College Of Physicians Tells Mds To Stop Cherry-Picking Patients
Greg Carr
Pamela Fayerman
Vancouver Sun
Thursday, April 17, 2008
Family doctors shouldn't charge new patients "entry" or annual fees,
or screen prospective patients to cherry-pick the easiest ones, the
B.C. College of Physicians and Surgeons says.
Complaints from patients about getting screened via "meet and greet"
visits has led to a recent directive to doctors from the college on
the matter of interviews. An earlier one discusses the matter of entry
and annual fees.
No one knows how many doctors are involved in such activities, but
it's not considered to be widespread.
Yet because there are an estimated 200,000 B.C. residents without a
family doctor, and because some complaints have been made, the college
decided to issue a policy statement on the matter.
College registrar Dr. Morris VanAndel told The Vancouver Sun that
every patient in B.C. has the right to equal access to doctors,
"whether they can afford to pay an additional fee or not."
In one case, the college heard about a walk-in clinic that told
patients they would get immediate appointments and other privileges if
they paid an annual fee.
"The college was concerned and promptly met with the medical director
of the clinic and following the meeting, the physician agreed he
wouldn't charge the fees," said VanAndel, adding that all such cases
will be met with a cease and desist order.
Last year, The Vancouver Sun reported that a Yaletown clinic had
proposed $30 "reservation fees" and an annual membership fee of up to
$125, but the plan was dropped after it drew the ire of the provincial
government and the college.
No one has been disciplined and the college won't confirm whether it
is now investigating complaints from anyone, including a patient who
recently told The Vancouver Sun she had reported such an incident to
the college.
The woman said she was asked for an entry fee of $125 on her first
visit to a new doctor. She described the request as "minor extortion."
Health Ministry spokeswoman Sarah Plank said doctors can charge
private fees for services not covered by the Medical Services Plan,
such as completion of certain forms and letters, camp or annual
physicals for patients with no apparent health problems and
prescription renewals over the phone.
According to BCMA president Dr. Geoff Appleton, the high cost of
office rent in high-priced Vancouver is what's driving the need to
generate more revenue. The government pays family doctors just under
$30 for routine patient visits.
The Canadian Medical Association just launched a new "online
housecall" type of service and advised doctors to charge for Web-based
consultations with patients if there are no provincial fee codes for
such services.
According to the college, patients can be charged for each uninsured
service or they can be billed an annual fee for an assortment of
uninsured services, but the following rules apply:
- The bill for the annual fee must list the service covered.
- The patients must be told how much each service would cost if paid
for item by item.
- Doctors cannot refuse a patient if the patient has no interest in
paying such annual fees.
- Patients must be given a copy of the rules on fees.
- Patients must be asked if they agree to pay a fee.
- Doctors cannot charge patients a fee for pledging to be available in
advance, as in the case of on-call consultations.
The college said it knows family doctors are feeling more pressure
because of the doctor shortage, but orphan patients are also stressed
by looking for doctors taking new patients.
The college website lists doctors taking new patients, but the
information is notoriously out of date and the college is asking
doctors to ensure their names are delisted when their practices are
full so patients aren't needlessly calling dozens of offices.
The college says "meet and greet" sessions with prospective new
patients shouldn't be used to select easy patients and screen out
those with more difficult health concerns.
Doctors may only refuse to take on new patients if they do not
practise the kind of medicine the patient requires.
Patients can use the "meet and greet" to size up whether the doctor is
a good fit and doctors should use the meeting to explain office
procedures, hours of operation, emergency or after-care arrangements,
how to obtain lab results and appointment scheduling, according to the
college.
Plank said doctors are allowed to bill privately for meet-and-greet
sessions if there is no medical treatment provided. But if doctors
take a patient history and create a medical record during the
appointment, they could bill the government for the visit.
Sun Health Issues Reporter
© The Vancouver Sun 2008
http://www.canada.com/vancouversun/news/story.html?id=d4c0b820-4f2b-4571-8cc8-29e3fa2c866f
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The College could check with the Dr's who say they want new patients
every week by phone or email to ensure they still want them. I once
had a doctor refuse to treat me because I was too difficult. He then
refused to give me my medical records. I contacted the College and
they told the Dr to give me my medical records but he mailed them to
the wrong address. I eventually got them.
The medical community does have some good practitioners but I have had
some bad ones. One Dr I had left another patients medical file in the
open while I was in his office and it was by fluke that of an old
classmate.
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college has absolutely no intention of enforcing this. this article is
primarily geared toward those private clinics that charge fees for
prompt and better care.
Greg Carr wrote:
: College of physicians tells MDs to stop cherry-picking patients