Comment: Incorporation changes will hurt MDs — and you

I am a family physician in British Columbia. I completed my residency three weeks ago and have worked every day since receiving my licence.

I have spent 12 years completing my education, and now, as I finally reach the point where I can begin to work toward paying off the hundreds of thousands of dollars of educational debt I’ve accrued, the federal government is proposing changes to private corporations that would cripple my efforts to work and raise a family in Canada.

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Incorporation allows doctors to hire staff, pay for equipment and supplies, pay for digital records and computers, and so many other expenses, as well as raise our families and still save rainy-day funds to pay for sick leave, maternity leave, pensions and our own medical expenses. The proposed changes mean that doctors and other small-business owners will no longer be able to save earned money in company accounts for retirement or for their own medical emergencies. These changes also mean that Canadian doctors can no longer share income with their spouses to raise their families.

For many doctors, these changes will translate into difficult choices such as cutting back on staffing, equipment and office hours. Ultimately, it means being unable to see as many patients. Some doctors feel so trapped that they are considering closing their practices or leaving the country.

These changes will hit female physicians hard, as female doctors represent an increasingly greater percentage of family doctors. Further, female physicians depend on their private corporations to allow them to take a (usually brief) period of time with their babies.

Taking this away is a slap in the face to the women who are providing front-line medical care in this country and is in stark contrast to the feminism that Prime Minister Justin Trudeau has stood up for.

I have two little girls, one who is about to start kindergarten, and one who has nearly mastered putting on her own shoes. I am the sole income-earner for my family. Years of moving to different cities for undergrad, medical school and residency have necessitated my husband sacrificing his career goals.

The reality of medical practice means that there is no outside child care that would work for us. It is hard to find a daycare that is available 24/7, as I am to my patients.

My husband’s contribution as a stay-at-home dad is completely ignored by the looming loss of my ability to incorporate. Supporting men who stay at home to raise their children while their partners work hard for their communities is a profoundly feminist message. The government should not let this message be lost.

As a physician, I receive no benefits of any kind from the federal government — there is no employment insurance, no vacation time, no medical benefits, no sick leave, and the federal government does not contribute to my maternity leave, disability insurance or pension. I spend 30 per cent of my income on overhead expenses (rent, employees, examining tables, suture material, speculums, hydro, phones, cleaning products, bandages, gloves — and everything else that is purchased by doctors, not the government or patients).

If I am temporarily unable to work for any reason — illness, childbirth, bereavement — I continue to pay for this overhead. Canadian doctors pay for our health-care infrastructure out of their own pockets.

When you come into a clinic wounded from doing battle with a bagel or avocado, the doctor who sews you up is the one paying for the chlorhexidine she cleans your wound with, the lidocaine she uses to numb the pain, the gauze to staunch the blood flow, the sutures that close the wound, the tools that let her hold the needle, the Polysporin to ward off infection, the bandage placed over top, the needle and syringe that protect you against tetanus, the paper sheet you’re sitting on, the bed underneath you, the products to clean the room when you leave and the wages of the person who cleans it.

And then there are the many thousands on top of this paid in costs for the privilege of practising medicine (licensing fees, insurance fees, fees required to join mandatory provincial bodies, etc).

There is no tax “loophole.” The right to incorporate was given to physicians by the Canadian government in lieu of the government increasing doctors’ incomes, so physicians are able to cover the above costs.

I am genuinely afraid that the changes Trudeau and his government are proposing to the taxation structure for small businesses will eliminate my ability to perform the job I have worked so hard, for so many years, to do.

All of the nights that I spent away from my babies, while delivering other people’s children, all of the times I left my toddlers crying at the window while I left dinner untouched on the table and went back into the hospital to assist on a surgery, all of the bedtimes I missed because I was working in the emergency room — what were these sacrifices for if I cannot pay off the void that is my student debt, if I can not take a few months off work to complete my family, if I cannot save for my children’s education?

I urge the government to rethink the changes it is proposing. The impact they will have is devastating to many Canadian physicians.

Dr. Kristi Herrling practises in Campbell River.

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