Sunday House Call, #861, December 4, 2022: When will we get off the pot? And I am not referring to cannabis.

The Ontario Ministry of Health has reduced the virtual care fees physician can charge in certain situations.
Family practices need extra funding to hire nurse practitioners, physician assistances and support staff to deal with the ever increasing pressures of providing care in the face of burnout and physician shortages. Who pays is the question. If the government is unwilling to do so, expect continued deterioration of services. There is another way but it is like Voldemort; “He Who Must Not Be Named”. The word is “co-payments”, for those above a designated income level.

A $10 co-payment would not go to the physician but to the clinic to support infrastructure: hire staff, modernize and improve electronic records, provide medical services and treatments for people who do not have insurance plans.

In our practice I would post what this extra income has done for patients. For example: “We have been able to provide Prevnar-20 to 40 patients this month thanks to your co-payments. We have hired a nurse practitioner and physician assistant. They have increased our ability to provide care to more patients and reduce wait times.”

Each family practice is different. Patients have different needs and come from different population profiles. The people providing the care know best how to serve their populations. It is impossible for Government to provide a top down approach or a one-size-fits-all funding model. It works much better if the funding is directly received by the practice to be used to meet the needs of their specific populations.

My question is how many people who reject this option claiming this represents privatization of medicine have their own private insurance plans to cover their costs that many other people cannot afford? We have reached the all-to-predictable point wherein the Government is unable or unwilling to cover the costs associated with supporting primary care, further exacerbating the family doctor shortage and/or retirements. I am open to other solutions, realistic ones from people who manage and run practices, not academics and “health care consultants” who have never treated patients nor run a primary care practice.

Your questions about:

  • The health care crisis
  • A woman with unintentional weight loss (12 lbs) in two month suffering from abdominal pain. What should she do?
  • Long wait times to get an appointment.

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