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But the deal, which landed after months of arbitration, doesn鈥檛 grant doctors all their asks.

An overhead fee to help offset the rising costs of running a practice was refused. And while both sides agreed to most changes for family doctors, a few sticking points remain.

Here is a breakdown of some of the wins, losses and outstanding issues in the new agreement with an eye to how it will make things better for patients.聽 聽聽

What is the Ontario Physician Services Agreement?

The contract between the Ministry of Health and the Ontario Medical Association (OMA) determines compensation for doctors and sets out rules for how they can practise, alongside targeted investments to improve patient care. The OMA represents about 50,000 Ontario doctors, medical students and retired physicians.

The new deal was awarded by an arbitration board and sees physicians get a 7.3 per cent increase in compensation over the next three years. This builds on a 10 per cent increase in the first year of the 2024-28 agreement. Last April, amid ongoing discussions, the province committed to targeted funding for emergency physicians, with a focus on rural and northern Ontario, to help shore up overburdened emergency departments.

Will specialists get a top-up?

Doctors at some teaching hospitals and children鈥檚 hospitals will be getting a pay boost in a bid to recruit and retain top specialists.

In his September arbitration award, the board stated that doctors at academic health sciences centres and physicians at SickKids and CHEO are due for a substantial increase in compensation. He noted that 鈥渞ecruitment and retention are a concerning reality in these institutions.鈥�

The arbitrator did not grant the OMA鈥檚 compensation request in full, but OMA president Dr. Zainab Abdurrahman said the targeted compensation that was awarded聽鈥� an additional increase of $25 million over the next three years at SickKids, for example聽鈥斅爓ill help the province鈥檚 specialist hospitals better compete with other centres.

鈥淯nfortunately, some of our talented specialists were leaving, and not just to the U.S., we were losing them to other parts of Canada. It鈥檚 very important that we鈥檙e able to retain that type of talent within Ontario.鈥�

How will the new deal help with the family doctor crisis?

The agreement updates the payment model for doctors working in a family health organization, the most widely adopted primary care model in Ontario. It鈥檚 the first such revamp in almost 20 years and will now allow doctors to bill for clinical and administrative tasks, such as reviewing test results and filling out forms. The unpaid administrative burden had been a top concern for family doctors, with many saying the escalating hours of behind-the-scenes work was leading to burnout.

Abdurrahman said the new FHO+ model will reward time doctors spend with complex patients and opens additional spaces for doctors to join family health organizations. FHO+ also includes bonuses for family health organizations to enrol new patients.

Both the OMA and the province say FHO+ will encourage more doctors to practise comprehensive family medicine and help solve the primary care crisis that has left two million Ontarians without a family physician.

What happened with overhead fees?

Amid rising costs for doctors, the OMA asked for a new $5 overhead fee for each in-person patient visit. The fee could be applied to up to 40 visits per day per physician.聽

Abdurrahman said soaring inflation and the escalating costs of running a practice are a top challenge for doctors, and the OMA wanted more support for community-based physicians. The fee聽would not apply for contract-based doctors or those working in hospitals or in family health organizations.

鈥淲e know it鈥檚 more expensive to hire staff, to pay for electronic medical records, to pay for rent,鈥� she said.

However, the arbitration board did not agree, stating more study was needed to determine the scope of the problem and decide which physician categories would qualify for an overhead fee. The board said the issue could be reopened in the next round of bargaining.

鈥淲e are not done advocating on this issue,鈥� Abdurrahman said.

Some family doctors get financially penalized when their patients go to a walk-in clinic. Did this penalty go away?

The arbitrator eliminated this penalty, known as dollar-for-dollar negation, for doctors in family health organizations. This is considered a win for physicians who have long considered the penalty unfair.

Doctors in family health organizations are paid through capitation, meaning the payment they receive from the government is determined by the number and complexity of patients on their roster. When patients go to a walk-in clinic, these doctors are financially penalized; whatever fee the walk-in clinic bills the government, the doctor will lose, dollar for dollar, that same fee from their income.

However, the move is not all good news for doctors,聽said Dr. David Barber, chair of the OMA鈥檚 Section on General and Family Practice.聽

鈥淣egation is now gone. But the government still wanted accountability.鈥�

What is the new accountability measure?聽

As of April 2026, the arbitrator ruled that doctors in a family health organization will face a new accountability measure, stating the government has a 鈥渓egitimate interest in ensuring that (family health organization) physicians provide their rostered patients with a reasonable proportion of the family medicine services they receive.鈥�

The new measure will see doctors penalized if their patients receive more than 25 per cent of their care outside of their office, at a walk-in clinic for example. Doctors will have a three-month window to fix the issue before they face a financial penalty. There are no penalties when patients seek care at their organization鈥檚 after-hours clinic or at hospitals or emergency departments.

Barber said doctors remain wary of this accountability measure since details about its rollout remain sparse. He also said the government needs to have more trust in his profession.

鈥淭his will just add to the stress that family doctors have.”