Dr. Paul Martin: Let’s talk #TaxFairness
When Dr. Paul Martin heard about the proposed federal tax changes, his first thought was that they were not well thought-out in terms of long-term impacts to incorporated professionals as well as patients and their families.
Dr. Martin is a urologist in Sarnia, and also an incorporated professional. He owns a solo urology practice, with two full-time employees. He sees about 1,500 new patients each year and averages between 100 and 120 patient visits each week.
While he says the proposed tax changes, if passed, would increase uncertainty in his practise and disincentive further investment in the health-care system—such as buying equipment, hiring additional staff and increasing his clinic size—his main concern is losing some of the country’s top physicians.
“You’re going to see a lot of skilled and hard-working physicians leaving the country,” he said. “We already have trainees writing their American exams to a larger degree than they were before, and are being encouraged by their mentors to do so to keep their options open.”
For those who choose to stay, Dr. Martin expects physicians may opt to work less hard (particularly fee-for-service physicians) who will not have an extra incentive to see more patients.
“If you know that you’re being taxed in not only the highest tax bracket, but beyond that, then what is the additional incentive to see more patients?” he questioned. “With that sort of incentive, wait lists may grow.”
Amid so much uncertainty, Dr. Martin says the proposals make business planning difficult. “We can’t plan or practice in any way with huge uncertainty at both the provincial and federal level,” he said. “We have no idea what our practice is going to look like in the next year. It makes manpower assessments basically impossible.”
“I’m sitting down with my accountant to plan my year in terms of salary, dividends and how I’m going to structure my practice and my life, and effectively I cannot,” he said. “You simply cannot plan.”
Personal plans are also proving difficult for Dr. Martin, his wife and their two children. “We’re not really sure what tax planning and estate planning and education planning for our family is going to look like if these changes go through.”
But ultimately, Dr. Martin’s main focus is the effect on patient care, which he voiced in a letter to the editor that appeared in the Toronto Star.
“If you want to affect change, you must focus on the people who are making the decisions, and on the patients and on the voters,” he said. “The important thing is to focus on the patient impacts: growing wait lists, increasing wait times, decreased health-care infrastructure and decreased quality of care.”