Hundreds of Ontario physicians have reportedly received government notices about how many days they work or how many patients they see. The province calls the letters educational; the doctors want an apology.
Written: Dawson Briggs Wilder
Medical/Wellness Journalist for VBNRADIO
There is one envelope no physician wants to find in the mail: the one from a government office with "Fraud Control" in its name. In Ontario this week, the doctors opening that envelope turned out to share a suspicious trait. They work a lot.
Dr. Adam Stewart is a family physician in Madoc, a small Ontario town where he looks after about 1,700 patients. He told CBC he spends more than 30 hours a week seeing them and another 10 to 20 on paperwork. His letter, dated Oct. 27, came from the Ministry of Health's Payment Accountability and Fraud Control Unit. It said the ministry had noticed a "high number" of days worked under his billing number, and that the pattern deserved "careful review."
What it did not say, by Stewart's account, was which claim was wrong, which year was examined, how many days he was supposed to have worked, or what the limit is. He posted a video about it, and Canadian news outlets picked it up. A colleague with roughly 1,150 patients got a letter too.
He has company. The Ontario Medical Association believes hundreds of physicians received similar notices, though it has no exact count and the ministry has not offered one. The OMA is now asking the province for an apology, along with answers about how recipients were chosen.
The ministry's case
The government's side deserves a fair hearing, because it is not a silly one. A ministry spokesperson says the letters are educational and assume nothing improper. Doctors can be flagged, the ministry says, for billing more than 15 hours in one day or more than 100 different patients in one day. Health Minister Sylvia Jones called the outreach standard practice and a follow-up to last year's Auditor General report. If the billing is appropriate, she said, nothing further happens.
And that audit is quite a read. Ontario paid $19.5 billion to about 35,000 physicians in 2024/25, and the auditor found the oversight thin. In 2024/25, 82 physicians had at least one day with 24 or more hours billed. In an earlier case, one physician billed 114 hours in a single day. In 2023/24, 130 physicians claimed to have worked 365 or 366 days.
A 114-hour day is not a work ethic. It is a physics problem, and somebody should absolutely ask about it.
The doctors' case
OMA president Dr. Rebecca Hicks points out that Ontario has no cap on days worked or patients seen. By her account, the province's own new family medicine payment model, in force since April 1, lets doctors bill hourly for up to 14 hours a day. She says the letters cited either many days worked in a year or many patients in a day, and she worries physicians will respond by trimming evenings and weekends. That extra work, she argues, is patient care rather than fraud. Rural doctors, she notes, often put in longer hours because nobody else is there to do it.
The timing is awkward. About 2.5 million Ontarians have no family doctor, and the province is spending $3.4 billion on a plan to connect them with one. Its message to family physicians has been consistent: please take on more patients.
Opinion: education usually comes with a syllabus
Here is where I, Dawson, put down the notebook. Auditing a $19.5 billion payment system is not harassment. It is the job, and Stewart himself allows that the profession has a few "bad apples."
But a letter that names no claim, no year and no threshold teaches nothing. A notice that cannot tell a 114-hour day from a country doctor who works Saturdays is not a precision instrument. It is a form letter with a frightening letterhead.
The fix costs a paragraph. Tell the doctor what tripped the flag, give the number, and ask for an explanation. The ones with a good answer will supply it in five minutes. The ones billing a 114-hour day will need longer, which is rather the point.
Skip that step, and the lesson doctors actually absorb is the simplest one available: do less. That is a rational response to being warned about volume. It is also the exact opposite of what 2.5 million people in Ontario are waiting for.
References
CTV News / CP24, "The Ford government sent this doctor a letter over the 'high number' of days he worked. He wants an apology," Nov. 5, 2026. https://www.ctvnews.ca/toronto/article/this-family-doctor-wants-an-apology-after-he-says-that-he-got-an-intimidating-letter-for-working-too-much/
CBC News (via Yahoo News Canada), "Ontario doctors demand apology from province for letters flagging high number of days worked, patients seen," Nov. 5, 2026. https://ca.news.yahoo.com/ontario-doctors-medical-association-demand-163712181.html
Quinte News, "Madoc doctor says he was flagged for billing too many hours," Nov. 5, 2026. https://www.quintenews.com/2026/11/05/madoc-doctor-says-he-was-flagged-for-billing-too-many-hours/
Office of the Auditor General of Ontario, "Oversight of Physician Billing," Annual Report 2025, Performance Audit. https://www.auditor.on.ca/en/content/annualreports/arreports/en25/pa_OPB_en25.pdf
