sarah Bernstein, winner of the Scotiabank Giller Prize. Register Here.
IPAC Mentorship Gathering
Registration is open for the Indigenous Physicians Association of Canada’s Annual Mentorship Gathering and AGM July 12 – 14 in Halifax. The gathering is an opportunity for Indigenous medical students, residents, and physicians, both members and potential members, to come together to share stories of their academic journeys, grow their networks, and enjoy cultural activities.