TORONTO -- Ontario's doctors, who have been without a physician services agreement for three years, have voted in favour of a deal that will send contract disputes with the government to binding arbitration.

The Ontario Medical Association, which has about 44,000 members, says the vote was 65 per cent in favour of the deal that determines how the doctors' next contract, and all subsequent contracts, will be settled.

First there will be an effort at negotiation, and if a deal isn't reached, they'll go to mediation and then binding arbitration.

Binding arbitration is used to set physician compensation in seven other provinces and the Northwest Territories, but Ontario's government had rejected the doctors' demand until earlier this year.

"After three years of unprecedented fee cuts and unilateral government action this agreement now provides for a fair, independent process and prevents the government from taking unilateral actions," OMA President Shawn Whatley said Saturday.

He added that after years of dispute, "Ontario's doctors can finally look to establishing a new, fair and respectful relationship with the government."

Doctors voted down a proposal last summer that would have increased the approximately $12-billion physician services budget by more than $1 billion but also included $200 million in fee cuts. They dismissed another proposal last year, saying it was just a rehash of the previous offer.

Binding arbitration has been a sticking point in the long dispute.

But there have been divisions in the profession -- the OMA supported the final agreement, but some independent physician groups had urged doctors to vote it down, saying it doesn't go far enough.

The provincial government appears to have made a significant concession in the agreement, a copy of which was obtained by The Canadian Press.

According to a memo prepared by the OMA's lawyers, the government initially sought a "hard cap" for the annual physician services budget, but eventually agreed not to include that provision.

The government capped the budget in previous years, meaning that when doctors collectively billed the government more than it budgeted for in a given year, the extra cost was clawed back from doctors' pay -- a move unpopular among doctors.

Under the new deal, how cost overruns are dealt with will be negotiated.

The Ministry of Health did not immediately comment on news that the agreement had been ratified.