Response

It grieves me to learn that several persons have construed my letter¹ responding to a commentary about fee-for-service (FFS) and alternative payment plan remuneration² as containing a racist implication.³

Let me begin by saying that to every person who has felt hurt, maligned, or marginalized by my words, I offer my heartfelt apology.

The specific phrase that caused so much distress referred to family physicians in my community who were not born in Canada and who, on average, tend to bill more under FFS than Canadian-born physicians. I speculated briefly that this might arise out of a more “utilitarian” (a word that I chose to reflect pragmatism, rather than greed or bias) stance toward the system of remuneration available in this part of the world. My point was that FFS allows this to happen, while alternative payment plans make this well-nigh impossible.

My comments were focused on billing patterns in our community and not on race, nationality, gender, sexual orientation, age, religion, language, or political affiliation—or even country of origin. Nevertheless, this phrase clearly sank into the hearts of some physicians or other readers who may have come here from other countries under challenging circumstances and caused added pain, especially to those who have experienced, in Canada, marginalization, rejection, racism, or any other form of groundless and mindless negative treatment.

Again, I apologize to anyone who felt my remarks were prejudicial and who suffered as a result. I truly sought not to be divisive, but only to be descriptive.

In future I will pay even closer attention to the exact implications of all my words in print.

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