The New Brunswick Medical Society is striking back against a report by the auditor general that shows some doctors are overbilling medicare without penalty.
"We don't believe that physicians are out there looking to misrepresent their billing," executive director Anthony Knight told CBC News.
"Physicians are there to do their best in caring for their patients."
Knight says doctors have an ethical and legal obligation to bill properly.
He contends any inaccuracies stem from the fact that doctors are using the same system and technology to bill the province as they did in the 1980s.
"Investing in a proper billing management software would result in a quantum leap in terms of the types of issues the auditor general has identified," he said.
"We'd be more than happy to work with government to address those challenges."
Health minister not jumping to conclusions
Auditor General Kim MacPherson found 16 doctors were paid more than $1 million in 2011, more than double the amount budgeted by the Department of Health.
Some doctors also double billed, charging both medicare and WorkSafeNB for the same service, according to the report.
Health Minister Ted Flemming says he's not ready to jump to conclusions about the motives of doctors.
"It suggests that it should be looked at. Does it suggest impropriety? No, but it sticks out enough that it's worth a look," he said.
MacPherson says she isn't necessarily placing the blame on the province's doctors. But she said she hopes her report has identified what she would call, "red flags."
She found there are no deterrents to wrongful billing because the provincial government's audit system is weak and ineffectual.
Only 53 per cent of medicare payments to doctors are currently audited, monitoring is "inadequate," and recovery of overpayments is low, the report states.
MacPherson called on the provincial government to enforce existing legislation and to publicly report the total remuneration for each doctor to allow for public scrutiny.
Improving the system would result in big savings for the province, she said.
"I think if they implement the recommendations, get stricter on their enforcement with the doctors to submit, and impose sanctions and penalties for the doctors who are still not complying, and if the doctors comply, if all of those things happen, I think that the recoveries will be far in excess of the $3 million a year," she said.
But total gross billings are "dramatically different" than what doctors actually earn, argues Robert Desjardins, the president of the medical society.
"While much was made about the less than one per cent of doctors who bill more than $1 million per year, it is important to see both sides of the issue," Desjardins said in a statement posted on the group's website.
"Keep in mind that most of these physicians lose almost half their income to practice-related expenses like full-time staff, their benefits, ongoing medical education, insurance, office expenses, information technology, etc," he said.
"Fee-for-service doctors pay their own staff, their own medical equipment, and the usual costs of running a professional office; they also don't get a pension, maternity leave, or health benefits like most New Brunswickers.
"This overhead is estimated at over 40 per cent across Canada, but can be even higher for some high-billing specialties, who typically use million-dollar pieces of equipment — that they buy themselves," Desjardins said.
Some specialists do make more than others, he said.
"Government has negotiated these contracts jointly with the NBMS, and we believe most New Brunswickers agree that it is important to pay highly-trained, highly-skilled professionals a fair wage," he said.